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: 

• Sometimes an organization requires a person attend a live training, where formal instructional hours that can be counted as college or other professional credits are offered, as well as hands-on practice of techniques.
• A program might be strictly home-based where books and other materials are what provide the education.
• Some organizations offer online programs.
• Organizations may have hydrid programs, which may make up a combination of all three of the above.
• For some programs a doula must attend births where it is noted they are in-training, and they receive feedback from the medical professionals and the families they worked with.
• Other programs deem the doula is good to go once their training materials are completed, even if they haven’t attended any births yet.
• There might be a test at the end of a program to see if the doula has remembered the things they learned, or there may not be.
• Some programs require recertification every so often, and generally recertification is comprised of proving the doula has obtained continuing education or a certain number of reviewed births.
• Other organizations say the doula now has a lifetime certification without any further proof of staying current with changing medical practices and new information.

​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.

• DONA is the pioneering doula organization, they have been around a long time.
• They only deal with doulas, and I feel this makes their focus more direct and undiluted. This allowed me to diversify my professional portfolio by going to other single-based organizations, where again, each organization practices only within the realm of their specialty (in my case, Lamaze, La Leche League, and Lactation Education Resources).
• DONA requires recertification every 3 years where continuing education is documented.
• DONA has a Grievance Policy which protects me and it protect my clients.
• DONA has a Code of Ethics and a Standards of Practice, which again, serve to protect me by giving me firm guidelines in how to act and work as a DONA Doula.

​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!

I've been a doula for over 10 years. I've seen a lot of doulas come and go in this profession for many reasons, but the one reason for leaving doula work that always hits at my heart, is when other doulas say "There's too much competition". I wish to flip that perception.
 
​Take a step back, and think of where you heard the term doula. Was it from a friend? You're own birth? In the news? Chances are, it wasn't a common discussion, no matter where you heard it.

Statistically, in the US (because nothing is coming up for Canadian doula stats) only 6% of birthing families chose to have a doula. If we are talking about over saturation in the job market, that number would be a lot higher! It also goes on to mention that another 27% would have liked to hire a doula.
 ​
I like to look at that as a challenge. Obviously, we know that the word doula is still relatively unheard of in most mainstream circles. For as long as I've been a doula, I still run into people that say - I don't know what that is.
​
How do we change this? How do we get the word doula to roll off the lips of every beautiful birthing person? This is the challenge; to make it part of everyday conversations.  The way for it to make it into more conversations, is if it becomes the norm, and a way to make it the norm, is if there are more doulas! Abundance.

I often share fellow local doulas info, blogs, etc on my business page. I have people ask me all the time why I do this. Why should I share and promote the "competition". To that I say, until every family on this vast planet knows what a doula is and does, I will keep sharing. I share because I'm not the right doula for everyone. I share because my doula sister has some great info, I share because even if I don't get the client, I know they are getting who they need and now one more family has doula support. One more family can now share the word doula with honour and love. Abundance.

I'd like to change the word competition (rivalry for supremacy) to abundance (overflowing fullness). If we believe that we do this work out of love, then we need abundance. The world we raise our children in, that we bring future parents into, needs more love. By believing in abundance of love and support we all win. 

When we flip the idea that other doulas are competition, we lose the fear, we start to see how strong we are. We start to see the tribe of support that stands around us, holding the space for big things to come. That there is strength in numbers, and with those numbers, we have the power to create a birth world revolution. ​

​Natasha is the mother to 4 spirited children who, along with their dogs, cats, and reptiles reside in Spruce Grove Aberta, Canada. 

Natasha has been a practicing doula for over 10 years, and has worked in all Edmonton area hospitals, along with the local Lucina Birth Center and home births. 

She takes her role as doula very seriously, and in doing so she is forever upgrading her skills.  Natasha has taken training through DONA, Stillbirthday University, and GK University. She is currently enrolled in The Cultured Doula Program, and has recently completed her Masters Rebozo with GKU. As a placenta specialist she trained with PBiU.

Natasha can be found at Supermomma Doula & Placenta Edmonton, and her Facebook page.

Through almost a decade of discussions with friends and family, this has been the most frequent question asked: what DO doulas do? A loaded one. In the few instances where someone does know the word doula, I typically see generalized notions picked up from media, college, or that hippy-dippy aunt of yours that had her baby at home, such as labor and delivery support, birth assistant, maid, personal assistant, stand-in for unsupportive partners, etc. And while I could speak on the subject for days, I often find myself explaining over and over again how integral a doula can be in any birthing experience from a planned cesarean to an unmedicated home birth, even a high-risk pregnancy and loss of pregnancy. Doulas wear many labels, often times several: birth doula, postpartum doula, antepartum doula, bereavement doula, etc. This led me to find out what the leading experts say about the modern-day doula.

