I know as a doula and birth professional who works with hundreds of families a year, there will always be families who want a doula who has the most experience at a higher price tag, and there will always be families who are happy to work with a less-experienced doula at a lower price tag. There is no right or wrong, there is just what is right for you.
Doulas aren’t like other professions we may sometimes link them to – take nurses, for example. You understand when you have need of a nurse that they all met a standard competency, and they all work to keep that license up. Even if your nurse went to school in Washington, or Florida, or the Netherlands, there are core competencies all nurses are expected to learn. There can be some slight variations, but for the most part, the educational requirements are similar.
In contrast, according to DoulaMatch.net there are over 120 doula training organizations. This means there are over 120 different ways to become a doula! The hard part is figuring out just what the training, certification, and experience means. When we look at websites or Facebook pages, doulas can pretty much appear the same. Each organization has different requirements for doulas to carry their names. Here are just a few of these:
I certified as a doula with DONA International in 2004. At that time, there were very few organizations to choose from. Now the amount is staggering! I think I would have still chosen DONA today as my values and what I wanted from a certifying organization hava not changed.
Many people don’t want the pressure of a governing organization hanging overhead. I have met so many people as a birth professional, and one thing that always amazes me is the wide variety of jobs out there! In learning about families’ occupations, I have found it is not unusual to have a professional agency, governing board, or larger organization that steers how people do their jobs. Architects, Realtors, Doctors, Cal Trans Workers, College Professors, Sandwich Makers, Day Care Workers, Teachers, Linemen, Physical Therapists, Lawyers, Dairymen, Nurses, Pharmacists, Landscapers, and even Doulas (I have a lot of clients who are doulas!), have organizations above them that offer scaffolding and organization.
I am a lone doula, and this I what DONA offers me – DONA gives me information, education, and support to aid me in doing my job. DONA sets expectations, they disseminate new evidence and educational opportunities, they create routes to streamline my work. DONA looks out for me, so I can look out for my clients, and that is why I stick with them.
After writing this, I realized Kim James offers much of this paralleled information on DoulaMatch.net. She has laid it our more succinctly and without bias; refer to her page to see more ideas about what information you’d like to know about your doula candidates.
For you doulas out there, who did you certify through, and what led you to that decision? Share what you love!
Connie was my own doula trainer, and she has been mentioned a lot in the last few 31 Days project, as she was Monalisa's and Amber's doula trainer as well. I can't say enough kind, incredible words about Connie. From day one of me meeting her, she has championed me on in not only the doula world, but also the related world of birth. Connie brings her heart to all she does, and that has made her an excellent mentor and a dear friend -- we should all be so lucky to have someone like Connie in life.
23 years ago, when I started my work as a doula, I experienced some of the greatest highs of my life! After a birth I would sit on the phone for hours, processing this and that with my other new doula friends. I was excited to carry a pager, to know I had a prenatal visit coming up, to be thinking about my doula bag. My learning curve was steep and I was devouring every piece of information I could find. Newly married, my husband delighted in how happy I was. He said, “when I married you I knew I was getting a great woman. I didn't know I was getting a doula as well!”
The years have passed. I usually don't need to process a birth for several hours. Usually I come home happy, but not always high. I often feel pressure to get to bed at a good time, be sure my cell phone is charged, know that my childcare is perpetually lined up. The weight of being on call 24/7 sometimes feels heavy. I feel frustrated with marketing my work on social media because really, marketing is not what I love to do. Neither is social media.
And yet, the joy of this work continues to fill me. I feel honored to be trusted and invited into what is surely one of the most powerful experiences a woman will ever have. I am humbled as I witness her strength, his kindness, their love. I learn as I watch women make very hard decisions. I help her gather information. I act as a sounding board as she talks through her options. I am present for miracles.
Perhaps there is a selfish part of me as all this occurs. I learn so much from these birthing women and from these powerful experiences. When I return from births I try to write down what I learned from the experience. This is part of what keeps me thriving as a doula – it's the learning. While my learning curve about the labor process is not as steep as it once was, my learning curve about life still is. These women are my teachers.
One woman I labored with for a few days never once complained. Trust me – if I had been in her shoes, I would have complained. As we walked the hallways for the millionth time I told her that I was so impressed at how she kept a positive attitude. She told me her story of growing up watching her brother who was very ill. At some point she realized she could complain about their lifestyle, in which regular trips to the hospital were a part of her life, but when she considered what her brother was going through, she felt that to complain would be an unnecessary indulgence. She had developed a mantra in her life: I will not indulge in complaint. Listening to this I began to realize that, in fact, I sometimes did indulge in complaint. The hours we spent together taught me a valuable lesson about myself. I still complain, but maybe just a little less. And my life is better for it.
Then there was the mother who had everything stacked against her, but she just kept making these great calls for herself as she labored toward having a much desired VBAC. After two sleepless nights of non-progressing contractions, her doctor told her that even though her labor was very mild and she wanted to go home, she couldn't advise her to do so because there had been a few dips of her baby's heart rate in the last several hours. The mother listened to what the doctor had to say, asked a few questions, and then made a decision to leave despite her doctor's advice. This was not someone I thought would ever even consider signing out AMA (Against Medical Advice), but she said she dug down deep and just knew it would be worse to stay. She had never heard of signing out AMA but described doing so in her own words to the doctor. The doctor said she completely understood what the mother was asking for and that she only was telling her the hospital's policy. As I followed the mom out of the hospital, her nurse whispered into my ear that she would have made the same decision for herself. The laboring mom left the hospital, got some much needed rest, but went on to encounter many other obstacles. Despite them, she and her baby had a very healthy VBAC. The lesson to watch for miracles was reinforced for me at this birth.
