Doula Drama
January 4, 2017 2:17 PM Subscribe
Inside The Million-Dollar Get-Rich Doula Clique. Buzzfeed profiles ProDoula, whose controversial efforts to "professionalize" doula services is described as both empowering and predatory. (Warning: includes disability slur).
Hey! The article quotes our doula! If you're in Columbus, Catie Mehl was great for us. We only did postpartum, but she was super helpful and very nice.
posted by kevinbelt at 2:49 PM on January 4, 2017 [2 favorites]
posted by kevinbelt at 2:49 PM on January 4, 2017 [2 favorites]
"But Patterson doesn’t feel she can control the actions of individual ProDoulas."
That's what these people are PAYING FOR, the sanction & "legitimacy" of the ProDoula brand. You can't take credit for participants' successes while abrogating responsibility when their behavior is ludicrously inappropriate. These people sound downright predatory. And the whole "de-politicizing" doulaship bit is self-righteous hot air. We do a shitty job in the US of treating childbearing people humanely and with respect, and you can't fucking de-politicize that.
posted by sutureselves at 3:39 PM on January 4, 2017 [7 favorites]
That's what these people are PAYING FOR, the sanction & "legitimacy" of the ProDoula brand. You can't take credit for participants' successes while abrogating responsibility when their behavior is ludicrously inappropriate. These people sound downright predatory. And the whole "de-politicizing" doulaship bit is self-righteous hot air. We do a shitty job in the US of treating childbearing people humanely and with respect, and you can't fucking de-politicize that.
posted by sutureselves at 3:39 PM on January 4, 2017 [7 favorites]
Towards the middle of this piece, there is an infographic listing how much various ProDoula services cost, and it's supposed to be jaw-dropping, I think, but the costs seemed pretty reasonable. $150 for social media consulting? I work in digital marketing and that's a standard hourly rate for an experienced social media consultant. $395 doesn't seem out of line for registration for a professional conference either.
I don't know, there are a lot of interesting issues raised here (how "women's work" is less valued, the transition from hippie side-hobby to professionalization) but a lot of this piece seemed to rest on Pro-Doula's big-personality, polarizing founder. And yeah, she sounds like a character who is ready with the sound bites, but that seems like just as much a part of the marketing as anything else.
posted by lunasol at 3:42 PM on January 4, 2017 [4 favorites]
I don't know, there are a lot of interesting issues raised here (how "women's work" is less valued, the transition from hippie side-hobby to professionalization) but a lot of this piece seemed to rest on Pro-Doula's big-personality, polarizing founder. And yeah, she sounds like a character who is ready with the sound bites, but that seems like just as much a part of the marketing as anything else.
posted by lunasol at 3:42 PM on January 4, 2017 [4 favorites]
Thanks in part to our on-demand economy, doulas are now more popular than ever.
What on earth does this mean? I kind of wish the author would explain it, because as it is it just seems like it's intended to link this to some larger, scary trend in society without having to do the actual work of showing what that link is or why it's important.
posted by lunasol at 3:47 PM on January 4, 2017 [4 favorites]
What on earth does this mean? I kind of wish the author would explain it, because as it is it just seems like it's intended to link this to some larger, scary trend in society without having to do the actual work of showing what that link is or why it's important.
posted by lunasol at 3:47 PM on January 4, 2017 [4 favorites]
Those women are relentless sharks, and not entirely in a bad way. I mean, there should be room for the business-minded doula who brands herself as a luxurious necessity, much like a photographer, but there should also be room for the hippie-ish lady who is doing it for the love.
I found the breathless quotes about "making six figures" to be interesting as a photographer myself, and I also thought the rates presented were extremely fair and in line with what it costs to hire any kind of skilled professional to do anything. Not exorbitant or in the realm of luxury at all.
If you work for yourself six figure revenue certainly sounds impressive but in reality that is barely a middle class living after the books are settled. Much like in photography, there is plenty of room for people who don't do it for monetary gain, but in this economy there is zero middle ground between "I do this for fun" and "I have bills to pay oh fuck I need to hustle 24/7".
Sharks survive because they never stop swimming. More power to these ladies.
posted by bradbane at 4:14 PM on January 4, 2017 [3 favorites]
I found the breathless quotes about "making six figures" to be interesting as a photographer myself, and I also thought the rates presented were extremely fair and in line with what it costs to hire any kind of skilled professional to do anything. Not exorbitant or in the realm of luxury at all.
