Reasons doula businesses fail (plus plans for prevention)

An important component to creating a business plan for success is examining failure. Know the things that cause businesses like yours to fail. Make a plan for how to prevent those obstacles. Most doula businesses have gone under within 3 years of starting. Many doulas complete their training and put themselves out there only to never succeed at getting their business off the ground. According to the Small Business Association, 30% of businesses fail within two years of launching, 50% in 5 years, and 66% within 10 years. All small businesses have some rough odds to conquer. Being an independently practicing doula that has to get a steady flow of clients and be on call 24/7 comes with its unique challenges. Let’s look at what some common obstacles are. Below each obstacle are potential solutions.
 

• Not clarifying your goals and defining what success is to you will leave you floundering early on in your plans. Before we begin to examine failure, you must first define what a successful doula business is for you. Do you want to work 4 or 5 births a month? Or would you rather only doula 3 or 4 times a year? Do you want to be a nonprofit and work with low-income families or at-risk populations? Do you want to pay your mortgage with this income or have this job be for your grocery money? These are big differences in business models. Would you like to work exclusively as a birth doula? Or would you like to also be a childbirth educator, lactation specialist, postpartum doula, etc.? Is something else your main thing while you want doula work to be a part-time or occasional thing? 
  • If you don’t know what you’re aiming for, you’ll miss it. Define your business goals before you open shop.
  • Write down a vision. Create achievable steps to get there.
  • Create a plan for success before you get started. Time is precious.

 

• If you financially need your doula business alone to provide a full time income with steady pay that you can support a family on, this may not be doable. There are certainly people that do it, but it takes time to build your business to that point. If you need a full time income from doula work alone within a few weeks of launching your business, the odds are not in your favor. Unrealistic financial goals from doula work are a big cause of business failure. Many doulas work part time. Quite a few – if not the majority – of doulas are married or in a relationship where their partner is the breadwinner. If you do happen to be in a household with more income than just your doula business, you’ll have a much better chance at sustaining your company.
  • If you are married, can you adjust your budget for your husband’s income to pay all the regular monthly expenses? If you can afford to be a stay-at-home-mom or housewife, you can sustain your doula business with income just from doula work.
    
  • If you are single, this doula life will be harder to swing financially. Save up a few months of regular expenses before you launch your business. You'll need the cushion. 
  • Have other sources of income that allow a flexible schedule. Brainstorm what you can do that will still allow you to be on call for births. Multiple sources of income are a must if your income needs to support a household. 
  • Live frugally. Read Happily Frugal to learn over 1,000 ways to save money. 

 

• Child care is a serious issue for many doulas that are moms. You have to have last minute child care available at any hour when a client calls you to come provide labor support. This includes midnights, weekends, holidays, bad weather, sick kids, etc…
  • Plan ahead!
  • Have backup plans. Have more than one sitter. 
  • You’re more likely to keep a sitter if you pay them well.
  • It’s common for doulas and birth photographers to pay their babysitters a fee for being on call.
  • If you know other doulas in your community well, it may work to use doula friends as on-call childcare. 

 

• Inability to be on call – If you can’t be on call for the births, you can’t sign a contract saying you’ll attend the birth (and show up in a reasonable amount of time). Childcare is often the number one reason people can't be on call. Aside from child care arrangements, here is the biggest obstacle with being on call. You can’t work a regular job unless you can either leave work to tend to your doula client or send a backup doula in your place until you get off work. Nobody is going to hire a doula that has hours of work left at their day job before they can even come home, eat dinner, get ready, and then show up for the birth tired as can be. This is probably the biggest obstacle for single women who haven’t yet built their doula business to full time, but need a full time income. It's very hard to find a job that lets you be on call for another job. If you do leave or call off, you're risking losing your job that provides steady pay for that one birth you had to leave for. 
  • Have a doula partnership. You can switch off weeks of being on-call. Let’s say you’re on call for births during weeks 1 & 3 of the month. During weeks 2 & 4 you schedule your prenatal and postpartum appointments. Also during weeks 2 & 4, you can work at someone else’s company who pays you by the hour for steady income. Or if one of you works Monday, Wednesday, Friday the other one can be available at their regular job Tuesday, Thursday, Saturday. Have opposite availability with your regular jobs. And take the amount of births each month that you two can manage on top of your jobs. Perhaps, both of you could work part-time regular jobs and do doula work part-time. 
  • Take a limited amount of births each year. Maybe schedule one per month. Maybe even take one client at a time when you are able. A part-time doula is still a doula. Sometimes we only get our dream careers as a side gig instead of a full time income. Do it anyway. Don’t live the next 20 years of your life without working the job you’re passionate about because you can’t do it full time.
    
  • Have a really awesome backup doula.
  • Have access to your phone at whatever your job is. You’ll need to answer your client’s call and call your backup.
    