I have learned that slow and steady progress often makes big changes. Not just in dilation! But even in birth advocacy. I have encouraged and watched as women kept asking for their babies to be taken out of the warmer and placed in their arms. Now it's standard for babies to be placed in mom's arms after birth. I have suggested to women that they might consider delaying their baby's first bath. Now I attend births in hospitals that post that they prefer not to wash babies for 24 hours. Episiotomies were routine. Moms complained. I haven't seen one in 6 years. I've learned that health care consumers really can make change if they are supported.
When I think about why I keep doing this work, it is because it fills me up. It makes me smile. This work helps me to learn and grow. The highs are not always as high as they once were – but the lessons are so much richer. Where else could I receive these powerful life lessons than at a birth?!
Connie Sultana, BA, CD(DONA), ICCE, LCCE has been a doula for over 20 years. She is a DONA-approved Birth Doula Trainer, and a Lamaze-approved Childbirth Educator Instructor. Connie is a former Director of Certification and Board Member of DONA International. Connie is forever grateful and appreciative to the over 700 families who invited her to provide support during their labors and births. She lives in Santa Rosa, California with her family and her two dogs.
Do you remember what it was like for those first couple years or those first few births, when being a doula was new and invigorating? Monalisa is a newer doula on fire for this work! I love hearing about her feelings, experiences, and excitement -- it stirs those feelings up within me and reminds me why I continue to love being a doula. Monalisa and I had the same doula trainer, and I am confident she learned the skills (to add to her already huge heart) which will help her on her doula journey.
I am a doula working in the Porterville and Tulare County area of California. I have worked as an in-home care provider for 15 years. In 2015, I attended a DONA-approved birth workshop. I quickly realized that I had not only found my passion, but I also found a tribe of strong, like-minded, loving and selfless women. I had never met these women, yet they accepted me and supported me -- they believed in me! These women instilled confidence in me and what I held within. My two-day workshop quickly came to an end, but these friends have remained close to my heart.
February of 2016 was my first experience as a birth doula, and it was EXTRAORDINARY! I knew without a single doubt this was my calling, this is what I was meant to do.
The remainder of 2016 was spent focusing on my family. Before I knew it, 2016 had come to an end. I had been feeling disappointed and very unsatisfied. I reflected back to remember the last time I had felt genuinely happy, fulfilled, and ALIVE: February of 2016, almost a year before, when I had helped welcome little Miss Katalina into this world. It was crystal clear: I needed to get back into my doula journey -- I need these mommies and they need me!
February 2017, I was on Facebook and came across a friend who had just announced her pregnancy. I quickly private messaged her to say congratulations, and in the course of our chatting I mentioned I was a doula, and I shared what doulas do. Then I offered my support if she wanted it, to which she quickly replied, “OMG, that sounds good. Yes!!”
I was shocked! What just happened ! Did I just get a client!?!?!?! YES!!!!
Our journey as mommy-to-be and doula had begun. She didn't seem to have a lot of support for pregnancy-related things, so I called around to get information about services in our area. Classes were being offered at our local hospital. I asked if she was interested in going, and she said yes. Every Monday evening, we got together for a quick snack, a review of her week, and we went over ideas for her labor and birth. Afterwards we attended the birth class together. Mondays, for the first time EVER, were now my favorite day of the week!
At home I read my doula books, strategically put together my doula bag, and went over our family plan on what to do when I got called to a birth. I was very thorough and clear to my family that I could be gone for 24 hours or more, and they needed to take care of each other.
April went on so slowly, it seemed like the days dragged! What does one do when their client’s due date is April 20 and it’s barely April 10? Role play! My family helped me out. We acted out different scenarios as laboring mother and doula. I have the best family! I must give credit to my daughters and my wife, they are always so willing to play along with my crazy ideas!
Every night I checked my phone, synced my Fitbit notifications so that my watch would alert me when my client called, and made sure my doula bag was all set and ready. I woke up numerous times a night to check things, and then I’d go back to sleep (but not a deep sleep because I was so worried I’d miss the call!).
Finally, April 20 had come -- this was the day we had all prepared for, this was the day we had reenacted over and over and over. But no baby came. My client felt great! She had no signs or symptoms of prelabor or labor. Every morning and every evening we’d chat: “How are u feeling? Do u feel any changes?” And she’d reply with a smiley face: “I feel good!”
The week went on like this, until one morning, I got the call! My client had been up all night with small inconsistent “cramping.” She was at the hospital. She assured me she was okay and she’d get back to me after getting checked out.
I went about my normal day. I took the kids to school, went to work, and gave my boss and coworkers a heads-up that I’d probably be clocking out early. Everyone was super supportive; we had all been waiting on this very special day. By noon my boss said, “get out of here, I can see how anxious you are, we will be fine.” So by 1pm I was clocking out and on my way to Sierra View hospital in Porterville.
Aril 26, 2017, I walked through the hospital doors and was asked where I was going? I proudly said, “I’m going to labor and delivery, I’m a doula.” Along the way I was asked again, where I was going? And again, so proud and full of glee I said, “I AM A DOULA here to see my client” I got buzzed in and at this point I think I was floating through the halls -- not even walking!
I opened the door to see my client in bed with the biggest smile I have ever seen. I calmly said “Hello, Honey, this is the day you have been waiting for!” She replied back with, “Yes, I can’t wait to meet my son!” I then introduced myself to the father of the baby and his mother. They looked confused, nervous, and unsure. We had never met, and it was now becoming apparent they had no idea who I was or what on earth I was doing there.
I gave them a brief description of myself and what it was I had to offer as a doula. Still confused-looking, they said, “ohhh, okay.” I then excused myself to get things ready. Again, they looked at me like I was crazy, and I know they wondered what the heck I had in this bag that I held onto so closely. Little did they know that my doula bag was my MAGIC BAG, my bag of TRICKS, my Other Half.
I went behind the curtain and begin using my electric pump to air up my peanut ball. My pump was not working! I felt my face turning RED, how could this be? My peanut ball was my main tool! Then I remembered I had also packed a hand pump just in case something like this happened. After airing up my peanut ball I set up a diffuser, battery-operated candles, a portable speaker, and massaging lotion just like my client and I had discussed.