In the fourth edition of The Birth Partner | The Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions, Penny Simkin states:

"The [birth] doula is on call for you, arrives at your home or the hospital when you need her, and remains with you continuously, with few or no breaks, until after the baby is born. The doula is trained and experienced in providing emotional support, physical comfort, and nonclinical advice. She draws on her knowledge and experience as she reassures, encourages, comforts, and empathizes with the mother."

Ann Douglas, in The Mother of All Pregnancy Books, writes:

"[Postpartum doulas] offer a similar service [as birth doulas] during the postpartum period, providing hands-on assistance to new parents during the first few days or weeks of parenthood. Postpartum doulas are “jill of all trades,” who bring a range of different skills to the table."

The Doula Book, written by Marshall H. Klaus, MD, John H. Kennell, MD, and Phyllis H Klaus, MFT, LMSW, explains:

"…a doula needs specific skills and insights. A successful doula is comfortable with giving of herself and is not afraid to love. She also can enter another’s space and be highly responsive and aware of another’s needs, moods, changes, and unspoken feelings. At the same time, she is able to be flexible in this process, adapting herself to each mother’s needs, and has no need to control or smother."

Clearly, there are a wide-range of definitions available for a doula, and often times doulas vary in what they offer to clients and their families. I’m reminded of a term I learned while watching animated films with my husband and son: Inbetweeners. In animation, these are assistants to the animators that ‘fill in’ drawings around the key frames to maintain smooth evolution from one to another. Just like a doula, they do not control the story line (that’s left to the writers, directors, editors, etc.), rather they assist progression to accomplish the end goal of a successful film. In birth, doulas are the Inbetweeners.

Doulas do the inbetween work – applying counter pressure on mom while she leans on her partner, managing meal prep and household upkeep while mom, dad, and baby adjust to their new life together, offering words of encouragement during a challenging transition. She does not control your birthing experience. You may not see her in birth photos (just like we rarely notice credits for Inbetweeners), but she is there, assisting progression to accomplish the end goal of each mother.

Her face isn’t what you’ll carry with you. A birthing experience void of confusion, desperation, frustration, or regret is the ultimate service of a doula, and this is a passive one. She is dedicated to facilitating an experience as close to the wishes of the mother as situationally possible.

What DO doulas do? Everything inbetween.

​​Erica Verbeck, born and raised in Southern Indiana, is the owner of Doula the Damn Thing. She earned a Bachelor of Science in Communication and Culture with studies in Anthropology, Family Studies, and Early Childhood Education from Indiana University.

She values homeopathic restoration of our natural bodies through healthy diet, minimalism (work-in-progress), and unschooling her toddler. She works to balance her traditional upbringing with the ancient methods of our predecessors to enlighten her journey through pregnancy, birth, and motherhood.

​When not playing with her young son or discussing birth and babies, Erica enjoys wire-wrapping jewelry and reading the latest research on pregnancy, birth, and parenthood. Through a mother's most intimate and primal journey, she hopes to build a trusting and informed birth experience for all who desire one. You can find her through her Facebook page​doulathedamnthing.com, or her website, Doula the Damn Thing. 

​I worked with somebody once that had a definite “bubble” of personal space. It was kinda fun to subtly test the limits of those boundaries. I finally determined, through months of occasional observation and experimentation, that the space was 3 feet. Step, even 1-inch, into that invisible 3-foot force-field, and my subject would move away to reestablish the 3-foot bubble.   

I, too, have a bubble.  When it comes to supporting a woman in childbirth, I temporarily deflate my bubble to support my client AND the rest of her support team. Conversely, I understand that my client may also have that bubble.  So, how does that work in such a short amount of time and in such an intimate setting?

​Simply being Probably the most important. The care team for my client become protective. We hold the space, her privacy, her concentration, her focus, her rhythm, her ritual, HER ever-evolving strategy for bringing forth her infant into this world. In the early stages of labor, a knock on the door is a welcome distraction. In the final stages, a knock on the door is met with looks of annoyance and protective aggression.  