 

• Inability to be gone for unknown amounts of time – This is a unique challenge to doing birth work in private practice (instead of working at a hospital or birthing center). You never know how long a birth will last. It could be 2 hours. It could be 3 days. Doulas are typically expected to be superheroes who can work round the clock, day in and day out, for longer hours than any employer would ever be legally allowed to require, and not need to sleep. Doulas are still human. They can only go so many hours without food or sleep. They need to shower. They have kids and pets and families they can’t just abandon for 24+ hours. In my opinion, it’s unrealistic to expect doulas to not need breaks after so many hours. It’s important to talk with your clients about expectations at your consultation.  
  • Have a strong network of backup doulas.
  • Put a 12 hour clause in your contract. It’s becoming more common. If you need to do that to be able to work as a doula, then do it. You could even do an 8-hour clause stating after 8 hours of work you take a break to care for your family. 
  • Another obstacle with childcare is you have to make sure whoever is caring for your children can do so for the duration of your shift. 
    
  • If the inability to be gone for long hours is due to pets, plan ahead for proper care. You can’t leave your dog (or other mammalian pet) unattended for too many hours. That’s animal neglect. They need water and food and attention. If you live alone, you do have to arrange for pet care. There aren’t many jobs out there where people are expected to work shifts longer than 12 hours. It is hard to live alone and have pets when you work long shifts. Consider living with someone else who can take care of your pets when you are gone. And, again, you have the right to take a break from work after so many hours. Your pet's physical needs (water, food) are more important. 
    
  • Partner with another doula who you work well with. Take shifts. Maybe Doula A can work 7am to 7pm and Doula B can do 7pm to 7am. Or if 12 hour shifts do not work with your household, get 3 doulas together to rotate 8 hour shifts that are scheduled. 
  • In practice, don't go in too early. Prepare them well to cope with the contractions and they won't need you as soon. Long births will still happen sometimes, but this practice decreases the amount of hours you are there on average. 

 

• Free doulas devalue the profession. Doulas who serve for free or low-cost is a common controversial issue in the doula profession. Regardless of your personal feelings on catering to the client’s income, reality is doulas that have to make money to pay the bills at whatever career they have get stomped out by neighboring doulas who can work for less than minimum wage. Free doulas can actually decrease their community’s access to doulas by setting an average cost that is so far below a living wage it is only accessible to married women who have the financial privilege of having a provider for their bills. All doulas deserve a living wage.
  • It’s hard to overcome this obstacle. If the average cost of doulas in your area is below a living wage, people are less likely to hire you because most people are going to want the more affordable option. That being acknowledged, food pantries don’t put grocery stores out of business. Your pricing attracts your clientele. If you price free or cheap, you attract a different audience than pricing at over $1,500.
    
  • Normalize charging a living wage. Even if you want to offer a sliding scale, set your regular fee at a living wage. 
  • Realize that there are people who truly can’t afford a doula. Don’t be angry when someone says they can’t afford your given prices. Also realize that your financial needs in your family have to come first. There are people you can help who will genuinely appreciate you. There are a lot more people who will use you up, empty your cup, and not care what you sacrificed to serve them. Don’t feel guilty at charging for the hard work you do. You can always refer to other doulas that are in their budget. 
  • Get connected to higher income circles if you regularly have the problem of people asking you to work for free. Go where you are valued. If you come from a low-income social circle, you'll need to make connections with people who can afford you. 

 

• The gender wage gap is still a problem. When I talk about the gender wage gap in this field, I'm not talking about male doulas directly compared to female doulas. I'm talking about female doulas being asked to work for free or less than their set fee because they like what they do and if they really cared about people they would be willing to lower their income. It is very common for women to be expected to work for free or cheaper than a man would charge if they love what they do. Doulas are often guilt-tripped for charging what they need to for their own financial needs. I've heard many times where doulas who charge a living wage are criticized for "doing it for the money". Hear me well. Women are worth fair wages. Sadly, birth workers devalue themselves and others because they’ve bought into the narrative they should set their prices for other people's budgets.
  • Charge a living wage. 
    
  • Set your prices at what you need to pay your bills. It's not your job to set your prices for other household's budgets. It's your job to work for an income that meets your budgeting needs. It's okay to love what you do and also pay the bills with that passion. 
  • Don’t give in to it when people ask you to lower your prices. Don’t continue it. Declare your worth. If people don’t value you at fair wages (especially when they are actually able to pay those prices), they don’t deserve your services.

 

• If you don’t market your business, you’ll never succeed. Ever. Marketing is 100% necessary. Not knowing how to market will absolutely sink your business. 
  • I have a blog with over 100 ways to market a doula business. Click here to read that. 
  • Customize your marketing plan.
  • Once you’ve done that, take it and schedule out your action plan. It’s one thing to know your options. It’s another thing to carry out the techniques. Get a calendar or make a document on your computer to schedule a marketing task 2 or 3 times a week. Update your action plan every month.
    