Next I asked my client if she’d like to get up and “walk the baby out?” She smiled and got out of bed. We walked around and around and around -- I was definitely putting in my Fitbit steps! Every time the nurses came into the room they oohed and awed over how relaxing the room felt and how it had smelled so good!
Contractions got slightly stronger but still were not consistent. It was now 6 pm and my client's progress was slow. The doctor recommended Pitocin. My client declined -- she knew the pros and cons and opted not to take it at this point. Her doctor supported her decision and said she’d check back in at 9pm. 9pm came and still not much change had happened. Father and grandmother were sitting in the corner of the room and were now starting to look a bit more concerned. They were unsure how to help the laboring woman.
I knew I could role-model for them if they didn’t want to jump right in. I proceeded to sway, dance, and hum through contractions with my client. I continued to give her words of encouragement; I continued to remind her of how strong and capable she was. I reminded her to trust in her body and to “let it go.”
Let It Go was a song my client loved and was very passionate about, so I was sure to have it ready on my phone along with earbuds and a few play lists for her labor journey. With every passing hour, my client held on strong. She trusted me, but more importantly she trusted herself. We got through every wave together. At midnight, she decided to try the Pitocin in hopes that it would help her dilate and make more progress. My client went on for the next three hours with back-to-back contractions, stronger and fiercer than before.
I looked at her partner and gently said, “She needs you, your son needs you.” I coached him through the double-hip squeeze and applying pressure to her back. After just a few minutes he was saying “let it go,” and humming through the waves. They found their rhythm and they were riding the waves together! While he worked her back, I worked her feet and legs. And his mother encouraged him and she supported him, and she supported the laboring woman. We all worked together as a team to give this woman and her baby a better, healthier, birth experience.
It was now 3 in the morning and my client fought with everything she had and then some, but she needed rest -- she opted for an epidural hoping it would take the edge off so she could get some sleep and finishing dilating.
The epidural did not take, and she was still in agonizing pain around 5. The staff decided to turn off the Pitocin hoping we’d see some change. The nurse came in and checked but my client was still at 7 centimeters, 90% effaced.
9am came and the doctor checked -- she was now at 7-8, but the doctor was concerned she had already endured so much and was not dilating accordingly. A cesarean birth was suggested. For the first time in almost 24 hours, my client cried. Her mother was holding her and saying, “Baby, I know this isn’t what you wanted, but you have to do what’s best for your baby.” My client signed the consent form and the doctor went to make the arrangements.
Meanwhile the nurse and I are still rotating my client from side to side with the peanut ball, hoping it would expand her pelvis and allow for baby to come down.
It’s now around 9:50am and the laboring woman says she has to push! She’s told not to push, to breathe through it, that they are almost ready to take her. She says it again, and this time she adds, “ I KNOW MY BODY!!!”
Wow! She had remained so soft spoken her entire labor, but when she said “I know my body!” I knew that momma lioness was roaring, and by golly, we had better listen!
The doctor checked and said, “We are having this baby!” By now the room was filled with at least half a dozen staff. Everyone was spread out in their strategic little stations, waiting for their role in the birth, but right now it was all about the woman!
The doctor was in position, the nurse was on the right side and the mother of my client was holding her baby tight, encouraging her, cheering her on, coaching her through. Father was a wreck! It was all becoming reality. I stood back next to him, rested my hand on his back, and said, “It’s all going to be okay. Your son is coming, and you did amazingly good job, Dad.” This is what being a doula is. We are not there to take away from the family, we are there to guide, to help, to support.
On April 26, 2017 at 10:41, I witnessed three miracles: One was watching a beautiful baby boy enter this world. The second was seeing a family evolve and come together to work as one unit. And the third was understanding a boy became a father and a girl became a mother.
April 26 was nothing less than magical, REVOLUTIONARY! Why wouldn’t I want to live my life being a doula? Birth is the closest thing to magic out there.
Monalisa Orduno serves families in California's Central Valley. Other than working as a doula, she lives a pretty typical mom-life, caring for, shuttling, and cheering on her children and her wife. When she isn't enlisting her family to doula role-play with her, she spends her time devoted to her kids' various activities -- football, horses, ghost-hunting, or shopping for make-up. Monalisa takes time to continually educate herself with personal study and trainings. She loves being a doula and is excited to dig into this calling. "My kids are my BIGGEST accomplishment, and being a doula is my second." Visit her on her Facebook page or her website.
Some doulas strive to venture into the world of birth as no-frills and intervention-free as it can happen. Other doulas, like Julia, offer their experience and knowledge to help families considered "high-risk." Julia and I agree -- we need both kinds! Julia also is passionate about mentoring doulas through the certification process, so virtually and on the phone she is able to provide support, feedback, and heart to help grow new doulas. If this is something you are curious about, contact your certifying organization and ask how you can help as a volunteer, ultimately helping your fellow doulas.
Around a year ago, I was hit by a drunk driver. While I recovered, I was unable to do what I loved most, parent. But secondarily, unable to also do the work I loved, doulaing! So, I decided there was one thing I could do, help doulas who were certifying. So, from my bed, I sent out my resume and letter of intent to become a volunteer certification packet reviewer for DONA, and so began a journey that has taken me on a fantastic ride with a organization I’m proud to be a of.
When I certified, I felt overwhelmed by the process, it felt daunting, and the organization felt large, with seemingly nowhere to turn… and so as soon as I was approved to be a reviewer, my goal became clear, and the doulas spoke this to me… I needed to help make certifying accessible, smooth, straightforward and personable for every doula. So, I set my sights on doing just that.
