Thursday, May 29, 2014

Should I get certified? An honest look at doula certification

Every now and then, I will receive an email from someone who is thinking about becoming a doula. This is usually the first question I get. This is also a very common question on all the doula message boards and facebook doula groups I have perused. 

Should I get certified? 

People are very passionate about their answers to this question. I am going to attempt to answer this question with the hope that I might be able to help someone who is trying to decide whether or not they should be certified. 

Before continuing, I should probably share that I am certified. I completed my training and certification through DONA International, and I finally heard the good news in September 2012 that I could finally put the letters CD(DONA) after my name. 

It felt like a graduation! It was as if the words of my college diplomas echoed through my brain, "You have successfully completed the requirements of DONA International and are entitled to all the rights and privileges appertaining thereto."

Only, I was just as confused as to what those "rights and privileges" were after my DONA certification was approved as to what they meant after I earned my music degrees. Was I a better flutist now that I had these two pieces of paper in my hands? Am I a Master of Music now because this piece of paper says so? Am I now, all of a sudden, more equipped to play in the same symphonies and teach the same students as I have been for the past several years? Am I all of a sudden a better doula because I can put letters after my name? 

No. Not really. 

Want to know something that stinks? I bet there are high school flutists out there that can play better than me. Especially now that I don't really get to practice anymore. However, you know what I can do that they can't? Get a job. One day I might want to teach at a university, and the position might require that one has earned at least a Master of Music degree. Many universities require a doctorate in music. Minimum. 

Sometimes if you are really really good, and have played in famous symphonies and have made a name for yourself, your education doesn't really matter. There have been a few of my friends who never finished school, who have been able to live a life performing in orchestras, musicals, and other shows that most people can only dream of doing. It's extremely rare, though. Most of us have to spend years in school developing our craft. And before I go off on a rant about my two music degrees and how they are not really worth the time, effort, and money I poured into earning them, I'm going to move on to something else. At least, at this point in my life, I can't see how all of that was worth it. Maybe it will all reveal itself one day.

So did the clouds part and a beam of light shine on me and proclaim me Kristi, the Better Now Certified Doula? Did I hear concourses of angels singing the letters CD(DONA)? Maybe for a minute or two as I basked in my accomplishment. Once reality set in, I realized I didn't really feel different. I guess I expected to feel different. Potential clients were like, "Oh, that's nice. Good for you." I suppose I thought business would boom. I suppose I thought I would somehow feel more qualified as a doula. I felt like the same ole me. 

Here's what I feel doula certification has done for me:

It has provided proof that I have met a minimum standard of training and education. I feel like certification is a START. It is the bare minimum training someone needs in order to start serving clients well. Whether or not someone completes the certification paperwork, aspiring doulas need to, at the very least, attend a training and read the material. 

It provided structure for my training and studies, and it gave me a place to start. Because I had absolutely no background in supporting women during pregnancy, birth, or the immediate postpartum period, I needed to attend a doula training. I am the type of person that thrives in a classroom setting, and I needed the structure that pursuing certification offered in order to remain disciplined to finish my work. The promise of having letters behind my name if I completed all the requirements kept me motivated. 

It has given me a sense of accomplishment. I am the type of person that just feels icky and unsettled if I don't finish something that I started. It would irk me if I did all that work to become trained and educated and didn't just go ahead and finish all the other paperwork in order to earn the letters. Some people ask, "Why be certified? It doesn't make you a better doula." My thoughts are, "Why not? I did all that work. Why not just finish?" 

It keeps me motivated. I want to keep my letters, so I will do what I need to do in order to continue my education. I feel like I am more motivated to sign up for continuing education opportunities if there is potential that I can lose something for which I worked so hard. This is my learning style. This is what I need to stay disciplined. 

Here's what I feel doula certification has NOT done for me:

It did not make me a better doula. The parts that made me a better doula (and continue to make me a better doula) were the training, the reading, and attending births. Continuing all of that after receiving my certification makes me a better doula. I become a better doula after every birth I attend, every book I read, and every workshop I attend. I become a better doula by gleaning all the information I can from other doulas. I become a better doula when I pay it forward and teach workshops. I feel like I am a better doula after adding to my skill set and becoming a Birth Boot Camp Instructor. The certification itself did not do those things for me. The work I put into obtaining my certification did those things for me. Some people don't need all of that to motivate themselves to pursue initial training and education and then continue it for as long as they are a doula, but I do. 