 

• Struggling to connect with people is an introverted business owner’s battle. 
  • Schedule your time to promote your business. Immediately after that reward yourself with time to introvert.
  • Wear doula apparel when you go out. Maybe it will strike up conversation. 
  • Get comfortable talking about what you do. Practice if you need to. 
  • Work on improving your social skills and communication with others. It may not be our nature, but it's necessary to promote a small business. 
  • Be your genuine self. You’ll attract your tribe. (You still have to leave the house.)
    
  • Ask your extroverted, social butterfly friends to help you spread the word. Sometimes chatty friends do a better job at connecting us to potential clients than we do with our socially awkward selves.
    
  • Find the things you can do as an introvert that you enjoy doing to promote your business. For example, writing blogs (shared with your community) is a great way to show yourself knowledgeable to potential clients. 

 

• Not putting enough time into your small business will surely sink your ship. I know many doulas juggle multiple things. Managing your company has to be a priority.
  • Improve your time management.
  • Give it the time it needs. You won't get your business off the ground if you don't have time to promote it. 
    

 

• Rural areas = low amount of customers. If you live way out yonder, doulas can suffer a dusty desert of an income.
  • Be realistic about how many clients you can have in a month or year if there aren’t many babies being born in your service area.
  • Consider expanding your service area. 
  • Offer other related birth services to attract your target audience.
  • Market hard!
    
  • Try to get connected with the providers and staff at your local hospital. There may not be many births, but wherever there is a labor and delivery unit open there are some births in that small town. 

 

• A saturated market is hard to break into. Stepping into this field as a solo practice when you have established and well-liked doulas already known in the local birth community is no easy journey. As much as I don’t see other doulas as competition (everyone has their own style), it’s hard to get your name out there in a crowded market.
  • Step into it anyway. You’ll make a name for yourself.
  • Make connections. Get to know other doulas. Be friendly. Maybe if they have someone inquire when their month is fully booked they can refer to you.
  • Make connections with non-doula birth workers such as childbirth educators, lactation professionals, and photographers who do birth or maternity/newborn.
  • You’ll have to market a little harder to not be the littlest guppy in the pond, but keep at it. 
    
  • Be realistic about how many clients you can have per month when there are a lot of doulas in your area. What percentage of births in your area have a doula present? The latest statistic I can find it still showing less than 10% of births. 

 

• Doulas can be fiercely competitive. So can nurses, lactation consultants, photographers, and any birth worker running a small business. Unfortunately, this is a fact of life in our culture. There's just as much hostility towards each other with doulas as there is with nurses. 
  • You don’t have to network with or associate with doulas that are not your cup of tea. Not everybody is a nice doula. 
  • You do you. Let their character be their own demise.
    
  • Live your passion. No excuses.

 

• Partnering with the wrong people can wreck your ship. Agencies, partners, or solo practice? Backups? Colleagues to network with? Choose carefully. The right partnership can flourish your business. A bad partner can do some damage. A bad backup can earn you a reputation you don’t want. Get to know your local birthworkers, but tread carefully. Some who seem friendly are really a foe.
  • Take time to get to know someone really well before partnering with them.
  • Contracts aren’t just for doulas and clients. Contracts are for backup doulas too. Co-teaching? Put the plan in writing. Get the idea? If you’re splitting money, have a signed agreement.
  • Don’t hesitate to cut ties with a partner who is causing problems. Here’s an example. A childbirth educator brought on a doula friend to be an assistant teacher and help demonstrate some techniques. The doula talked over the educator, said she was wrong in front of the students, and basically train wrecked her class. The students were clearly uncomfortable. The childbirth educator – clearly being a sweet and compassionate person – felt bad at the idea of no longer having the doula co-teach. Honey, burn that bridge! Don’t let anybody damage your dream business. Protect it like the diamond that it is.

 

• Niches can be good for business, but don’t make them too narrow. Generalized products or services that target everyone tend to not sell as well as businesses that have a target audience. This goes for all small businesses. Identify your target market. Cultivate your niche. BUT don’t take it too far. If you have a really narrow audience that you’re wanting to work with exclusively, that’s going to drastically reduce your flow of clients. For example, a doula that only wants to do home births in an area where few birth at home won’t be doula-ing very many births.
  • Identify your target audience.
  • Identify your boundaries. Know who you don’t want to serve and situations you don’t want to be in.
  • Connect with consumers in that niche.
  • Think outside the box. If you’re wanting to primarily support the goal of natural childbirth, where can you find that audience besides birthy stuff? Get your business name out there in your niche audience.