This year, as a reviewer, I started the “Tips from your Friendly Certification Packet Reviewer,” a Monday post on the DONA Facebook Boards where I bring frequent “bump in the road” items I come up against in the packets I review. Some of the tips I’ve covered include:
The conversations that have emerged from the posts have been insightful, and I’ve started to see cleaner, more organized packets since these posts. As a result of having cleaner packets, I’m able to really sit back and relish the best parts of the packets, the birth stories. One of the best parts of packet reviewing is that I’m basically part of a doula birth story sharing circle every single day. I get to read how doulas experience birth, their tips and tricks from all over the world, and glean their knowledge. And let me tell you something, as someone who is “seasoned,” I’m learning from them every single day. I’ve certified close to 200 doulas in the past year, and every birth story I learn something.
Just today, I called a doula to let her know I had her packet to review. She told me that she had an acting background and how it played into her doula career. I couldn’t quite picture how, and she explained that if she had to meet a client for the first time in birth, she needed to improv into the role, and read the room immediately. GENIUS. In another birth story, a client was having a hard time focusing because of the people in the room, but still wanted them there. The doula pulled out an eye mask for the client to wear, and it worked like a charm. GENIUS. This is what I get to be a part of.
I’m proud to play a small part in the big world that is DONA, and to hopefully continue to show that certification can be a straightforward, personable, welcoming experience. If you are certifying, or mid-process, please feel free to reach out to me if you have questions that I can assist you with! I would love to help you along the way!
Julia has been a practicing Birth Doula since 2013. Her passion is supporting families prenatally. Her main goal is to make sure that each birthing client (and partner) feels that they are well prepared for birth. Julia specializes in high-risk births and families expecting twins or triplets. She is confident and knowledgeable when it comes to navigating the medical system and helping families feel informed and empowered to participate and lead their own birth story. She has written a twins-doula curriculum that she has subsequently taught to doulas around the country.
She is currently certifying as a Childbirth Educator as well in addition to her work as a birth, fertility, postpartum and bereavement doula. In her free time, she volunteers on the Birth Doula Certification Committee for DONA International.
You can learn more about Julia on her website at www.northwestbirthservices.com, on her Co-Op page, www.doitalldoulas.com/julia/ or by emailing her at email@example.com!
How fun to have the first English/Spanish contribution for 31 Days of Doulas! Clara is a doula in an area of Argentina with a high cesarean birth rate. She told me, a woman basically has to be progressing very fast to have a vaginal birth. When faced with so many obstacles to normal birth, it is important to retain your passion for doula work -- what brought you here in the first place? And to have an incredible support system in place. I am confident Clara has both. I am also confident that she will make a difference in the lives of the families she serves. I can't wait to see where doula work takes Clara!
The night after my first birth as a doula I couldn’t sleep -- I was very sad, very tired, and very quiet.
“My water broke, no contractions yet, the midwife told me to go to the hospital at five.” I was on a bus, busy with formalities when I received the mom’s text. I went back to my house as soon as I could, checked-in with my doula group on WhatsApp, washed my hair, got my doula bag, printed DONA certification papers, and left. Filled with excitement and adrenaline, I was happy. At last, 2 years after my first doula course, 3 months after my DONA training, a mama had trusted me to be her doula, and I was over the moon; although I knew this wasn’t the best scenario.
“Remember all our plans? Well, we are going to let them go.” I said that to the mom, but I was saying it to myself, too. An hour later I was in her bedroom, had turned the lights down, and understood that the couple’s choice was to go soon to the hospital. I had half an hour to time contractions. With the birth ball, rebozo in dad’s hands, and massage, a few contractions came -- shy, like someone who comes into a new place and doesn't know what to do. Respecting their decision to leave for the hospital at five (we had an hour or so of driving), I suggested we go.
“Wait, I have to do some stuff before -- get me the hair iron.” So there I was, with a mom about to go to the hospital not in labour -- but I was supporting with love what was important to her though it wasn't ideal to me. I took the iron, and while she was on the birth ball I did my best so she wouldn't realise I have no experience with hair irons (my hair is so straight!), and my fingers were burning. I took my time, this was important to the mom, so it was important to me. When I finished I helped the dad so he wouldn't forget anything. She put on perfume, called for a car, and we were out.
“It’s not a big deal, just relax yourself.” The driver had been a policeman, and he had attended three births himself. I think this man knew more about births than a lot of OBs. The energy in the car was pretty high, there was confidence and smiles, but the mom already knew that as soon as she entered the hospital, the interventions and protocols and rules would start.
“We’re going to try a vaginal birth, ok? But you know that at 37 weeks, your cervix is immature, and a c-section, is always a possibility, ok?” The midwife talked to the mama, but she was in another place. She sadly signed admission papers -- each form was a broken expectation given away with her street clothes and her credit card.
“Everything is perfect, Clari. There’s always a bigger plan than the one we can see or understand.” The WhatsApp group of my doula-mates was strong, careful, douling the doula. The same group that replied when I asked for a photo of “Labouring in bed” by Penny Simkin. In the hospital, I learned I would not able to be with the couple in the room -- rules are rules and only one person goes with the mama. We all sat in the waiting room. I lent my doula stuff to the dad and gave him some advice and information. When the mom was finally called, she was so upset I didn’t know what to say as they walked away.
The waiting room was full with grandmas, aunts, sisters and expecting couples. Absolutely every birth of that afternoon/night was a cesarean birth. C-sections were so many that the OR was full all the time. I cried a little, then got calmed -- I did my best, there was nothing I could do but wait, think positively about them, pray a bit, and wait some more. We were on the 10th floor, and as I watched elevator numbers rise up, I tried to visualize it was the mom progressing to 10. I listened to sticky-sweet love songs on TV, and whenever I opened WhatsApp, my doulas were always there, supporting me.
No news. I texted the dad, sending him inspirational pictures, advice, good intentions -- they knew I was there. Time passed and I thought that maybe so many scheduled c-sections (Easter holidays were coming) would give her some time to progress. Five hours later, I saw the OB, and then the midwife.