If you work for yourself six figure revenue certainly sounds impressive but in reality that is barely a middle class living after the books are settled. Much like in photography, there is plenty of room for people who don't do it for monetary gain, but in this economy there is zero middle ground between "I do this for fun" and "I have bills to pay oh fuck I need to hustle 24/7".
Sharks survive because they never stop swimming. More power to these ladies.
posted by bradbane at 4:14 PM on January 4, 2017 [3 favorites]
Absolutely women should make money for their work, and more power to those doulas who want to position themselves as the service that clients looking for "doula as luxury" want. It shouldn't be a scandal to charge highly for a valuable service, and for sure nobody should ever be instructed to work for free to gain experience or as a public service or whatever.
But that doesn't mean nobody should be able to choose to volunteer. I have been a volunteer doula, and I'm here to say that I'm not taking money out of anyone's pocket (except possibly mine) by accompanying women who are in rough situations (asylum seeker, refugee, borderline homeless, etc.) and would otherwise be going to the hospital alone. If I want to do that with my time, I get to do that with my time; and me doing that doesn't change what a professional doula is worth one bit. I'm not offering free services to middle-class families who could afford to pay for a ProDoula, and on the other side of the coin there are always folks who will pay above the going rate for the Best Shiniest Service in town.
Frankly, though, I read this article thinking "so what" until this point at the very end: But Patterson is opposed to third-party insurance for doulas. “I don’t want anybody determining how much money I make,” she said.
Be a shark, sure, but this sounds like actively working against the profession to me. If third-party insurance pays for doulas, more people can have doulas (good) and more doulas will get paid/get paid more (also good). Where is the problem? And anyway, would doula coverage on insurance plans really stop anyone who wanted to from charging a bonus co-pay for premium services? I'm not in the US or knowledgeable about insurance so I don't know, but I suspect Patterson could find some ways to get paid the big bucks even if her more altruistic colleagues would rather just collect from Blue Cross, thanks very much.
posted by snorkmaiden at 5:49 PM on January 4, 2017 [10 favorites]
But that doesn't mean nobody should be able to choose to volunteer. I have been a volunteer doula, and I'm here to say that I'm not taking money out of anyone's pocket (except possibly mine) by accompanying women who are in rough situations (asylum seeker, refugee, borderline homeless, etc.) and would otherwise be going to the hospital alone. If I want to do that with my time, I get to do that with my time; and me doing that doesn't change what a professional doula is worth one bit. I'm not offering free services to middle-class families who could afford to pay for a ProDoula, and on the other side of the coin there are always folks who will pay above the going rate for the Best Shiniest Service in town.
Frankly, though, I read this article thinking "so what" until this point at the very end: But Patterson is opposed to third-party insurance for doulas. “I don’t want anybody determining how much money I make,” she said.
Be a shark, sure, but this sounds like actively working against the profession to me. If third-party insurance pays for doulas, more people can have doulas (good) and more doulas will get paid/get paid more (also good). Where is the problem? And anyway, would doula coverage on insurance plans really stop anyone who wanted to from charging a bonus co-pay for premium services? I'm not in the US or knowledgeable about insurance so I don't know, but I suspect Patterson could find some ways to get paid the big bucks even if her more altruistic colleagues would rather just collect from Blue Cross, thanks very much.
posted by snorkmaiden at 5:49 PM on January 4, 2017 [10 favorites]
Are the rest of the women in this group actually making a good deal of money, though?
posted by Selena777 at 5:59 PM on January 4, 2017 [1 favorite]
posted by Selena777 at 5:59 PM on January 4, 2017 [1 favorite]
This sounds a lot like the ciropractic "industry". Snake oil and never a rational substitute for professional medical care.
posted by Brocktoon at 6:10 PM on January 4, 2017 [1 favorite]
posted by Brocktoon at 6:10 PM on January 4, 2017 [1 favorite]
If third-party insurance pays for doulas, more people can have doulas (good) and more doulas will get paid/get paid more (also good). Where is the problem? And anyway, would doula coverage on insurance plans really stop anyone who wanted to from charging a bonus co-pay for premium services?