Birth is a short, intense, intimate journey. Some are “mush longer den udders.” Sleep deprivation joke, get it?!? Guffaw, snort! Emotional support begins long before labor begins. Physical intrusion into the bubble is typically a gradual process, becoming more involved as the intensity of labor calls for more support and the temporary removal of the bubble. Informational support never ends. Doulas aren’t medical experts, but we are quite familiar with the key terms to know in the chapter of life called the Journey to Parenthood.

What do you remember of yor births? Are there thing you would change? Things you are surprised you did that didn't follow what you learned about or expected? In this feature, a doula shares her birth story with additional hints and advice as seen through her professional lens -- what a great idea!

I felt so loved and safe and cozy in our room after that epic experience.  BirthCare is like a hotel with midwives.  The food is delicious and plentiful, the midwives help you establish breastfeeding, and there are educational video streams on the TV in your room.  It makes me so upset that mommas of O’ahu don’t have access to the same maternity care experience covered by insurance.  You can hire a home birth midwife and pay out of pocket for a similar set up.  I count myself monumentally blessed to have been living in that part of New Zealand with my incredible midwife and our amazing natural birth experience at BirthCare.  After three nights there, we headed home with our treasure.  My midwife visited us at home for the next 6 weeks to check on my stitches, help with breastfeeding, and track Madam Blueberry’s growth.  We did well.  My husband had two weeks off work, then Mom and Dad came from Hawai’i for two weeks. We cherish this birth story and are so grateful to our midwife and all the midwives at BirthCare.  DOULA TIP: postpartum blues are normal and the American maternity system is NOT mom-centered.  Ask for help.  A postpartum doula can provide references to services and can support you with newborn care, routines, sleep solutions, etc.     
 ​

​Although doulas are increasingly popular additions to the birth team, not everyone is clear on what they do for a birthing family. There are several useful analogies out there, but the comparison of a doula to a real estate agent is less discussed. So here is my attempt, 10 ways a doula is like a real estate agent!

1. The doula's goal is the client's goal.
Just like your real estate agent is not searching for his/her perfect home, your doula is not pushing her perfect birth onto you. Your doula will get to know you before your birth as much as possible, so s/he knows what you want in your birth.

2. Your doula can help you navigate your options.
Your real estate agent knows her/his local real estate market, just as your doula knows his/her local birth market. Your doula can help you find the best birthplace to fit your desires, just as your real estate agent can help you identify your ideal neighborhood.

3. Your doula is up-to-date on the current market.
Your real estate agent will know how properties are selling currently. Your doula will be familiar with local maternity care.

4. Your doula knows what to look out for to help you have a positive birth experience.
Just as your real estate agent knows what items to ask for on your offer (the appliances!), and whether or not the cracks in the plaster walls are something to fret about, your doula will know what questions you need to ask in order to make informed decisions. 

5. Your doula is trained and experienced in the field.
Even a brand new doula without children of his/her own has received extensive training in both normal childbirth and its variations and complications, and in caring for childbearing women. Just like a real estate agent has been trained in navigating the real estate market. 

6. Your doula will support you if you change your mind about what you want.
Just as your real estate agent will continue to help you if you change your property search criteria, no matter your reasoning, your doula will support you if you change your mind about choosing that hospital, or planning an epidural, or having a waterbirth. 

7. Your doula will offer his/her advice, but you are the decision-maker.
A real estate agent will offer her/his advice when pricing a property, or writing an offer, but you are still the one making the sale or the purchase. Your doula will remind you when you stray from your birth plan, but this is your birth, and your baby. 

8. Your doula knows where to go for complementary pregnancy and birth services.
Your real estate agent knows the title companies in your area, the lenders, the exterminators, the inspectors, and has worked with them before. S/he can help you find a reputable professional in your property-selling/purchasing process. Your doula knows the chiropractors, the accupuncturists, the prenatal yoga instructors, the lactation consultants, the babywearing groups, the back-to-work support groups, in your area, and can help you find perinatal professionals in your area to help you.

9. Your doula will walk you through the entire birth process.
Just as a real estate agent will assist you through the entire purchase or sale, your doula will help you from the earliest inklings of Birth Day through the first couple of hours postpartum. Whether her support is over the phone, email, text, or in person, your doula is supporting you the entire time.

10. Your doula follows up with you after your birth and helps you adjust to your new family.
Your real estate agent will follow up with you after your sale or purchase to make sure everything continues to go well, and answer any last-minute questions. In the years after your property purchase, you can even contact your realtor for referrals on remodeling projects! Your doula is the same way. Just because your contract period has ended with your birth doula does not mean you cannot contact him/her again! For example, the definition of postpartum depression is any depressive symptoms in the year following the birth. Your doula wants you to be well, go ahead and reach out to her if you need anything.

