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!
I have often thought I need that wonderful old t-shirt, "Frankie say relax!", to wear when I am teaching classes or attending a birth. Could you imagine? I often joke that telling someone to relax is like telling someone to calm down -- it isn't helpful, it irritates people, and it often feels accusatory or as if someone overreacted to something. In labor we must learn when to actively relax, and when to work -- here Connie offers her thoughts on the subject.
If you were to believe the movies –- coping in labor means that you look like “The Buddha of Birth.” You sit in a lotus position, gently breathing, eyes closed. People in the birthing room often think that if the laboring person is doing well, they are completely quiet and deeply relaxed during each contraction.
While that might be nice, it is an unrealistic expectation of someone who is working hard! And that is what Labor is – Work! When I go to the gym, I see lots of people working hard. They don’t look relaxed at all. They make noises, move around and look to others for encouragement and assistance. Why do we expect less of a person giving birth?
Real coping in labor often looks and sounds like someone at the gym, especially during a contraction. But remember, a contraction lasts for about a minute. Then there will be several minutes that there is No Work to Be Done because the contraction is over. That is when we can relax!
Having a doula there to remind to you let go, release, and relax between contractions helps you to feel more in control. It allows you to rest and restore, so that when the next contraction comes, you have more energy to work with it -- more confidence and less fear.
It may help between contractions to think: “My forehead is relaxed. My shoulders are dropped. I sink down into my pillow. I am at rest.” Your support team can say these words to you to help you relax when you actually need to. In this way, then (if you want to be!) you can be “The Buddha of Birth”!
Connie Sultana is grateful to the 900 families that have taught her about relaxation in birth. Connie is a DONA Birth Doula Trainer, former member of the Board of Directors of DONA, a Lamaze Childbirth Educator and a trainer for Passion for Birth, a Lamaze Accredited Childbirth Educator Training. Learn more about her by visiting her website.
Today Sharon Muza shares one of her most embarrassing moments as a doula. We can all recall our missteps -- those times we wish we would have done something a little differently, said something else, or held that poker face a bit more tightly. We are human, and these things will happen. All we can do is laugh at ourselves when appropriate, and try to do better the next time!
As a doula, I always try to do my best. And sometimes, doing my best results in funny outcomes. I am sure that we all could share a funny story or two about our birth work. This is one of my favorites.
I had been at a birth of some clients. I was with them for about 15 hours. It was a perfectly normal birth, things moved along as they should, and a baby was born. I took my leave at the appropriate time, said my goodbyes and made my way home to rest and return to the rest of my life, which as you know, had been put on hold. It was mid morning, and I took a quick nap, thinking I would just go to bed early that night.
Another baby had a different idea. I received a call from a client about four hours after I got home from that first birth and soon joined another family at a different hospital. This birth took a bit longer and I was with family number two for about 24 hours, including through what was now my second consecutive night of missed sleep.
This baby arrived and once again, after providing post birth support, I began to say my goodbyes with baby number two and its family. It had been a long 24 hour birth (after a long 15 hour birth) and I was now officially and totally wiped out and ready to throw myself in bed for a long sleep.
As I was heading for the door, I looked back over my shoulder for one last goodbye. I called out “Goodbye Samantha, goodbye Jason, I will talk to you tomorrow.”
Before I could open the door and go through it, the dad called out to me. “Oh Sharon, by the way, my name is Kyle, not Jason.”
I stopped dead in my tracks. What?!?! I had been calling him Jason for the past 24 hours. How could his name not be Jason. Then it hit me. Jason was the name of the dad from the first birth I was at, the day before. This indeed was Kyle. I had called him the wrong name probably a 100 times over the past 24 hours. On the day of his child’s birth, the doula had called him by the wrong name every single time.
I was mortified when I realized what I had done. But why did no one correct me. Not the birthing person, not the partner, nor any hospital staff. Not one person questioned why I was calling Kyle by the name Jason. I had never realized my mistake due to my exhaustion and back to back births with Jason.
I did not know what to say. I mumbled some apologies and rapidly shuffled out the door. I was stunned and ashamed. What a fool.
When I saw them next at the postpartum visit, we laughed, sort of, at my mistake. They told me not to worry. I worry about this to this day, probably ten years later. I wonder why he never told me that I was using the wrong name? Why wait till I was walking out the door? I can laugh at it now, but I am still completely curious why I was not corrected. Strange but true.
Have you had strange or funny things that have happened at the births you have attended? Please share in the comments below while respecting client confidentiality.
Sharon Muza, BS, CD(DONA) BDT(DONA), LCCE, FACCE, CLE has been an active childbirth professional since 2004, teaching Lamaze classes and providing doula services to more than a thousand families 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. In September 2011, Sharon was admitted as a Fellow to the Academy of Certified Childbirth Educators. In 2015, Sharon was awarded Lamaze International’s Media Award for promoting safe and healthy birth. Very active in her community, serving in a variety of positions that promote maternal-infant health, 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 an engaging 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.
It can be daunting to try and show the world how you differ from other doulas -- and this can often set us up for competition. In Day 4's selection, Natasha Longridge shares her feelings about the race between doulas, and how we can realistically shape our ideas about competition.
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.
Recently I was asked to doula a fellow doula for her upcoming birth. A close member of her family, who supposedly knows what doulas do, asked, "So Stacie is going to deliver your baby?" This pregnant doula was exasperated by the question, because she has explained many times to her family members (who have been her biggest supporters) what she does when she is hired by families -- and that is always punctuated by, "we don't deliver babies." Erica shines a new light on the answer to this question, and the idea to me is lovely and accurate.
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 pagedoulathedamnthing.com, or her website, Doula the Damn Thing.
