Competition and Doulas

I’ve been thinking about competition and birth work a lot lately.  Between preparing for my DONA workshop Beyond Competition (2015), conversations on social media, and heartfelt conversations with coaching clients,  I am getting very different pictures about the nature of competition in birth work.

Is there competition between doulas? midwives? childbirth educators?

It seems that the answer depends on who you ask.   There do seem to be some communities where competition, at least as it might be experienced in a negative way, simply doesn’t come into play.  Perhaps your birth community is extraordinarily supportive with shared referrals, community events, and plenty of support for new doulas and childbirth educators.  Or maybe you live in a small community with only a few of you, and you’ve found creative ways to work together.  If so, consider yourself blessed and keep on spreading that birth love around!

The fact is there is a lot of lovely support that happens within the birth community.  From backup doula partners to birth collectives and community workshops there are countless ways I see birth professionals working creatively together.  We all share a common goal & commitment to changing our birth culture, and this creates an important bond.  As well, the intensity of birth work tends to create strong friendships between birth professionals, offering the personal support we need when we have a challenging client or birth.

And yet… I hear about struggles with competition in the birth community all the time.  I hear from new doulas struggling to find their place and feeling excluded.  I hear from seasoned doulas with 20+ years of experience who are suddenly finding it difficult to get clients with so many new younger doulas in town.  I hear from childbirth educators who have experienced other childbirth educators in town actively putting down their classes.  I hear concerns about fees and how to compete when there are so many new doulas doing births for free or low cost.  I hear worries that doula A offers nutrition consulting and placenta encapsulation and birth photography while doula B “only” does birth and postpartum doula care and wonders how she can compete.

All of this is shared mostly in private, however, as it is difficult to share business struggles with your friends who also happen to be your competitors!   So why don’t we talk about it?  I think at the core we feel that there isn’t Supposed to be competition in birth work.  I see a few core personal agreements shaping this dynamic of hidden competition (Note: these are variations on assumptions I’ve heard over and over again based on years of working within the birth community).

1.  Because this work is our calling we should be more committed to supporting birthing families than growing our business.

2.  Competition is a very “male” energy.  As women business owners we should be able to do things differently.

3.  Feeling competitive with other birth professionals is simply not acceptable, we should all be supporting one another.

Should there be competition in birth work?  That depends on how you view competition. It can certainly be a positive force, encouraging innovative marketing, creative partnerships, and devotion to your unique practice.  When experienced in a negative way, however, it can also cause a lot of internal strife and even external conflict within the community.

Ultimately I would love to see our community talk openly about competition.  I’d like to see us sit down and talk openly about competition and jealousy and insecurity and how these can negatively impact our work.  I long to see us feel fully comfortable sharing in our process as business owners – talking about the internal & external challenges we face in building our practices.  I long for more creative dialogue about our shared vision and the potential for collaboration.  It would be amazing to see more support for new doulas and childbirth educators just starting out.

I have this lovely gift of a broader perspective on the birth community as a Birth & Website Doula. I get to talk with birth professionals from all over the world and hear about the amazing working that you all do. Yes, I hear about the challenges, but at the heart is the longing that each of you share for More:  More community, More support, More collaboration, More care for families in your community.  This is our challenge, sisters.  Let’s talk.

Be sure to check out my Beyond Competition ebook as support and resource for your doula business >  

About Sarah Juliusson

Hi there, I’m Sarah Juliusson, The Website Doula. I support your practice growth with creative website design, seasoned business guidance, and plenty of great resources to help you find your way. With 20+ years as a doula and childbirth educator, I believe in the value of your work as much as you do. >> learn more about my work as the website doula


  1. Jenny Bennett on July 20, 2013 at 12:25 am

    I’m new so I don’t have a lot of experience working with my area’s birth network yet, but I am a little intimidated by it. I think that’s because from what I have observed it seems sort of like the Greek system in college; everyone has their preferred method and likes to stick with their “sisters.” I understand that because I feel a special connection with other Hypnobabies instructors. When you and Tami took us through the class, it hit me that everyone has a “right person” and wouldn’t it be cool if we could refer women to other professionals without feeling like we’ve lost something. I try to keep this idea in mind as I think about how to grow my business. I want every pregnant mom to come to me, but do I really want the women who would be less likely to write a great review later? I guess not!

    • Sarah Juliusson on July 20, 2013 at 2:53 pm

      I’m really struck by this notion of “sticking with their sisters.” I have seen a kind of rigidity as well, and certainly have played into it myself at times. It strikes me that there may be an element of fear here. So many have come into birth work from a place of personal birth trauma (either our own, or witnessing) and there is perhaps a desire for that one path that will make it right…

      As for referrals, I’ve always held a strong belief that my classes are not going to be right for everyone. And not every client I work with will be a good match for the massage therapist I love, or my favorite midwife team. When helping families get connected with resources we absolutely have to set aside personal preferences and listen to who that client is and what she is seeking.