It did not bring me more business. I suppose it was naive to think that I would all of a sudden have more business because my name and information were now on the DONA website. I have yet to receive a client from the DONA website. I have received inquiries from people who are thinking about becoming doulas, hence this inspiration for this post, but not from women who are seeking a doula for their upcoming births. Most of my business comes from word of mouth. Some comes from doula match, my website, and from Facebook.

It did not prepare me as much as I thought it would. Maybe I was expecting too much from my training. I feel like I was thrown into the ocean with the instruction, "Now, swim!" I've had a few life preservers thrown my way in the form of a few amazing doula friends who are always there for me. I've had some pieces of driftwood float past me, in the form of additional trainings and workshops, that I have been able to use to build a sizable and comfortable raft. The glue and rope that holds it all together is all the reading and studying I do. Every book I read makes my raft just that much stronger. Sometimes the wind and rain beat against me, and the waters are choppy. Other times, the waters are as smooth as glass. However, my raft is strong, and my life preservers are still waiting there should I ever need them. 

Do I think everyone should get certified? 

Not really. I don't mind what other people do, except in a few cases. 

It bugs me when someone who has no training whatsoever starts calling themselves a doula, behaves in ways that trained doulas would never behave, and makes us all look bad. In other words, trained professional doulas follow what is called a Scope of Practice. There are certain guidelines for doula work. There are certain things we should and should not do, things that are outside of our range of expertise. Do you know what these things are? If not, you should probably take a training. 

Other than that, I am not bothered by someone's method of training, or whether or not they are certified, as long as they are trained in some way and conduct themselves professionally

How does one receive training as a doula? 

There are several options available for anyone wanting to receive training as a doula. 

Live training: Usually these are held over the course of 2-3 days, and participants learn birth support skills in a hands-on environment. Organizations such as DONA International require attendance at a live training taught by an approved doula trainer in order to complete certification. 

Online/distance training: Some programs do not require a live workshop and provide all of their training via distance or online learning. 

Apprenticeship: This type of training allows participants to learn from a more experienced doula, and the requirements and length of training vary. Depending on the skills and experience of the mentor, I feel like an apprenticeship has the potential to be one of the most thorough trainings available. Combined with all of the book work required of other types of programs, this would make for a very comprehensive training. It doesn't matter how long I do this, I will never get so big for my britches that I won't feel like I would benefit from spending lots of time learning from a more experienced doula.

To summarize, I feel like whether or not a doula should become certified depends on his or her learning style and previous experience. There is not a one-size-fits-all doula, just as there is not a one-size-fits-all way for becoming a doula. For me, however, certification works. 

Wednesday, May 21, 2014

Want a natural birth? Don't just hire a doula!

I'm about to be really transparent. Ready? Here it goes. After calculating doula birth stats today, I discovered something that I began to suspect about a year and a half ago. 

Hypothesis: My clients who take a comprehensive independent childbirth education course are more likely to achieve their desired results. 

Is it fool-proof? No. Are the results pretty amazing? Yes. 

Conclusion: It is not enough to just hire a doula. A comprehensive childbirth education class is a must!

Doulas are great. I love doulas. I am a doula! But I will go ahead and admit it. I am not all you need for a satisfying birth experience. I'm a pretty cool, pretty awesome, good-at-my-job doula, but I can't impart all of the knowledge and preparation learned in a childbirth education course in our prenatal visits. I can send link after link, article after article, study after study, and I can talk A LOT about birth, but I can't force you to read them. However, there is something to be said about devoting 2 hours a pop for 10 weeks on birth preparation. I spend around 6 hours with you during your 3 prenatal visits discussing exactly what it is that you want from your birth experience, how I can help you as your doula, going over techniques for helping your birth go as smoothly as reasonably possible, and just getting to know you, your hopes, and your concerns. That's pretty far from at LEAST 20 hours worth of education received in an independent childbirth class.

What is an independent childbirth class? It is a class not affiliated with a hospital. These include classes such as Birth Boot Camp, Bradley, Hypnobirthing, Hypnobabies, and many others. 

Without further ado, here are some numbers:

Total Doula Stats:

Natural*: 56%

Medicated Vaginal**: 28%

Cesarean: 16%

*Natural birth includes those moms who may have been induced but did not receive pain medications

**Women who received pain medications

Those who took an independent or out-of-hospital (OOH) childbirth class:

Natural: 90%

Medicated Vaginal: 10%

Cesarean: 0% 

Those who took a hospital-based or took NO childbirth class:

*12% took a hospital class, the rest took no class

Natural: 33%

Medicated Vaginal: 40%

Cesarean: 27%

How many clients took childbirth classes?