“The baby was born.” I never, ever wrote a message so fast. I needed them, I needed my doulas. Their experience was my support, their words, my relief. I asked the midwife if everything was fine and she said yes, “she didn’t progress and she had a c-section." She said I was able to see them now. I started to go down the stairs. I cried. I cursed. I read messages of support, of the lovely presence beyond this hospital, doula sisters. I held my tears and entered the room.
“You know how this works… doulas, midwifes, the more you know about it, the worse it is.” I thought the worst was over, I was wrong. There was the midwife, putting poison in mom’s mind with her words, blaming the c-section on a painful tired new mama who knew too much or had too much support, who was still dealing with anesthesia. I turned down the lights, stroked the mama, and watched a new mama with her baby -- the greatest love that exists, the one that heals everything.
Mi Primer Acompañamiento
La noche de mi primer acompañamiento como doula no pude dormir, estaba muy triste, muy cansada, y también muy tranquila.
“Rompí bolsa, estoy sin contracciones, la partera me indicó que me interne a las 5.” Estaba en un colectivo yendo a hacer trámites cuando recibo el mensaje de la mamá. Volví a mi casa lo más rápido que pude, di aviso a mi grupo de doulas, me lavé el pelo, agarré las cosas, imprimí los papeles de DONA y salí. Después de la excitación y la adrenalina inicial, disfruté. Por fin, después de 2 años de mi primer formación de doula, a 3 meses de la capacitación de DONA, una mamá había confiado en mí, y yo estaba en las nubes de la felicidad, aunque sabía que el escenario no era el mejor.
“¿Viste todos nuestros planes? Bueno, los vamos a soltar.” Se lo dije a la mamá pero me lo dije a mí misma. Una hora después estaba en su cuarto, había bajado las luces, y comprendido que el deseo de la pareja era llegar pronto al sanatorio. Tenía media hora para llamar a las contracciones. Con la pelota, un poco de manteo de parte del papá y masajes, fueron llegando algunas contracciones, tímidas, como quien recién llega a un lugar nuevo y no sabe bien qué hacer. Respetando el deseo de llegar puntual a la institución (teníamos una hora o más de viaje), sugerí ir saliendo.
“Esperá, antes tengo que hacer cosas, alcanzame la planchita.” Ahí estaba yo, con una mamá a punto de internarse sin trabajo de parto, acompañando con profundo amor lo posible, lo real, dejando de lado lo ideal. Agarré la planchita y mientras ella estaba en la pelota, hice mi mejor esfuerzo para que no se note que soy casi inexperta en el tema (mi pelo es hiper lacio) y que me quemaba los dedos. Me tomé mi tiempo, esto era importante para ella, así que fue importante para mí. Al terminar ayudé al papá a que no se olvide nada, ella se puso perfume, llamó al remís y nos fuimos.
“No es nada del otro mundo, solamente hay que relajarse.” El remisero había sido policía, y había atendido él mismo 3 partos en vía pública. Hoy creo que el remisero sabe más de partos que muchos médicos. La energía en el auto estaba alta, había confianza y sonrisas, pero la mamá ya sabía que apenas pise el sanatorio, empezaría el baile del protocolo institucional.
“Vamos a tratar de que sea por vía vaginal, ¿sí? Pero igualmente vos sabés que en semana 37 el cuello está inmaduro y que la opción de la cesárea siempre está, ¿sí?” La partera le hablaba pero ella estaba en otro lado. Firmaba los papeles de la internación con tristeza, cada formulario era una expectativa que se iba, que debía entregar junto con su ropa de calle y la tarjeta de crédito.
“Todo es perfecto Clari. Siempre hay un plan más grande que el que podemos ver o entender.” El grupo de whatsapp con mis compañeras doulas atento, firme, douleando a la doula. El mismo grupo que respondió de la mejor manera cuando les pedí una foto de “Trabajo de parto en la cama” de Penny Simkin. Ya me habían dicho que no podía pasar, que por normas sólo pasa una persona, que es la misma que luego entra a sala de partos. Nos sentamos a esperar la internación, le pasé mis cosas de doula al papá, le di consejos, y le reenvié la información de Penny Simkin. Cuando la vinieron a buscar, el ánimo de la mamá estaba tan bajo que no supe qué decirle.
En la sala de espera había abuelas, tías, hermanas, parejas. Absolutamente todos los nacimientos de esa tarde/noche habían sido por cesárea, tantos que el quirófano no daba a basto. Lloré un poco y después me calmé, había dado lo mejor de mí y ya no podía hacer nada más que esperarlos afuera, pensar positivamente en ellos, rezar un poco, y esperar. Estábamos en el piso 10, miraba los números que indican en qué piso está el ascensor y visualizaba que era ella quien progresaba a 10. Escuchaba canciones melosas en la tele. Abría whatsapp, las doulas ahí, conteniendo, acompañando.
No hay noticias, buenas noticias. Le escribía al papá por whatsapp con imágenes inspiradoras, consejos, buenas intenciones, ellos sabían que yo estaba ahí. El tiempo pasaba, pensé que tantas cesáreas programadas (ay, los médicos, se acercaba Semana Santa) quizás le den tiempo. Cinco horas más tarde, veo pasar al obstetra, y luego sale la partera.
“Ya nació.” Nunca escribí tan rápido un whatsapp, las necesitaba, necesitaba a mis doulas, su experiencia era mi sostén; sus palabras, mi consuelo. Pregunto a la partera si estaba todo bien, me dice que sí, que no progresó y fue a cesárea y que podía pasar a verlos. Empiezo a bajar la escalera. Lloro, puteo. Caen mensajes de contención, de presencia amorosa incluso a la distancia, mensajes de doula. Bajo la escalera, contengo las lágrimas, espero a que salgan las enfermeras y el obstetra y paso a verlos.
“Viste cómo es esto, doulas, parteras, cuanto más sabés… peor es.” Pensé que había pasado lo peor, pero no, ahí estaba la partera, culpando a una mamá dolorida, cansada, aún bajo los efectos de la anestesia, poniendo veneno en el suero con sus palabras. Bajé las luces, acaricié a la mamá, y contemplé el amor más grande que existe, el que todo lo cura.