      I had a great experience of a mom who came back to my practice for postpartum support after I referred her to another childbirth educator and doula team that was better suited to her need. She was thrilled with her experience with them, felt thankful for my support in helping her get connected, and now felt that my postpartum group was a great match for her. Ultimately clients that we refer out of our care leave knowing that we are a great resource and we care about their needs. That can only be good!

  2. Kong Choon Yen on July 21, 2013 at 11:49 am

    I love your idea. We all work towards a common goal. i.e. to make birth better for the family. It is difficult to work alone. Love to join you. Thank you for sharing the wonderful idea.

    • Sarah Juliusson on July 30, 2013 at 3:58 am

      Yes Kong Choon Yen, it can be very hard to work alone. We all of course have the need for backup support for times when we are sick or with another client, but beyond that is the need for the emotional support of others on the same path. Thanks for sharing.

  3. Heather Self on July 22, 2013 at 3:03 am

    I think the best thing we can do in the birth community is get to know each other’s work: so we can best serve our shared client base with cross referrals. It elevates all of us to join together. I think there are lots of clients out there and plenty of work to go around, especially if we join together in educating the general public about our services. That’s good for the world and for business. We are all offering amazing things that are desperately needed. I think thriving collaboration (vs. competition) is way juicier and more sustainable for all, with each of us carving a niche and finding the clients whom we resonate with. We can’t be everything to our clients. We must look honestly at our limitations and stay within our scope of practice and make referrals when we can’t serve our clients well.

    I have to say that I take issue with doulas charging very low rates for their services. I understand that many of these doulas believe in what they are doing and that it should be low cost. But that makes it hard for the rest of us who can only be doulas if it can support us financially. I can only be a good doula when my own basic needs are being met: I need a working vehicle, quality food to eat, ect. These things require money. I can’t work in a restaurant or use my household income to finance someone’s birth. So I need my doula business to generate an income, or I can’t really do it. It is as simple as that. There are many ways to work pro bono as a doula, and that is also desperately needed. But charging substantially less than the other doulas in your area is a disservice to professional doulas everywhere. It undervalues our profession and compromises our ability to support ourselves doing the work we love.

    Our profession has evolved from a deep cultural need for more support for birthing families. It is my hope that we can all work together to create better conditions for families everywhere and support one another in our work.

    • Caressa on July 29, 2013 at 3:59 am

      I understand your frustration with low or no cost doula services. I just want to offer another perspective and then maybe you can make a suggestion in return. A new member of our birthing community (I myself am rather new) is regularly asked how many births she has attended as a doula by perspective clients. As she has not attended any as a doula, only as an observer, none of these clients have chosen to hire her. She finally decided to offer free services simply to gain experience so that she can gain future clients. I personally do not agree, but I have never been in her shoes. I co-own a non-birth related company and we have never given away our services, we simply target a higher market and offer excellent quality. How can that translate into a Doula business model?

      • Sarah Juliusson on July 30, 2013 at 4:03 am

        Good question, Caressa. I find that new doulas have a unique challenge to convey their value to prospective clients. The # of births she has attended is only one of many characteristics that define what she offers a family. I am not sure what you mean that she has attended only as an “observer” – I’m guessing that means as a helper to a primary doula? Her task is to represent her skills, training, and experience (at births and life experiences that may apply to doula care as well) in a way that is honest but not in any way minimizing what she has to offer. Many doulas do make the choice to offer free care for their first few births, and in some communities that is simply the norm. Whether or not that is a good choice for our profession as a whole will likely need to become a separate blog post – lots to explore here!

        • Caressa on July 31, 2013 at 4:45 am

          Thanks for your the thoughts on this…I agree that it is a business owner’s responsibility to “sell” themselves when prospective clients seem uncomfortable with a price. Our area is very low income so that may have something to do with lack of clientele. She told me she has attended family births as an observer and has completed training with another doula. My hope is to work with her to promote birth work in our community and possibly join with larger birth communities in the surrounding areas.

          • Sarah Juliusson on July 31, 2013 at 2:27 pm

            When I hear the word “observer” it suggests to me that there is a minimizing of her role at these births. I would guess that she was not sitting in the corner taking notes, but rather actively engaged along with a seasoned doula in caring for this family. For new doulas there can be a real leap to step into the full authority of saying – YES! i have the skills and training to support you. And for most of us there simply comes a time when we feel that confidence within ourselves – the # of births attended does not seem to be the primary measure so much as a inner knowing. I would encourage your friend to explore why she is using the word observer rather than co-doula’ing, unless she truly was in the corner in a pure observation mode.

  4. Emily Royer on July 23, 2013 at 3:44 am

    thank you for writing this! I have just discovered your website, as I make my way back into the doula world after some time at home with my kids.
    I completely agree with referring potential clients to other doulas if there is potential for a better match. I’ve moved to different cities 3 times over my career as a doula, and it is always a little intimidating when you are going into a new community to find your place – as you say though, we share a common goal of bettering birth experiences through supporting families in our own various ways – let us allow that to strengthen our communities!
    I look forward to following your blog 🙂

    • Sarah Juliusson on July 30, 2013 at 4:07 am

      Welcome back to the doula world Emily! It can be intimidating in a new city, yes, but I also find it offers a great opportunity to recreate your practice with new energy and intention. Having moved more than a few times myself, I especially appreciate the exposure I’ve had to different care norms within each birth community. Best wishes as you re-establish yourself!

