Doula Programs: How to Start and Run a Private or Hospital-Based Program with Success! 2nd edition
by Paulina Perez with Deaun Thelen. Foreword by Christiane Northrup, MD

[2010. Johnson, Vermont: Cutting Edge Press; 244 pages, paperback.]

[Review first published in Midwifery Today Issue 96, Winter 2010/2011, © 2010, Midwifery Today, Inc. Review by Kelly Moyer.]

For many women, the act of becoming a doula is a fulfillment of a dream, a thrilling experience. But starting your own doula business can leave even the most inspired doula feeling lost and alone. Paulina Perez understands the challenges facing doulas who strike out on their own to start a hospital-based or home-based doula business. With more than 45 years experience in maternity care, Perez has been writing about doula issues since the word first popped up in the US birth scene in the mid-1980s and is a recipient of the Childbirth and Postpartum Professional Association (CAPPA) Lifetime Achievement Award. In the second edition of her book, Doula Programs: How to Start and Run a Private or Hospital-Based Program with Success! Perez (with the help of co-author Deaun Thelen, from the book’s first edition) combines resourcefulness, common sense and experience to help doulas run a successful business in their own community.

The first few chapters delve right in to the nuts and bolts of starting a doula program, including chapters dedicated to planning, financing, growing, marketing and sustaining your doula business. Chapter 7 fleshes out the details of actually running a doula program and Perez focuses on the process of hiring doulas who will suit your business model and community and offers helpful tips such as, “A doula must be confident of her ability to emotionally support the laboring woman, so when hiring, be mindful to look for a doula who pays attention to her own emotional needs and is cognizant of signs that she herself needs rest and renewal.” Chapter 9 discusses this type of self-care and support that are critical when you’re working in a field as intense as the doula business. Perez offers suggestions to the new doula business owner, including:

  • Physically delineate your office work space from your home areas; and
  • Establish clear-cut business hours, and let all your clients know that unless it is an emergency they should contact you during those times.

“It takes courage to start a doula program,” Perez tells her readers. “Don’t let fear hold you back. Be brave and push on toward your goal.”

In Chapter 12, “Troubleshooting,” Perez uses experience and wisdom to conquer common problems. For example, how do you get the hospital in your community to “buy into” your new doula program? Perez’s solution is to “begin by interfacing with upper management about the role and benefits of doulas and then procure a preceptor site for the program.” Doing this, “allows the staff to get used to the doulas, understand what doulas do, and get to know them better.” With no obligations, this benefits the doula and the hospital staff and can lean to faster attainment of certification for the doula, Perez notes. Other problems that are troubleshot in this chapter include: Getting doulas to stay with your program as volunteers; dealing with a medical staff that is intimidated by doulas; providing education on evidence-based doula practices; and gaining the medical staff’s acceptance of the concept of doula.

Like the first edition, this book focuses on the birth doula business. However, the second edition also opens its pages to the postpartum doula business, which is growing in popularity in the US. The book also includes a new section (Chapter 15), which is devoted to established as well as growing doula businesses to help spark creativity and inspire the reader. As a person who gleans a lot of my knowledge from the stories of others, this section helped me understand the diversity of doula businesses. If you are a doula who is considering starting or growing your business, check out the details in Chapter 15 for business ideas and inspiration. Here you’ll find everything from WakeMed Labor Support Services in Raleigh, North Carolina, where a staff of eight doulas works with a local hospital in an on-call fashion, to Birth Sisters, a doula business in Boston, Massachusetts, which has a staff of 45 diverse doulas, who speak a combined total of eight different languages and offer their clients a “sister-like” network of support.

The back of the book brims with resources, sample evaluation forms, sample tests for potential doula employees, standards of practice and code of ethics for a nonprofit doula program, marketing tools and much more.

For doulas, this book is an invaluable tool and can help erase that feeling that “you’re in this alone” when you first start your own doula program. In her Afterword, Perez notes that women’s past is our heritage. “The present is our responsibility,” she writes. “The future is our challenge. Through your own unique, nurturing doula program, you will be able to show others that doula support is priceless.”

Reviewer Kelly Moyer is the mother of Eva Dolores, who was born at home on the central Oregon Coast in 2002. The former managing editor of Midwifery Today, Kelly is passionate about empowering women and their families through natural, holistic birth. She currently works as an editor in the Portland, Oregon, area and is pursuing her certification as a postpartum doula.

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