 

• If you have birth baggage, doula work may be too emotional for you. People become doulas for different reasons. Quite often, people become a doula after suffering a bad birth experience personally.
  • While they have the best of intentions to help others, the rescuer mentality is one of self-gratification. What you perceive to be a bad experience someone else might be happy with. Remember this. As a doula, your job is to support them in their birth choices. Your job is not to try to get someone to make the decisions you would.
  • Process your negative birth experience before becoming a birth worker. Get professional counseling.
  • It’s okay if there are certain situations you’d rather not work in. For example, if you placed a child for adoption, it’s okay to not take doula clients who are placing their baby for adoption. That’s a lot of tough emotions.
    

 

• Dissatisfied customers – eek. Nobody wants to think this may be a problem for them. I would like to think that all doulas are amazing support professionals that leave magical sparkles of happiness everywhere they go. That’s simply not reality. Some doulas are 5 star awesome sauce. Others are not truly supportive. And sometimes a doula and client may simply clash for unrelated reasons.
  • In your consultation with potential clients, talk a lot about what they want in the ideal doula and what their expectations of you are. Make sure they understand what you do and don’t do, terms of contract, etc…
  • Decline clients that aren’t a good fit for what you offer. Doulas are supposed to help a person have the best birth possible. Maybe referring elsewhere is what’s best for certain clients. In all honesty, declining a client you suspect to be troublesome (really rude or drama queen with a toxic personality, etc..) can prevent problems before they have a chance to brew.
  • After services are over, email an evaluation feedback form.
  • Consider all feedback with an open mind. In the end, you should run your business in a way that represents the authentic you. It’s okay to try new things. It’s okay to go back to something else. It’s important to ask for feedback.
  • Keep learning always. You'll grow as you go. 

 

• Not being able to process your emotions and let go of what bothers you is going to eat at you. I know you, doula. You’re a healer. You’re a caretaker. You’re a nurturer. You want to save everybody and fix everybody and pour your heart into what you do. Painful truth – you can’t fix every broken person. Nor can you run the maternity unit to ensure evidence based practices is delivered in every room.  You’re a doula. You want people to have best care. You can’t stand it when doctors sweep membranes without permission, cut episiotomies without consent, and lie to their patients. {Note: Many, many, many OB/Gyns are absolutely wonderful. I adore them and am grateful for them. Unfortunately, there are still bad apples on the tree. Eventually all doulas will come across some bad apples.} It’s really hard to see a client be mistreated or lied to and keep going back in those rooms.
  • Know that your support helps your clients have a better birth than if you were not there. Obstetric care has come a long way. It still has a ways to go.
  • Don’t carry your client’s pain as your own.
  • You need to learn how to let go.
  • It's also okay to choose not to attend births at certain hospitals or with certain providers. Protect your peace so you can stay in business. 

 

• Burn out happens. Being on call is rough. Birth can be rough too. It’s not always happy deliveries and healthy babies. Stillbirth happens. Prematurity happens. Drug addiction happens. Diseases happen. Suffering happens. Doulas take care of healthy people and unhealthy people. You see good outcomes. You see bad outcomes. You see joy. Sometimes you will see death. You comfort grief and the next day you may be rejoicing with a healthy client. The emotional toll of birth work is real. The grief healthcare workers bottle up is real. Burn out happens.
  • Self-care is crucial!
  • One great thing about being the owner of the business is you get to set your availability. If you want to take December off, then don’t schedule any births that month. If you want to take a summer vacation, schedule it.
  • It’s okay to switch roles in birth work. Maybe you want to switch to postpartum doula care for a while and be done with being on call. Maybe you’d really like to spend a year only teaching classes and give your sore body a break from all the physical support.
  • And maybe – just maybe – it’s okay to close up shop for a while. Go do something else for a few months. Or be a stay-at-home mom when your little ones are tiny. It’s okay to take a sabbatical.
  • Know that you can always come back to being a doula. Birth will always be here. Take care of yourself.

 

• Discouragement when success isn’t happening as soon as you need it to or in the way you need it can dishearten a doula to the point of slipping away from being in business.
  • This hurts. This truly hearts your heart when business is struggling. It is disappointing. It is heartbreaking. Love yourself through it. Maybe adjust your goals for how many births you do a month or year.
  • Is it worth it? Is the struggle and the marketing battle and the discouragement doulas (and all small business owners) face worth carrying with you in your dream career? If you said yes, keep going. Despite all the things that can cause failure and all the obstacles you face, do it anyway. Do what you can with what you have. Adjust your goals if you need to. If you were made to doula, then doula. The amount of money you make or the amount of births you do a year is not what defines your purpose. If God made you to be a birth worker, walk your path. ​

What are/were your obstacles to building a successful birth doula business?