What Is It Actually Like Being a Birth Doula On Call?

People hear “on call” and immediately imagine a five week stretch of sitting beside their phone, canceling their entire life, and waiting for someone to go into labor.

That is not what being on call looks like.

You can go to dinner. You can go to your kid’s dance performance. You can get a massage. You can go to therapy. You can go hiking. You can live your life.

There are rules and there are systems you need to have in place. But once you have been doing it for a while, being on call just becomes a normal part of your life. Bianca, the founder of bebo mia, has been living the on-call doula life for nearly 20 years. Here is how it actually works.

The basic rules of being on call as a birth doula

First, you stay reasonably close. What reasonably close means depends on your community, where your clients are birthing, and what you have agreed to in your contract. You do not need to sit within a five minute radius of the hospital, but this probably is not the weekend to spontaneously drive six hours away. Bianca keeps herself within a 90 minute drive of her clients or their birthing place during the on call window. You can set whatever works for your situation in your contract.

Second, you are sober. If you are the primary doula on call, you need to be able to drive and provide safe, competent support at any time. If you take medication that affects your ability to wake in the night, this is where a shared care model becomes your best friend. More on that in a moment.

Third, sleep when you can. Do not stay up until 2am watching TV. Do not assume that because your client had a prenatal appointment that afternoon with no signs of labor, you are definitely safe for the night. Babies do not give a single thought to your plans. If you are tired and you have the opportunity to sleep, sleep.

Fourth, your phone needs to be accessible. But accessible does not mean you can never put it down.

The communication system that makes everything work

You are going to have times when you cannot answer. Therapy. A massage. A school performance. The dentist. You are a person and you have a life.

The key is communication. If you know you will be unavailable for a short period, let your client know in advance. Something as simple as: “Hey, just a heads up that I’ll be unavailable from 2 to 3 today. If anything starts happening, send me a message and I’ll get back to you as soon as I’m out. If something urgent comes up, here’s how to reach my backup.”

That is it. You have not disappeared. They know what is happening and you have a system.

ProTip: Put your on-call clients on Emergency Bypass in your phone. If you use Do Not Disturb or keep your phone on silent at night, Emergency Bypass allows those specific contacts to get through. When your client enters their on-call window, turn it on. When they have their baby and you are no longer on call, turn it off. Otherwise six months later that client is going to text you a picture of their baby’s poop at 3am and somehow be the only person who can break through your Do Not Disturb. Ask Bianca how she knows this.

 

 

Build a little on call birth doula checklist

When your client hits 37 weeks, run through this:

Emergency Bypass goes on. Birth bag checked. Gas in the car. Childcare arranged. Pet care arranged. Backup doula notified.

When the birth is done, reverse it.

Childcare needs a plan and then a backup plan

If you have children, you need childcare figured out before the call comes. And then you need backup childcare. And honestly, backup for your backup childcare.

Birth does not care that your mother-in-law has the flu. It does not care that your babysitter has an exam. It does not care that your partner has an important meeting.

You need options and you need to get creative. 

• Barter with another doula. 
• Lean on retired neighbors who love your kids.
• Use family, friends, your partner. 
• Nanny share with someone who uses a nanny full time. 
• Have a last minute daycare in your back pocket for emergencies. 

Build a whole little network.

The same goes for pets. Who has a key to your house? Who can walk your dog if you are suddenly gone for eighteen hours? Figure this out before you are three hours into a labor thinking about whether the dog has been fed.

When you enter your on-call window, follow up with your people. 

A simple “Hey, I’m officially on-call now, just reminding you that you might get a call in the next few weeks” goes a long way. 

Now everybody knows.

You are allowed to have important days

This is where a lot of new doulas get it wrong. They believe that being on call means handing their entire life over to the possibility that someone might go into labor.

There will always be something. A recital. A wedding. A graduation. Concert tickets. An anniversary dinner. Something that matters to you.

You are allowed to go. This is why we have backup doulas.

If you have a wedding you absolutely do not want to miss, you can tell your client well in advance that your backup will be primary from 4pm until midnight that day. That is completely reasonable. You are not abandoning your client. You are planning their care.

