Episode 75 When Clients Don’t Show Up: Navigating No-Shows in Birth Work

Dr. Robin Elise Weiss [00:00:06]:
Hey, Hillary!

Dr. Hillary Melchiors [00:00:07]:
Hi, Robin!

Dr. Robin Elise Weiss [00:00:09]:
Long time no see, at least in this space.

Dr. Hillary Melchiors [00:00:12]:
It's true, we've been not able to like get together in the space for a while, even though we've seen each other in person.

Dr. Robin Elise Weiss [00:00:18]:
I've missed you.

Dr. Hillary Melchiors [00:00:20]:
I've missed you too, right? I mean, we've, we've definitely been in other spaces together. I keep saying that. Listen, you and I, we were— we enlisted, right? Isn't that what you said?

Dr. Robin Elise Weiss [00:00:33]:
Yeah, that's what I said. We've done our time, we've gotten out, it's time for someone else to enlist and do the work.

Dr. Hillary Melchiors [00:00:39]:
Yeah, we passed the torch.

Dr. Robin Elise Weiss [00:00:41]:
Um, pass the torch to some really capable people that I'm excited about.

Dr. Hillary Melchiors [00:00:45]:
Exactly. So we did our service and I'm really excited that we get to come back and do this again together. So yay, here we are.

Dr. Robin Elise Weiss [00:00:54]:
Well, and one of the things that I was saying to you is, so first of all, I don't know if you know this, but the average length of a podcast is 7 podcasts.

Dr. Hillary Melchiors [00:01:04]:
I, I mean, episodes. We are— wow.

Dr. Robin Elise Weiss [00:01:08]:
10 times that. And one of the things that you have to do to be a sustainable doula is build a great partnership. Mm-hmm. And part of that is finding backup, right? We talk a lot about having that backup doula. Um, and, you know, one of the things I've appreciated about our partnership as Birth Geeks is that, you know, when I had something going on, you stepped up. When you had something going on, I stepped up. And so we have kept the Birth Geeks going. We had this original idea in 2018, and we're still here in 2026.

Dr. Hillary Melchiors [00:01:42]:
I mean, my oldest was 10 in 2018, and she's graduating high school this year. So, like, it's a little— we've been

Dr. Robin Elise Weiss [00:01:51]:
doing this a long time. But in, in, in that, I wanted to talk about something that you agreed was a really important topic. And that is, we're talking here about how we just showed up for each other.

Dr. Hillary Melchiors [00:02:05]:
We did.

Dr. Robin Elise Weiss [00:02:06]:
But what happens when your client no-shows or your potential client no-shows? So today's episode is all about the no-show.

Dr. Hillary Melchiors [00:02:16]:
Oh, I'm— I'm thankful that it doesn't happen very often for me, um, and less so since I've, I've taken some steps to like kind of mitigate that. And I know we're going to get into that, but they happen.

Dr. Robin Elise Weiss [00:02:31]:
Um, well, let's talk about what is a no-show. Like, what do you consider a no-show?

Dr. Hillary Melchiors [00:02:37]:
I, I— so, you know, I have a little like German person that lives in my brain that tells me like, you made an appointment and you will be to this appointment, you will be 10 minutes early or you're late. And And I know that not everyone has that little German person in their brain, thankfully, um, because ew, um, but also, so, um, no-show is, is you have an appointment with someone or you have made an arrangement of some sort to meet with someone or ha— and they don't show up to— or, and

Dr. Robin Elise Weiss [00:03:11]:
I would say they don't call. Like, things happen and, right, your kid gets sick on your way and they just barfed all over the car, right? I've had that happen more than once, right? And you call someone and you say, oh, I was on my way and this happened and I can't make it. I don't consider that a no-show. I consider that life. Mm-hmm. But this is a no-call, no-show, right? Like, you just feel ghosted, I think is the term the kids use these days.

Dr. Hillary Melchiors [00:03:38]:
So many— yes, yes, ghosted. That's, that's a, that's a great term, kids.

Dr. Robin Elise Weiss [00:03:44]:
So that's how we define no-shows here. And no-shows could be about consultations. I think that's where we hear about it most. Like, somebody made an appointment to do an interview with you and you show up at the appointed time and place and no call, no show, right? They're, they're not around. Yeah. So there's that. But we're also going to talk a little bit about the no-show of you've got a client, they've signed a contract, they've paid your fee, um, or, you know, whatever arrangement you had, and they go into labor and they don't call you. That is also a no-show we're going to talk about today.