  5. Heather Self on August 4, 2013 at 4:07 am

    When starting out, offering free services is how most of us get experience. That’s what many of us do. But at that point, you aren’t advertising alongside professional doulas. You are going through your network of friends and people in the community, until you are comfortable with your level of experience to consider yourself a professional. Then you put yourself out there.

    My frustration is with doulas who, for whatever reason, price themselves well below what most other professional doulas in their regions are charging. I have seen this quite a bit. Maybe it stems from idealism (no one should ever have to pay for this) or they just don’t think of their work as a business. I think it gets confusing to our client base: “why is this one charging $200 for a birth and that one $800?”

  6. […] Taken from –  Competitors or Sisters? Competition and Birth Work […]

  7. GL on December 30, 2013 at 11:08 pm

    I think doulas who get offended at those that charge less should look at it this way: the population they’re going to reach is those who can’t afford to pay more. It’s not anyone else’s place to say anything about what a doula can charge except for that doula–and it’s not fair to those who can’t afford to pay more to tell them they don’t deserve to have a doula.

    As a doula “why is this one charging $200 for a birth and that one $800?” should be on your list of standard questions you already have an answer for–and the answer is really simple: doulas charge what they need to in order to cover their time, costs, and living expenses, and that experience and certain skills may also be factored into those prices because an experienced doula is for most cases is going to be a better resource than an inexperienced one–to ignore or deny that is denying the advantage of experience–and others skills take money to develop (classes, etc.) as well as add value to the service being given.

    Competition is not a “male” energy, and I think that ” As women business owners we should be able to do things differently.” is a pretty sexist statement.

    • Sarah Juliusson on January 1, 2014 at 3:46 am

      Thanks for joining the conversation, GL. We all of course have the choice of what we will charge for our care, and that choice is shaped by our training & experience as well as the socioeconomic needs of our community, our own family economic needs, etc… I do often see, however, doulas also adapting their pricing based on their sense of worth and/or fear of not getting clients.

      You’re right on in saying that competition is not a “male” energy and labeling the sexism within the belief that we should be able to do things differently as women. In my experience, however, I have heard variations on this statement over and over again within the birth community and in conversations about our role as women business owners. There is a real reluctance to even speak openly to the presence of any competitive energy within our community, and I wonder if perhaps the “male” label helps it become more of an “other” energy that we don’t have to own or explore.

  8. Stephanie on June 5, 2014 at 11:51 pm

    Hi! This topic is one I am spending a lot of time with lately. I’d love to see which communities work more harmoniously together versus ones that do not. Where I am, it’s getting intensely competitive, nearly aggressively so, i.e. doulas beginning to bad mouth each other and one doula agency is trying to service the entire birth market.

    • Sarah Juliusson on June 6, 2014 at 12:50 am

      Oh Stephanie, I hear you – and have heard similar stories from many communities. How on earth does it serve our shared goal of healing our birth culture when we are busy bad mouthing one another? I hope you are finding others who are coming from a similar place of wanting to heal and work together.

  9. Catherine on November 3, 2014 at 2:16 am

    A seasoned lactation consultant I just found out is only charging 65 dollars. A less experienced lpn and lactation conselor charges 125. A team of to lactation counselors charge 110. My partner and I were charging 200 and were trying to Bill insurance initially then dropped to 100, now a year later decided to raise our rates to 150. Each of us spend anywhere from 1,5 hours up to 3 and all do in home visits. I may see the ibclc that does 65 and tell her you can always adjust your rates to a family in need but value yourself to charge more. It makes me frustrated because we all want moms to breastfeed and be happy. Some families may be choosing between my services and 5 outfits at gymboree or babies r us. Pricing similarly helps the community as a whole value us more. In my experience people listen better to my advice when they paid for it. Male energy competition that whole concept is interesting to me. Competition in our birth community is more catty and back handed and I feel males when they are competitive are more upfront. I have a hard time referring to other lactation professionals unless prenatal for education because I don’t know how the others practice. Also I have a partner and one of us or both is usually a good fit because we are so mom baby dyad focused. Not agenda or this is what a mom should do. I am able to feel less frustration with my clients because when I leave their side I have developed a plan that I have checked and double checked will be something the family will feel is doable. Mom and baby dyads are not textbooks.

    • Sarah on November 3, 2014 at 5:07 am

      Thanks for your perspective, Catherine. I so often see birth & postpartum pros frustrated with what others are charging, but the conversation doesn’t seem to happen. I’d be intrigued to hear what happens if you do approach her? Interesting insight on the nature of competition as well. I think what i was trying to convey there is that it is harder for us sometimes to perhaps admit that we’re being / feeling competitive because of the layers of how we “should” be acting – perhaps it is this energy that creates the catty / back handed vibe?