Titles and terms can be confusing when it comes to assessing a doula's experience, training, and certification. Did you know:
I am the first to admit, you don't need experience, training, or certification to be an incredible doula and make a difference -- we all start from a desire to serve. I value the doulas in my community and I honor the differences in our personalities and styles, interests and specialties. This is a work of the heart, and by following our instincts to care for a mother and family during birth, we offer unique support that helps build them up for the start of their parenting journey.
Why certify? Read what doulas and moms have to say about it.
This week I received notification that I, once again, passed the Lamaze International certifying exam (making me the only listed LCCE in Bakersfield, one of two in Visalia). In light of that, I was curious to know why as doulas and educators, we choose to extend the extra effort and resources to gain and keep these initials after our names? Sharon Muza offers her thoughts to this topic. Additional quotes follow from not only doulas, but also mothers. And my answer? Grievance policy, as strange as that sounds -- I appreciate DONA offering this, as it protects my clients, and it protects me.
I am both a certified doula with DONA International, CD(DONA), and a certified childbirth educator with Lamaze International, LCCE. I am very proud of the fact that I hold and maintain these certifications. I worked hard for them and it means a lot for me to have these credentials. Here are my top six reasons for certifying AND maintaining certification with well-known, long-standing, internationally recognized organizations:
1. Demonstrates my serious commitment to being recognized as a professional doula and childbirth educator.
2. Assures my clients, students, my colleagues and the health care providers that I work with that I have successfully completed the requirements for certifications as set forth by my certifying organizations.
3. My clients, students, my colleagues and HCPs are assured that I abide by and practice according to the standards of practice and code of ethics that have been established by well-known and well-respected certifying organizations.
4. It allows me to support the organizations that I believe in, with my membership and certification dollars, allowing them to work toward improving maternal infant health outcomes as a serious player on the national and international level with my support.
5. Maintaining recertification shows my commitment to receiving continuing education that is current and applicable, and demonstrates my desire to remain up to date with best practices.
6. Provides a grievance process for clients, students, colleagues and HCPs who might have concerns about my practice standards, actions or ethical behavior.
I am very proud that I am a certified birth doula with DONA International and a Lamaze Certified Childbirth Educator. I look forward to continuing to maintain these certification in the years to come. I encourage you to seek out reputable and well-respected organizations to align yourself with and pursue certification in a professional manner.
Sharon Muza, BS, CD(DONA) BDT(DONA), LCCE, FACCE has been an active childbirth professional since 2004, teaching Lamaze classes and providing doula services to hundreds of couples through her private practice in Seattle, Washington. She is an instructor at the Simkin Center, Bastyr University where she is a birth doula trainer. Sharon is also a trainer with Passion for Birth, a Lamaze-Accredited Childbirth Educator Program. Sharon is a former co-leader of the International Cesarean Awareness Network’s (ICAN) Seattle Chapter, and a former board member of PALS Doulas and Past President of REACHE. In September 2011, Sharon was admitted as a Fellow to the Academy of Certified Childbirth Educators. Sharon Muza has been the community manager, writer and editor for Science & Sensibility, Lamaze International’s blog for birth professionals, since 2012. Sharon enjoys active online engagement and facilitating discussion around best practice, current research and its practical application to community standards and actions by health care providers, and how that affects families in the childbearing year. Sharon has been a dynamic speaker at international conferences on topics of interest to birth professionals and enjoys collaborating with others to share ideas and information that benefit birth professionals and families. To learn more about Sharon, you are invited to visit her website, SharonMuza.com.
I have known Avira for almost a year now. I remember being struck by her professionalism, and entirely impressed by what she had built up, all while waiting and feeling frustrated at the lack of doula clients coming her way. She didn't sit around waiting for business, she went out and created awareness about doulas, and community for birth workers! I was amazed at what her passion and efforts had "birthed." Hopefully this is encouraging to anyone still feeling stuck in that waiting period between wanting to work as a doula, and actually working as a doula!
I had felt a tug since my own births, the first being over 12 years ago, that I wanted to be involved in other women’s births. But raising two little ones, dealing with special needs, and deciding to homeschool my children for a time, meant there was little time to give to this dream.
A new season in my life opened a way to my doula training at the end of 2011. It was intoxicating and surreal to be fully immersed in my favorite subject for a full weekend!
Afterwards I was left with the job to complete my certification steps and to blaze forward in this work, on my own accord, which seemed daunting, if not impossible. I was in an area that seemed to have NO birth community or even an awareness of what doula care is. There did seem to be a thriving little birth community about an hour away, but that didn’t seem very practical as a source to plug into, as our local moms would not be reaching that far either.
After a few months it occurred to me that I needed to start to round up some doulas to create a support circle. There were at least the ones I did the training with, and I had caught wind of a second nearby training that had taken place shortly after mine, so there MUST be enough of us to start a group! I sent out an email to everyone’s name I could gather, and the email got forwarded and forwarded, and soon we had rounded up a group of about 7 of us who were interested in meeting. We met at a local coffee shop and chatted up a storm. One of these amazing ladies, Coleen Salazar, was an experienced doula and IBCLC who had moved to our small area from San Diego several years ago, and was such a valuable resource for us! She welcomed us into her home for monthly meetings! From there we started our little Valley Doula Group, which ranged from 3-8 doulas a meeting. We would advance our education by digging into subjects and even have an occasional guest come and share with us. More than anything our purpose was to share and support each other on our various paths of birth work. This group was so inspirational and so needed for me. I would leave every night with my cup overflowing, by having others to share in my passion with me.
As months went by, as much as I tried to promote myself as a doula in the community, no births would come. I felt so frustrated. How am I going to be a doula if no one will choose me to be theirs! Even offers of minimal fees and sliding scale didn’t seem to work. Then it occurred to me… people are not going to hire a doula if they don’t know what one is!