Dr. Robin Elise Weiss [00:04:19]:
So those are the two kinds of no-shows that we are going to talk about. We're not going to talk about generic ghosting, like you send an email and someone didn't email you back. That's life, right?

Dr. Hillary Melchiors [00:04:28]:
Right. Or you've interviewed with someone and then you never hear from them ever again. Unfortunately, I— that's ridiculously common. Like, it just happens, and that's okay. I let it go.

Dr. Robin Elise Weiss [00:04:39]:
Yeah. So those are our definitions of no-shows. I also want to talk about who's more likely to no-show. So one of the things that I have found in all the years that I've been in practice is that when people are not invested in some way physically, mentally, emotionally, monetarily, they are more likely to no-show in some manner. And let me give you some examples on the consult level.

Dr. Hillary Melchiors [00:05:10]:
Okay.

Dr. Robin Elise Weiss [00:05:10]:
So the consult level might be, my mom really wants me to have a doula. They've offered to pay for a doula. They found a couple doulas. I halfheartedly reached out. I scheduled some interviews and I really just don't care. And there's a basketball game on tonight that I would rather do than— right, I live in Kentucky, um, the basketball game on, right?

Dr. Hillary Melchiors [00:05:37]:
I'm just trying to imagine you preferring a basketball game, but yeah,

Dr. Robin Elise Weiss [00:05:42]:
not me personally, right? Like, you know, there, there's all this stuff going on and I'm not like— I'm not— it's not worth getting dressed. Right, to go out. Um, and I will tell you, it takes a lot to get me to leave my house. So I completely get it. But that person, because they're not like, I want a doula. Um, I also think we have some no-shows who maybe they're really excited about having a doula. They're really into having a doula and they have booked 3 or 4 consults. And the first doula they meet, they're like sold, right? And sign on the spot because they're just so excited.

Dr. Robin Elise Weiss [00:06:16]:
And there's no way doula number 2 could be any better than doula number 1. And They just, they don't want to, they don't know how to like break the news to doulas 2, 3, and 4 that, you know, oh, I've, I hired someone else.

Dr. Hillary Melchiors [00:06:29]:
Right. Well, and I think we also get, so in my agency, I, which we're going to talk about like a couple things, steps before we get to that interview process, but sometimes we'll have people who like directly from our website will book a consult and then, um, immediately we have like an automated, it'll send them some information and then they're like, oh, just kidding. That's not what I thought it was. That's, you know, it's out of my price range or whatever, for whatever reason. Um, and then sometimes they no-show, but again, part of that automated system is mitigating some of that. But, uh, anyway, so that's the point, right?

Dr. Robin Elise Weiss [00:07:07]:
So you're going to have no-shows. That's part of doing business. But there are things that we can do to mitigate the number of no-shows we have, right? And so we need to understand that sometimes it's just You know, you always hear about pregnancy brain, like, I just got busy and forgot, or, you know, whatever happened. It was this Tuesday and I thought it was next Tuesday, or, right, whatever. Mm-hmm. You've forgotten. And so number one is I send reminders. Now mine are automated.

Dr. Robin Elise Weiss [00:07:35]:
You book on a calendar. Mm-hmm. I'm gonna send you a couple of automated reminders and that's helpful. I always talk about, I need a lot of scaffolding for my brain to remember. It's not enough for me to put it in a calendar. Because I also have to remember to look at the calendar. And so I think like, where am I in general? And for example, I'm always in my email. And so if I have something that I need to do, number one, my calendar emails itself to me 3 times a day.

Dr. Hillary Melchiors [00:08:04]:
Oh my gosh, I'm overwhelmed just thinking about that, just so you know.

Dr. Robin Elise Weiss [00:08:08]:
This is a lot. So I can read it in the subject line and I can say, oh, okay, yeah, my next thing is 3 o'clock. My— after that, it's 7. And that's helpful for me because it's just that little, um, I can also get up and, and I know that at 8:01 my calendar's gonna be in my email and I can open my phone and go click, click, click and turn on all of the alarms to alert me like, oh, that's a phone call. I need a 5-minute warning. Oh, that's someplace with a 30-minute drive. I need a 35-minute warning, right? Like, so I can go in and set that and remind myself. I also will sometimes, if I— my spidey senses are on that this person might be like me and not remember as well, I might send them a text.

Dr. Robin Elise Weiss [00:08:56]:
So excited to see you. I'm bringing X, Y, and Z. Anything else you can think, you know, like, uh, like maybe they said they were interested in, you know, lactation consultants or childbirth ed, right? Whatever. I'm bringing this. Is there anything else you can think of before I leave the house? That you want. So they've got that reminder and they've got that chance to say, oh, actually the basketball game's on, right? Or like whatever, right?