Independent classes: 40%

No classes: 52%

Hospital-based classes: 8%

A few things to mention:

Not all of my clients were planning natural births. Some of them were planning to receive epidurals. It probably goes without saying, but those who were planning natural births were more likely to take an independent childbirth class. 

I started teaching Birth Boot Camp classes because I could see the value of childbirth education. It's so important! Doulas are very helpful, and when you are in the heat of the moment, it is important to have someone there to help you remember all the things you learned in your childbirth class. That is who your doula is, a walking, talking, childbirth encyclopedia. A doula helps you carry out all of those comfort measures you learned in class. She knows exactly when to use them. She is there to remind you that what you are experiencing is normal even though it may NOT have been covered in your childbirth class. She is there to support you no matter what course your birth takes. She helps your partner to shine! She is a calming presence for other members of your birth team who did not take those many hours of birth classes with you, who may not be very experienced in birth. But don't leave it all up to your doula! Invest in yourself. Invest in your birth. If you want a natural childbirth, commit to it! Take an amazing, comprehensive childbirth class. 

Sign up today. Shoot me an email at: with the message, "Sign me up!" 

Friday, May 9, 2014

Doula growing pains

As my hands ventured under the running water to wash dishes for what felt like the hundredth time this week, my mind began to wander. It tends to wander to some of my favorite subjects when I am doing unpleasant things like washing dishes or exercising. Motherhood. Birth. Family. Birth. My cute husband. Birth. Birth Work.

Today I was mulling over my past clients, thinking back to my time with them, and what I could have done to help them better than I did. I think over past births quite frequently, assessing my performance as a doula, in the event that I face a similar situation in the future. That way I can be better prepared for Next Time.

The only thing is, Next Time never comes. That's one of the challenges of birth work. Every birth is a new experience, and I am always learning something new at each birth I attend. No two births are the same. Sure, they often follow a certain pattern. Early labor, active labor, transition, pushing, and BABY! There are as many variations to how one's birthing journey will go as there are differences in the women who are on those journeys. Sure, I might have a better idea of what to do the next time a woman experiences a cervical lip or the next time a woman has a posterior baby, but what works for one woman may not work for the next. What one woman loves another woman may hate. Some women want to be loved on, caressed, hugged, touched, massaged, and some women just want a peaceful presence. A watchful eye. Someone to just BE there who has been where she is before. My job as a doula is to try to figure out what each woman needs right there in the moment. Most of the time, we've met several times before to try to determine what she might want during her birthing time, but sometimes, and oftentimes, it's totally different when we're in the moment. I do my best. I try to guess what may help her. Sometimes I guess wrong. I probably guess wrong a lot. I wish it weren't so, but it happens.

I just hope my humble offering of MY BEST EFFORT is enough. I really want to help the women who have honored me by inviting me to serve as their doula. The help I offer will look different to each woman and each birth.

After each birth I think back. Did I help enough? Did I do too much? Did I say enough? Did I say too much? Did I interfere in any way? Did that position I tried to help her with annoy her? If I would have suggested that one position I was thinking about but didn't get a chance to, would that have helped her avoid the epidural? Is she happy with her birth? What if? What if? What if? Sometimes I wish I could go back in time with the knowledge that I have now and have a do-over with some of my earlier clients. Would it make a difference, though? Is that the kind of support they wanted or needed at the time?

The perfect recipe
I had a conversation with the bishop of my ward the other day, and he started talking about missionary work. He compared each missionary to a recipe and used his hands to illustrate. To compare that conversation to doula work, the recipe that is Me, with all my strengths (represented by my fingers) and weaknesses (represented by the spaces between my fingers) is a perfect fit for the client who hires me with her various strengths and weaknesses. (Interlace the fingers) I'm not a perfect doula. I have various strengths and various weaknesses that complement the families that I am allowed to serve. I thought that was cool when he shared that with me. So perhaps at the time, I was just the doula they needed.

It's still uncomfortable for me at times to experience periods of growth, whether it is in my doula career, or if it's just life in general. Life has provided ample opportunity to strengthen and stretch my emotional and spiritual muscles. Quite often, it's very uncomfortable for me. Even painful. It's not my favorite thing to do, to be molded and stretched, but it's necessary. I have to go through these growing pains in order to become a more experienced doula, and I have to go through these growing pains in order to more effectively serve those families who honor me by allowing me to serve as their doula.