No Shame

An age old question has revolved around doula ethics for some time: “Should doulas offer their services on a pro bono basis?” As DTI has reimagined the role of the doula, that answer has evolved. This isn’t even the first time this topic has been discussed with DTI specifically. We still see this question all the time on social media channels being met with hostility. Shouldn’t doulas be encouraged to volunteer their services if they are financially able and willing? DTI unanimously says YES.

Let’s stop for a minute here and reflect on that fact that there is a CRISIS happening right now the United States with black and brown birthing people and babies. DTI believes that ethics come into play here. We can not have a conversation about reaching communities in need and options for payment without bringing this crisis into the discussion. To do so is unacceptable.

You’ve seen the headlines: Black Mothers and Babies are in a Life-or-Death Crisis, Black Mothers Keep Dying After Giving Birth. Shalon Irving’s Story Explains Why, or Childbirth is killing black women in the US, and here’s why, etc.

In the United States, black parents die at 3-4 times the rate of white parents. In NPR’s infamous article discussing this matter, they presented another haunting fact. “A black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 243 percent more likely to die from pregnancy- or childbirth-related causes.” According to the article by the New York Times, “black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies, according to the most recent government data….” Black parents and their children are dying at an incredibly alarming rate in comparison to their racial counterparts. In the wake of their unjust deaths, doulas have come together to further assist with births in order to close this gap and perform healthy child birthing sessions. Our mission has been, and always will be, to improve the birth and postpartum experience. This includes providing affordable resources for doulas and their clients. Even, and especially, if that means providing pro bono work.

DTI believes in the autonomy of doulas to run their business in any way that they choose. We support doulas working in both the for-profit and nonprofit sectors. In our opinion, this is a current crisis in America that can not be ignored as a birth professional. If you are working as a doula currently and are unaware of these issues the time is now to take a step back and take a closer look. There are two books that we would recommend any doula, or potential doula, read to get a broader idea on this conflicting topic: Birthing Justice: Black Women, Pregnancy and Childbirth and Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others.

The better you are able to provide for you and your family the more you will have to give to your clients and the more social change we can make. Take the time to consider what your doula business will look like and how it may be structured to support your current fiscal goals, families in need, and your future growth. There are more than enough options for business structure whether for-profit, nonprofit or a mix of the two. If you have experience in fundraising consider starting a foundation that could feed into funds for clients to tap into. Create a collective with other doulas and see what change you can make happen together. But at the end of it all, do what is best for your practice, your community, and your heart.