Dr. Hillary Melchiors [00:09:18]:
Oh my gosh, right? Like I was just telling you, I had, um, someone who scheduled something during the Super Bowl and I was like, are you sure you want to meet, um, during— that's fine, like I will meet you during the Super Bowl, but I just want to make sure you know that that is when the Super Bowl is, is going on. So, um, and that's not everybody's thing.

Dr. Robin Elise Weiss [00:09:37]:
So I do reminders. What do you do for the consult no-shows to try and mitigate that?

Dr. Hillary Melchiors [00:09:43]:
So again, it's some of the pre-work, right? Like, so, okay, you've said that you're interested in birth doula services. Here is some information about birth doula services. So I'm answering some of those questions even before we get to that consult level. But then I have it automated, um, in my calendar, um, like invite thing that it will automatically send those reminders to them. I'm also not doing consults in person.

Dr. Robin Elise Weiss [00:10:10]:
Mm.

Dr. Hillary Melchiors [00:10:10]:
Um, partly because of where we live. Um, so some of our clients, you know, live 1 to 2 hours away from us. Um, and are coming to give birth where we live, or, you know, in our vicinity. Um, so it also— I mean, it— to cut down on mileage on the car, frankly. Um, and frankly, then the, the other part with regards to no-shows is then I'm way less upset I didn't drive an hour to meet you at, you know, a coffee shop and then you

Dr. Robin Elise Weiss [00:10:43]:
did— and an hour back.

Dr. Hillary Melchiors [00:10:43]:
Yes. So like, it's, it's showing the level of investment that I have in that client as well. And it's not because I don't— I'm not excited to talk to new people. I love— Robin, you know, I love to talk to new people. It's totally my thing. Um, I, I really do love it, but it's because experience has taught me sometimes people no-show, and I can do all the things to mitigate that, and that's okay. And I'm way less upset if I'm upstairs in my office on a Zoom call than if I, like I said, drove an hour away. So that's, again, some of the things that we do.

Dr. Hillary Melchiors [00:11:21]:
And I know, um, that's— that's not— everybody's excited about doing, uh, virtual you know, consults.

Dr. Robin Elise Weiss [00:11:31]:
I get that, particularly when there's a big distance, like if you live rurally or you live in a huge metro where people might be all over. Um, you know, one thing I do is I try and have one location and make it to the same— like, I make it like, this is my work time, and if you don't show up, I'm just going to do doula work, right? Whatever that may be, social media, right? Website, whatever it is. Um, and the other thing is there are some doulas who have started charging for their consults, and then that fee goes into— like, if you hire— like, they charge $25, $50, and if you don't get hired— or if you get hired, that money goes towards your balance, right? If your fee is $2,000 and you pay $50 for a consult, your fee is now $1,950. And so that's one way that you can do it, and that way, uh, you can make them pay that up front. So that is that. Like that cost, right? Oh, I just paid 50 bucks, I'm gonna show up. And if you choose not to, like, hey, that's 50 bucks.

Dr. Hillary Melchiors [00:12:31]:
Well, I mean, also it's then still a consult. Cool, you can ask me all kinds of questions about doulas and you're going to learn something if we spend this time together. So okay, you've either paid for my hourly fee or it goes— rolls into your doula fee, either one.

Dr. Robin Elise Weiss [00:12:46]:
Yeah. And so either way you've gotten that, that benefit of that money. But I think that is one way, and it's not right for every doula, but it— that is something that is right for you, uh, that is certainly something that you can do. And part of that's going to depend on, are you having a problem with no-shows? Right? And then if you are having a problem with no-shows, right? If you're having more than one or two no-shows a year, I would say that's— you're probably having a problem. And if you're doing that, then you might ask, like, is there something I could do to be mitigating it? Am I doing something to encourage the no-shows? And sometimes I will say, sometimes it is actually the opposite. There is a sweet spot of communication, and there are some— there's a problem that I have for sure, and I know a lot of doulas have, which is info dumping. We're so excited and there's so much to tell you, and let me send you 73 different things about it, right?

Dr. Hillary Melchiors [00:13:44]:
Like, right. Well, I think, and we can get into this in another episode, but I think, you know, the info dumping versus gatekeeping, like, finding that line is a whole other, um, fun thing because it's like, I'm not trying to gatekeep the information, but I also don't want to overwhelm you. Um, anyway, that, that's been a fun line to follow. It's like the slow trickle out, like, and building on itself. But I mean, what about when— so, but we talked about konsul not showing, but what happens if they don't call you?