The easiest way around this is to not accept insurance at all but to provide a form that the patient submits directly to the insurance company for reimbursement. Not uncommon among USA specialists with widely variable insurance coverage (like dermatologists) as some USA insurance plans not only offer absurdly low reimbursement/coverage but also will not let an in-network provider do balance billing (charge a patient for what remains of the charges after insurance pays its portion). So the specialist charges say 250USD, the patient gets reimbursed the accepted rate of say 55USD; the ideal patient complains about lousy insurance coverage rather than specialist rates. The specialist often can charge less than if insurance were accepted since the specialist does not have to maintain a billing department.
posted by beaning at 7:34 PM on January 4, 2017
The easiest way around this is to not accept insurance at all but to provide a form that the patient submits directly to the insurance company for reimbursement. Not uncommon among USA specialists with widely variable insurance coverage (like dermatologists) as some USA insurance plans not only offer absurdly low reimbursement/coverage but also will not let an in-network provider do balance billing (charge a patient for what remains of the charges after insurance pays its portion). So the specialist charges say 250USD, the patient gets reimbursed the accepted rate of say 55USD; the ideal patient complains about lousy insurance coverage rather than specialist rates. The specialist often can charge less than if insurance were accepted since the specialist does not have to maintain a billing department.
posted by beaning at 7:34 PM on January 4, 2017
This sounds a lot like the ciropractic "industry". Snake oil and never a rational substitute for professional medical care.
Doulas aren't medical care; they're emotional and sometimes cognitive assistance for people whose brains are unable to focus on external reality because their entire body is screaming BABY BABY BABY.
My doula - a close friend, not someone I hired - knew what I wanted in labor, and what I thought was invasive, and was there to tell hospital staff, "no, she will not be more comfortable lying down" and "unless that needle is absolutely necessary, take it away" and "if you have a problem with the noise, close the door," because I knew I wouldn't have the focus to insist on sticking to the details I'd written up in advance.
It wasn't her job to override medical recommendations, but it was her job to listen to them, and decide if I should be pestered to do something about them ("hold still, honey, they need to take your blood pressure... yeah, it hurts, but it'll be over soon") or not. ("No, she wants to be walking. Quit asking her if she wants to lie down. When she wants to lie down, she'll tell you.")
I am in favor of anything that makes people giving birth more comfortable with a terrifying, agony-filled event. I am less in favor of people taking advantage of those facing such an event, and convincing them that they need to spend a thousand dollars or more out of pocket to have someone in the room that they trust.
posted by ErisLordFreedom at 12:45 AM on January 5, 2017 [8 favorites]
Doulas aren't medical care; they're emotional and sometimes cognitive assistance for people whose brains are unable to focus on external reality because their entire body is screaming BABY BABY BABY.
My doula - a close friend, not someone I hired - knew what I wanted in labor, and what I thought was invasive, and was there to tell hospital staff, "no, she will not be more comfortable lying down" and "unless that needle is absolutely necessary, take it away" and "if you have a problem with the noise, close the door," because I knew I wouldn't have the focus to insist on sticking to the details I'd written up in advance.
It wasn't her job to override medical recommendations, but it was her job to listen to them, and decide if I should be pestered to do something about them ("hold still, honey, they need to take your blood pressure... yeah, it hurts, but it'll be over soon") or not. ("No, she wants to be walking. Quit asking her if she wants to lie down. When she wants to lie down, she'll tell you.")
I am in favor of anything that makes people giving birth more comfortable with a terrifying, agony-filled event. I am less in favor of people taking advantage of those facing such an event, and convincing them that they need to spend a thousand dollars or more out of pocket to have someone in the room that they trust.
posted by ErisLordFreedom at 12:45 AM on January 5, 2017 [8 favorites]
This feels a lot like a similar issue: don't do spec work (or "fuck you, pay me") side of things.
posted by k5.user at 8:15 AM on January 5, 2017 [1 favorite]
posted by k5.user at 8:15 AM on January 5, 2017 [1 favorite]
I'm totally down for women making a living doing something which is actually work but societally devalued. Yes, women's work should be paid. Go ProDoula for recognizing that.
Where I part ways with ProDoula is the idea, as mentioned in the article, that they've been considering signing collaborative agreements with hospitals to work together on the patient's medical care, perhaps against the patient's wishes. Why bother with a doula at that point? The whole idea of a doula is to advocate for the patient.