​Driving home from a birth or a late-night home visit, it’s quiet.
The car, my mind, the road– the same sort of weighty hush surrounds me that accompanies a snowfall at midnight.
The cobweb-cones of streetlights in the fog reach out for my car as I pass the dark trees on either side, making my way to my bed. The road shines in my headlights and gets dark. A bit beyond that, it’s lit a little by the moon and an orange brush of the lights ahead.
It’s this time when I think the veil is lifted just a bit. I’m jangled and frayed, having ridden the adrenaline and oxytocin and catecholamine waves with the family I’ve just come from serving.
I’m tired, and I’m quiet, so I’m listening. Connected.
In my exhaustion and exhilaration, it sometimes feels like something is standing just behind my left shoulder, just at the edge of my perception. I can all but hear the ebb and flow of life like waves crashing on a beach miles away.
Right now, someone is being born.
Right now someone is dying.
Birth, death, over and over and over again.
It’s endless- but these moments are so singular and defined. Everyday miracles, I guess, but those words fall so short.
It feels a little bit like sacrilege--  tapping into the pulse of the world.
When I get home, I pull off my shoes and grubby birth clothes, leave everything in a pile on the bathroom floor and slide into bed like nothing happened at all.
It’s just another night of work.

​As doulas our profession is one that is infused with passion. We are passionate about the families that we serve and the beliefs that we hold, but unfortunately a doula’s passion does not always translate into professional communication. There seems to be a never ending obstacle course for doulas in their struggle to conduct themselves in such a manner that honors the profession that they have chosen. Unprofessional conduct from doulas spans from scope of practice violations to lack of respect towards fellow doulas and other providers such as nurses, midwives, and obstetricians. How many times have you read a doula’s post criticizing a nurse or provider’s actions at a birth she recently attended? Have you met a doula who is quick to speak negatively about another doula behind her back or criticize a doula for doing things differently? Doulas then wonder, “Why isn’t the nurse more accepting of me?” or “Why doesn’t that doula refer clients to me?”
 
Unprofessional conduct is not only an obstacle to a doula’s personal practice, but it breaks down the level of professionalism within the doula community as a whole. Professional conduct is actually an easy skill to master. At the heart of professionalism lies communication. With the advent of electronic communication, personal communication skills have seen a significant breakdown. If you don’t use it, apparently you lose it. Luckily, by adhering to the following communication 101 principles a doula can maintain a level of professionalism at all times.
 
1. Think before you speak/act/email. Remember the old adage to count to 10 before speaking? Turns out that this isn’t just a line your parents made up but is a timeless truth. Taking a moment before responding, whether in person or by electronic communication, can easily avoid a knee-jerk response that can cause irreparable harm. When it comes to electronic communication, think about whether you would actually say what you are typing if the person was sitting in front of you.
 
2. Speak with integrity. Choose your words carefully! Avoid words that intentionally inflame or create gossip. Ask yourself, “Is this how I would like to be spoken of/about?” Keep private subjects private, and avoid flaming or gossiping about other professionals in public forums.
 
3. Keep your promises. If you say you can back someone up, help with an event, etc., then do it. If you aren’t sure, don’t commit. Be clear when you communicate expectations around working with other professionals so that miscommunication doesn’t cause you to go back on your word. Don’t leave other professionals or clients in the lurch.
 
4. Don’t Assume. I am sure you know the expression about assuming! If you are ever unsure, clarify with the person directly, and by directly I mean in person as long as it is conceivably possible. While electronic communication can be an effective tool for a quick message, tone and body language are totally lost and these are integral to meaningful conversations. To not take the time to sit down and talk in person might send a negative message about your level of professionalism and respect for clients or colleagues, no matter what profession you are in.
 
5. Treat others the way you would like them to treat you. Is the provider at your client’s birth less than pleasant? Is a particular doula not giving you a warm fuzzy? You have no idea what that person has gone through that particular day. Maybe that person is struggling. Perhaps their loved one is critically ill. Perhaps they have been up for 24 hours working non-stop. Rather than taking it personally and speaking ill of that person behind their back, try extending that individual some grace and empathy. Ask yourself, “How would I like to be treated?”
 
By following these communication 101 skills, you can not only improve your own personal practice, but you can also help to further the level of doula professionalism as a whole. Be an advocate for all doulas by starting with your own professional conduct!