Dr. Robin Elise Weiss [00:14:18]:
So I will tell you, my very first time that that happened, I still can feel it in my heart just the feeling that my heart sank when I called somebody up to just be like, hey, like, I haven't heard from you in a couple of days where I've been hearing from them a lot. Right. And I was just like, I just want to check in on you. You know, I know that you're, you know, almost 41 weeks. How are you doing? Oh, I had the baby. And I was just like, what? Right. Like, and you're trying to be professional, but I also go, what the heck? What do you mean, had the baby? And they actually told me, Oh, it was 2 o'clock in the morning and I didn't want to bother you. And, and I'm thinking like, this is exactly like— and I was doing the birth for free because I was trying to get some experience.

Dr. Robin Elise Weiss [00:15:13]:
And that was my experience with it. And it was, it It was, you know, probably, you know, one of my first 20 births. Like, I wasn't doing births for free on the regular, but this person, like, had a, you know, a sad story and needed some help and was down on luck. And I was trying to, you know, I was like, okay, yeah, I can help you out. And I spent a lot of time with them prenatally. And then that happened, and I just like, what did I do wrong? Like, I, I felt like it was me. I wasn't sure what was going on, but I've heard this story over and over again, same story from so many people. Um, have you heard that story?

Dr. Hillary Melchiors [00:16:02]:
Um, I mean, I've, I've literally had that happen, but, um, I mean, I've also had it happen with paying, like, self-pay clients. Um, I'm hearing the story now a lot more from like insurance and like pay. Like, that's— again, it's that lack of investment by— on their part. But the, the problem—

Dr. Robin Elise Weiss [00:16:27]:
I don't want

Dr. Hillary Melchiors [00:16:28]:
to get too deep into it, but the problem being like, maybe you won't get paid if you're not there. And so it's like this extra— it's an extra worry of mine if I have a client who's not in any way invested, um, even, even if they're just emotionally, if they're not financially in any way invested, it's like I have no protection there as a doula. Um, if they don't call me and their insurance is dictating whether I get paid or not, I— as a doula. So, um, I, I worry about that stuff. Again, something we could talk about in another, in another episode, but Um, yeah, I mean, the long and short of it for us as an agency is we build that into our contract and talk about it very regularly, um, because maybe people don't understand that, um, that, you know, they have to call us. No, you have to call. No, you cannot text me at 3 in the morning. I will not wake up to text.

Dr. Hillary Melchiors [00:17:33]:
You have to call me. I've had some very close calls as well where it's like people forget and they text me and like, oh, magic, Magic. I did wake up.

Dr. Robin Elise Weiss [00:17:43]:
Yay.

Dr. Hillary Melchiors [00:17:45]:
Um, but, you know, building that into our contract as well, um, for those self-pay clients has been really important.

Dr. Robin Elise Weiss [00:17:53]:
Yeah, well, and I think that there are so many things that we can do, and there are so many things I love to say to people. Somebody should pay you. It doesn't have to be your client, right? That there are other ways to get paid. And we do have an episode coming up where we are going to talk about deciding whether or not insurance is right for you as a doula to accept. And I think you've highlighted one of the things to go— or, right, one of the things to say, right?

Dr. Hillary Melchiors [00:18:23]:
Making sure we're talking about it. But again, I think at the end of the day, I just don't— like, I don't take it personal if somebody doesn't show up or doesn't call me. Um, uh, like we did for each other, I really try to extend a whole lot of grace for people, um, and grace for potential clients as well as like our clients that we have now. Um, and you know, because you know, the world can be a little challenging sometimes and you know, juggling all the things, I get it. Um, gosh, how many times have I taken a phone call from someone who's like, na, I do what now? No, I, I— are you accepting patients? I'm like, okay, let's— yes, let's talk about that.

Dr. Robin Elise Weiss [00:19:09]:
So to sum it up, you're going to have no-shows. It's not your fault, but do what you can to mitigate that upfront, whether that be set up some systems for yourself and for your client. Um, and then again, talk about it, particularly if you are taking insurance clients, let them know, set that expectation and let them know what happens if they don't call you. Um, but that is our advice on no-shows.

Dr. Hillary Melchiors [00:19:34]:
And look at us, we showed up for each other again. Yay.

Dr. Robin Elise Weiss [00:19:37]:
We did. So we will see you soon in another episode of The Birth Geeks. Yeah.