When you communicate this, keep it simple. Dates, times, who is covering, how to reach them, what happens if labor starts. That is all they need.

They do not need a five paragraph explanation of why you are unavailable and they do not need to know you are going to see Beyoncé. Nothing matters more to them than their birth at that moment and that is completely reasonable. So do not make them decide whether your reason is important enough. Just give them the information.

A script you can actually use

Here is one Bianca has used for years that you can adapt:

“Hey [name], I hope you’re feeling good this week! I wanted to remind you that my backup, [name], will be on call for you this Friday from 5pm until 11pm. If you think you’re in labor during that time, please let both of us know. I still like to stay updated on how you’re feeling. If you need in-person support during that window, [name] will attend and I will take over at 11pm once I’m back on call. Here is their contact information: [name, email, phone]. Let me know if you have any questions.”

Keep it simple and clear and don’t over explain!

A few more rules for planned off call time

Give lots of notice, at least five days for a reminder though your client should already know from your contract that this is occasionally possible. If there is a reasonable chance your backup will actually support this family, have them meet beforehand, even a quick Zoom introduction or having your backup attend a prenatal visit.

Talk ahead of time about what happens if your backup attends the birth. If your backup goes in at 8pm and you are available again at 11pm, does your client want you to swap in or would they rather keep the doula who has been supporting them for three hours? Ask this before labor, and again during it because they may change their mind based on how they feel at that time. 

Whoever attends the birth should also be involved in the postpartum check in and birth debrief. They were there and they know what happened. This is an important part of the continuity of care and to understand for holding space and debriefing.

And please, pay your backup. Their time has value. If they are holding a window for you or attending a birth for you, compensate them according to your agreement. Do not build your sustainable doula practice on another doula’s free labor.

The shared care model for doulas who cannot do nights

If your health, medication, childcare situation, or anything else makes traditional overnight on call genuinely difficult, the shared care model is worth building into your practice from the start.

You do days, your doula partner does nights. You both attend prenatal appointments so the client knows and trusts both of you. When labor happens, whoever is on shift shows up and the transition is seamless.

Bianca used this model with her doula partner for over ten years. Her partner could not manage daytime childcare logistics but could leave at night when her kids were asleep and her partner was home. The system worked beautifully for both of them and for every client they shared.

This is the kind of creative problem solving we build into the bebo mia full spectrum doula training because we want doula work to be sustainable for the real humans doing it. You can read more about the shared care model and managing client volume here.

The goal is not to stop living

This is the most important thing. Being on call really is not that hard once you have systems. At first it can feel strange. You might check your phone constantly. You might go to bed every night wondering if tonight is the night.

And eventually it just becomes part of your life. Your phone is set up. Your birth bag is ready. Your people know. Your dog has somewhere to go. Your backup is in place. Your car has gas.

And then you live your life.

We do not want doulas building practices where they resent their clients because they feel like they cannot leave the house for five weeks at a stretch. You can have boundaries. You can have important events. You can have hobbies and children and a partner and therapy and massages and an entire life and still be an excellent birth doula.

The answer is planning. And community. And good systems.

And if you are reading this thinking absolutely not, I never want a phone call at 2am telling me to get my pants on and drive to a hospital, that is completely valid too. Birth support is not the only way to be a doula. Postpartum work is scheduled. Fertility doula work has no on call component. Childbirth education is entirely on your terms.

There are lots of ways to do this work without being on call. But if birth support is what you want, do not let the on call piece scare you away. It becomes normal. Build your systems, build your village, get an excellent backup, keep your phone close, get some sleep, and then keep living your life.

If you want to talk through what this looks like for your specific situation, book a free doula career strategy session with our team. We love this conversation.

👉🏽👉🏽Book here👈🏽👈🏽

And if you are ready to start, our full spectrum doula training begins September 17th, which also happens to be Bianca’s birthday. We would love to celebrate with you in there: https://bebomia.com/doulatraining

Email us anytime at [email protected], we are here for you!