Sadly, we live in an area where a very small percent of the population seemed to care about their childbirth experiences, very few even attend the low-cost or free childbirth education offered by the local hospitals. I knew that it had to start with education!
Where I had formerly lived, in San Luis Obispo, CA, there was a “Birth & Baby Network." I had browsed through one of their resource guides while sitting in the waiting room for an appointment with the CNM group who was providing my care. It was by browsing through that pamphlet, back in 2001, when I learned of the term doula, and became area of all my local pregnancy, birth, and parenting-related resources.
The idea hit me like a lightning bolt! We need a local birth network!! Ideas are funny how they hit you and they stick, and fester and grow. Well that’s precisely what happened. Soon I had the name chosen, the website purchased, began building it (thanks to my IT savvy husband!) and the beginnings of a birth network started to take structure. Now I just needed a team!
Surprisingly only one of the doulas from our doula group was as inspired as me: Denise Stricklind, a local doula, placenta encapsulation specialist, and birth photographer. Denise recognized the need in our area and was fully on board with my mission! Together we plugged away, like a full time job, how to establish a local birth network as a resource for support and education in our community.
Visalia Birth Network was founded in the late summer/early fall of 2012. Now, a year and half later, we have grown to 21 members, all various local professionals who support the Mother Friendly Childbirth Initiative, which is the cornerstone of the Coalition to Improve Maternity Services and birth networks across the globe. The 10 steps in this Initiative propose a wellness model of maternity care that improves birth outcomes and substantially reduces costs. Every member must endorse this document upon joining.
VBN offers free monthly educational meetings for our community. We have had topics like: 10 Ways to Avoid a Primary Cesarean Birth, Cloth Diapering and Baby-wearing, the Midwifery Model of Care, Perinatal Mood Disorders, VBAC: Can it be Done, Breastfeeding Q & A, and so much more. We also make a monthly appearance at our local farmers market to help integrate, and we also host some amazing events throughout the year such as the BOLD Red Tent (our 1st one coming this Saturday!), the Big Latch On, and the Rally to Improve Birth. We are a local collective of moms and professionals who care about birth experiences and who strive to make grassroots change in our community (you can follow us on Facebook if you’d like to keep up with our activities!).
I love the way VBN seems to be impacting our community. We are starting to have loyal moms, who come out each month, not only for the information but for the support circle that VBN provides. It’s a group where moms are met with nurturing, supportive, and a “come as you are” attitude. I believe moms are grateful for our presence.
And the other good news is that I’m starting to get busier with doula work! Our education appears to be working too! Moms are learning the benefits of doula care and the undeniable help that doulas offer at every birth. My hope is that this birth community we’ve created continues to grow and take hold in our area for years to come, and that our area moms and families continue to benefit from the access and support of caring perinatal professionals.
Avira has an expansive list of accomplishments! I just want to share what I know about her. She is eager to learn and eager to help. She has passion and talent. Avira's ability to rearrange her goals in order to maintain her love for doula work is the sign of her endurance and her creative thinking -- both excellent qualities on someone who supports families through the birth process! It has been a joy to work with her, and I have appreciation for what she offers to area moms, babies, and birth workers! Find her through her website, her Facebook page, VBN's Facebook page, and if you are an area doula, check out the Valley Doula Group.
I hear people ask this questions a lot. There seems to be the belief that for a woman to truly support another woman during birth, she has to have experienced childbirth herself. I say with testimony, there is not truth in this -- it is a doula myth. While it may be important for certain families to know their doula has passed through the rite of passage of motherhood, being a doula means one thing and one thing only: this birth is not about you. And guess what? You have more of an opportunity to make it about you if you have had your own birth experiences! Read more to see why Amber feels confident in her abilities; just because you haven't mothered your own baby, doesn't mean you lack the heart and hands to mother someone else!
When I am being interviewed by families seeking a doula, I often get this question: “So you do have any children?” I smile sweetly and give my standard answer, “No not yet.” I know this question will come at some point during most interviews.
It used to be a question I dreaded. I used to have this nagging voice in my head “Why would they want to hire you? You’ve never given birth, and there are plenty of other doulas who have that experience.”
These days, though, my internal chatter has stopped. I know that regardless of whether or not a woman has given birth herself, she can still be a phenomenal doula. In fact, I think I have a couple perks to offer, since I don’t yet have children.
#1 I don’t have to worry about childcare. This is a big one! Many, many doulas out there that have children need to coordinate who’s going to watch little ones, drop off and pick up from school, or take care of a sick kid, if they get called to a birth or postpartum situation last minute. Being on-call can be challenging in and of itself, and not having to worry about kiddos yet may mean that I am more immediately available to families.
#2 I don’t have any baggage from my own births. Many doulas that have given birth are able to put their own birth experiences, joys, and struggles aside and simply focus on the family they are serving. But this can be challenging. Perhaps a doula wishes things had gone differently during her birth, and she may subconsciously steer her clients toward birth choices she herself made or didn’t make. Without any previous emotional ties to my own birth experience, I can fully hear families’ wishes and support them in their ideal birth or postpartum time.
Many women take an interest in doula training after they themselves have given birth. Maybe their birth was a life-changing ecstatic and empowering event, and they want to share with other women the potential for birth to be wonderful. Or maybe they had a challenging birth or postpartum time that they wish they could go back and do differently. As I do not have children yet, I come to doula work with a different background, although I share the same passion all doulas have for making birth and the postpartum time as empowering, positive, and supported as it can be.
My first experience with birth was witnessing my mother giving birth to my little sister when I was 13 years old. She had Maryann in a nice hospital in Southern California. I was at the hospital while my mom was in labor, but I wasn’t much interested in it. I remember she was in bed, on her back the whole time (or so it seemed). I was in the room when an epidural was placed, and I remember her vomiting a lot. All in all, labor looked like the pits. I remember there were a few family members in the room, but no one seemed to really be helping her. I remember everyone sitting around chatting, knitting, doing crossword puzzles. I remember thinking if I was in my mom’s shoes I would yell at everyone to either get out, or to get off their butts and do something like give me a massage!