Obviously doulas aren't going to go against medical advice (they can't, anyway, as they're advisors not practioners) but avoiding the unnecessary medicalization of birth is literally the point of having a doula.
posted by librarylis at 8:54 AM on January 5, 2017 [4 favorites]
Where I part ways with ProDoula is the idea, as mentioned in the article, that they've been considering signing collaborative agreements with hospitals to work together on the patient's medical care, perhaps against the patient's wishes. Why bother with a doula at that point? The whole idea of a doula is to advocate for the patient.
Obviously doulas aren't going to go against medical advice (they can't, anyway, as they're advisors not practioners) but avoiding the unnecessary medicalization of birth is literally the point of having a doula.
posted by librarylis at 8:54 AM on January 5, 2017 [4 favorites]
“Do you think plumbers sit around fretting over the problem of people needing plumbing help who cannot afford it?”
I mean . . . yes? There are a lot of people who work and get paid for a living who also donate their time and talents to those less fortunate. Habitat for Humanity and other such organizations exist for a reason.
My dad's an electrical engineer with a job working for the public transportation system in my area, and he has always done electrical work and rewiring projects for older people at his church for the price of them making him some lunch while he's on the job.
So . . . doesn't sound so strange to me.
posted by chainsofreedom at 12:01 PM on January 5, 2017 [8 favorites]
I mean . . . yes? There are a lot of people who work and get paid for a living who also donate their time and talents to those less fortunate. Habitat for Humanity and other such organizations exist for a reason.
My dad's an electrical engineer with a job working for the public transportation system in my area, and he has always done electrical work and rewiring projects for older people at his church for the price of them making him some lunch while he's on the job.
So . . . doesn't sound so strange to me.
posted by chainsofreedom at 12:01 PM on January 5, 2017 [8 favorites]
... Snake oil and never a rational substitute for professional medical care.
I provide professional medical care to women in labor as a registered nurse. I am board certified in inpatient obstetric care and I have more than 10 years' experience at the bedside. You have no idea what you're talking about.
Doulas are evidence-based.
posted by jesourie at 12:07 PM on January 5, 2017 [9 favorites]
I provide professional medical care to women in labor as a registered nurse. I am board certified in inpatient obstetric care and I have more than 10 years' experience at the bedside. You have no idea what you're talking about.
Doulas are evidence-based.
posted by jesourie at 12:07 PM on January 5, 2017 [9 favorites]
I mean . . . yes? There are a lot of people who work and get paid for a living who also donate their time and talents to those less fortunate.
Sure, but in the course of their work, do plumbers have to deal with people who assume they work for free because of a deep love of hot showers?
posted by bradbane at 2:36 PM on January 5, 2017
Sure, but in the course of their work, do plumbers have to deal with people who assume they work for free because of a deep love of hot showers?
posted by bradbane at 2:36 PM on January 5, 2017
Sure, but in the course of their work, do plumbers have to deal with people who assume they work for free because of a deep love of hot showers?
Yeah, but as snorkmaiden says, volunteer doulas aren't taking money out of anyone's pockets. If you volunteer to doula for a woman who cannot afford to pay for one, then it isn't like if you don't do it, the woman will hire a doula - she can't afford it!
I understand that doula-ing as a profession has a culture of reduced rates and giving services away for free, but the solution to that is not putting the entire practice out of reach of the less-wealthy. The example of plumbers from the article struck me as weird - there are tons of plumbers who see the value in offering their services as volunteer work, and yet still have jobs which pay them to do plumbing. No need to attack anyone's volunteer or compassionate spirit for that.
posted by chainsofreedom at 3:17 PM on January 5, 2017 [2 favorites]
Yeah, but as snorkmaiden says, volunteer doulas aren't taking money out of anyone's pockets. If you volunteer to doula for a woman who cannot afford to pay for one, then it isn't like if you don't do it, the woman will hire a doula - she can't afford it!
I understand that doula-ing as a profession has a culture of reduced rates and giving services away for free, but the solution to that is not putting the entire practice out of reach of the less-wealthy. The example of plumbers from the article struck me as weird - there are tons of plumbers who see the value in offering their services as volunteer work, and yet still have jobs which pay them to do plumbing. No need to attack anyone's volunteer or compassionate spirit for that.
posted by chainsofreedom at 3:17 PM on January 5, 2017 [2 favorites]
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