After seeing enough of what looked like a hellish labor, I went out to the waiting room until my aunt came and got me when my sister’s arrival was imminent. The birth went by quick, and I don’t remember many details, other than holding my little sister soon after she was born. It was the labor that stuck with me; I was convinced that I never wanted to go through what my mom went through.
Fast forward to when I was 21 years old. Some of my girlfriends started having babies, and when I asked them about it, they all had horror stories. Most of them had cesareans, and seemed to think that if not for their cesarean/OB/other decision, they would have died or their baby would have died. I started adding these stories up, along with the memories of my mom’s birth, and it just didn’t make sense to me.
If birth was so exceptionally awful, how had all the generations of our ancestors made it through? This little idea started to develop in the back of my mind that maybe birth didn’t have to be so scary and dangerous, and gut-wrenchingly painful.
When I was 22, I had just gotten out of a yucky relationship and was kind of in a rut. Being close to my mom, she was privy to my interest in my friends’ birth experiences, and she suggested I complete a doula workshop that was coming to town. When she first sprang the idea on me, I wasn’t convinced it would be neat. I thought doulas were like woman shamans who attended births and oversaw the spiritual aspect of birth; was I up for that?
But by the first hour after my doula training began, I realized doulas were not old-lady shamans, we were the reclaimers of the potential for positive birth experiences!
I’ve been a birth doula for six years now and a postpartum doula for one year. It truly is my life’s passion to help every family have their best birth and postpartum experience as they define it.
Amber is one of my most favorite doulas. She even volunteered to come be my doula after I moved 6 hours south of her! I didn't take her up on it because with a baby coming, it seemed that might be hard to count on. But I love and appreciate her just the same, and I know she would have been awesome for me.
"I come to this field as a woman, and as a daughter. I am a teacher, and also a student. A former aspiring elementary school teacher, I was drawn to this work after hearing stories from my young mother friends who had less than ideal birth experiences. I truly know that a positive and empowered pregnancy, birth, and postpartum period is integral to creating a more compassionate species."
Find Amber online at her website or her Facebook page.
Tesa is a doula who, after my recent move, gave me my first insight into the local birth climate. She has such a passion for helping moms and babies through pregnancy, birth, and breastfeeding, working with families to ensure they have positive, safe experiences. A mother herself, with a 10 year career in the Air Force, she has an impressive story of how she even ended up in the birth world. She is currently overseas getting practical training to become a midwife; I appreciate that she took the time out of her educational pursuits to share this with us.
I discovered soon after training as a Doula that I wanted to pursue Midwifery. I was told by many my Doula experiences would translate into my midwifery training and the experiences of supporting Mothers in the hospital would be immeasurable. I focused intensely on how to interpret a woman’s body language during labor. I knew from experience that most women did not communicate their emotions or physical discomforts throughout labor. I knew that I needed to get good at feeling what she needed. I did not realize the extent of this intuition that I developed until my experience while interning for my midwifery clinical requirements.
Our family decided that I would take an opportunity to travel abroad to volunteer at a birth home in the Philippines for my clinical experience. I was a bit nervous about the language barrier, even though I was assured that most of the mothers spoke English to a point which we could communicate. I planned to learn basic phrases before I set out. Of course life was busy, and a lot of other preparations became a higher priority. So I landed in the Philippines without even knowing how to say hello. I know, bad planning on my part. Luckily I was met at the airport by an American and was never in a sticky situation where I needed to speak Tagalog (the language spoken by Filipinos). From the airport I was taken to the birth home where I met the other American Interns and the Filipino Midwives. Again no need for language skills there either.
The next morning I was integrated into the prenatal check up routine, and that’s when it all came and smacked me in the face. I quickly realized I needed to learn how to communicate with these women if I was going to assist in their care. So where am I going with this? Well after a few weeks I was ready to start attending births as student under supervision, and again I was nervous about communicating with the mother. How would I know what she was feeling? Up to this point my training had focused on the physiological changes to observe that would help me assess the stages of labor, the health of the mother, and fetal well-being. My first birth was a bit of a blur, but the second birth I settled into a very familiar role as this Mother immediately connected with me.
Reflecting I can recall the moment when I understood not a single word she said to me but I could feel everything she needed from me. My Doula heart took over the emotional and physical care of this mother as she labored hard and just needed to feel safe in her moment of vulnerability. I did not need to speak in her language to support her. I was able to express that I was there for her by not leaving her presence. With sincerity in my touch I think she was able to feel safer and more relaxed. I helped her with breathing patterns and movement, only through demonstrating it myself first. These unspoken instructions quickly helped her gain control of her labor and gave her confidence in her ability. Holding her hand through contractions, reassured her I was not leaving. Simple nods from me seemed to confirm to her that everything was normal. No words were required between us; it was a dance of sharing a common goal to bring her baby into the world safely and peacefully.
It’s now been almost 3 months since I have been here in the Philippines and I have since learned many useful Tagalog words to aide me in communicating with woman in the prenatal as well as labor and birth. Like sakit and pwerta, go look them up. Now more than ever I realize the value of my Doula experience, and how it will always be a part of me as a Midwife. The ability to communicate without words extends across many roles in life. I’m very grateful for my experience here and the woman that have allowed me to stand, rock, moan, and cry with them as they birthed their babies. They have given me more than I have given them, and I will hold it close as I move forward to serve many more.
Tesa Kurin is the mother of 6 wonderful children, each different in their own way. She believes that every pregnancy is different and every Woman’s needs are different. Tesa also believes you have the right to choose your birth path. Whether you choose to give birth in a hospital or home, she will provide you with the support and information you need. Find her through her website.
♥ four young boys and a boy dog (offspring)