Anne is one of my most favorite doulas in the world. I wish we still lived close to each other so we could work together. She has a different way of looking at things, which makes them more memorable and easy to understand. I thought this post was a great one to end on -- it shows how we can let go of the discomfort that might normally accompany us when it comes to being around and touching others -- as doulas, this is what we do. Enjoy, as Anne shares how she bursts her bubble.
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?
In a combination of ways. Conversation, empathy, care-taking, simply being, and sometimes, sleep deprivation.
Conversation and sleep deprivation Labor room conversations, at least the ones influenced by my quirky personality, can be hilarious. The people in that labor space learn things that –- well, let’s just say that things that happen in the labor space, stay in the labor space. Humans are social. Somebody has a story about skunks, everybody else has to share their story about skunks or some other wildlife interaction, which leads to some other topic like nudist colonies and the technicalities of furniture cleanliness in regard to naked rears. Sleep deprivation just makes it all that much more entertaining. People start shlurring theyr wors an mis..misum.... an people don hwere tings wite.
Empathy I have huge amounts of empathy. The people that have chosen, or have been chosen, to be in the labor space care about the mama in labor. We all want to make the experience easier in whatever way we can. We cheer her on, we give her water, we massage tense muscles, and tell her how beautiful she is. We acknowledge her perception of her experience and help her to see the big picture. We all get giddy when her efforts culminate in 10 glorious centimeters of openness. Pushing is the best. Everybody breathlessly tells her that is the way, just like that, good job…and we grunt and we hold our breath and we push too!
Care-taking The bubble slowly deflates with a soothing of a brow. Light massage. As labor intensifies, the bubble deflates completely. It becomes all hands on deck. Time for position change; one person holds IV lines, another person holds the blankets for privacy screen, another person changes the chux pad, another person physically helps mama roll, the person holding the IV line passes a pillow to the person helping mama roll, the person holding the privacy blanket then wipes mama’s brow with a cool washcloth, and the nurse readjusts the baby monitor-ducking under the person giving the mama a sip of water. All bubbles deflated, we are all up in one another’s business!
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.
Anne is the youngest of 6 children, which is probably why she gets along well with people. She also grew up on a dairy, which is probably why she gets along with animals. She has two daughters, and is a volunteer 4-H Community Leader. She was one of the original creators of the Chico Doula Circle, volunteered for a hospital-based doula program, and offers gratis support to expectant teen moms. Anne is currently waiting with bated breath to see if she passed the Lamaze Exam to be a Certified Lamaze Childbirth Educator. Find her at Happy Pushing or on Facebook.
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!
On my first born's 6th birthday, an idea popped into my head to share the story, but this version will be injected with Doula Tips and new discoveries I’ve made since being a natural health educator.
When you get to know me, you know that I’m a big planner. Fortunately, we got pregnant the first month of “trying”. I took the pregnancy test in the morning, saw the + sign and danced with delight. I brought the test into our room to share the news with my husband. We instantly prayed together to thank God that pregnancy happened easily, and asked Him for health and well-being. I didn’t experience morning sickness. There were a handful of times I needed to vomit in the morning, but as soon as it came up I was ready to rock ‘n roll. I figured out that I was taking my prenatal vitamin on an empty stomach, first thing in the morning. DOULA TIP: purchase a natural prenatal vitamin.
One issue I experienced was the increase in headaches around the beginning of the 2nd trimester. My midwife advised I needed to drink more water. I remember one day driving home from work, and I had to pull over and vomit in a plastic bag because my headache was throbbing. Ouch + ick. The headaches didn’t last long. DOULA TIP: essential oils can address head tension. I wish I knew about them when I was pregnant the first time.
I have fond memories of prenatal yoga. It was so fun being surrounded by other mommas and baby bumps. Another great experience was our antenatal childbirth education class provided by BirthCare. It’s a 6-week class and they structure it so you have a coffee group once all the babies are born. We met weekly for about a year (when we all went back to work). To this day, these mommas are some of my favourite people in the world and I miss them dearly. DOULA TIP: create your supportive group of peers while pregnant.
Her due date was Friday … but she arrived three days early on Tuesday.
I woke up before midnight to use the restroom and when I wiped there was a “bloody show”. Exciting! There were mild tightenings, so I went to the living room to watch the wall clock. Sure enough, those tightenings were coming and going every 10 minutes. I remember our midwife telling me to sleep at night and not wake my husband (if at all possible). DOULA TIP: let your partner sleep and you really need to sleep too!
Back to bed I went to try to sleep, but let’s be honest, this is an exciting moment. I laid in bed, took a nap, then eventually woke Brad around 3am. In his delirium, he started to pack and wanted to throw things into the car. I laughed at him and just told him to calm down because it would be a while before going to the birth center. Brad started to time the contractions. We got ourselves organized, packed the last minute items, made some toast and a smoothie, and walked around the house. At 7am, we called the midwife to tell her what was happening. She encouraged us to keep moving at home and call when the contractions got closer together. I got into the shower, washed my hair, shaved my legs. I had rented a TENS machine, so we tried that around 9am. This was not comfortable for me, so we ditched that. Bummer that we wasted over $100 to rent it. DOULA TIP: ask your maternity provider about TENS because this can be an effective pain management tool for you.
We put on a Grey’s Anatomy as a distraction… do you remember the theme song? When you play the DVD, that song just keeps rolling over and over again until you press “play” so that was on in the background as the contractions started to get more intense and closer together. My husband was amazing. We found a groove of him massaging my lower back during the contractions.
After talking on the phone again with our midwife, she agreed it was a good time to head to BirthCare. We arrived around 11:30am and she said I would probably have to leave because I was smiling upon arrival. When she did the vaginal exam, I was 6cm dilated. She filled up the birthing pool (huge, Jacuzzi style tubs in the birthing room). I noticed that she dropped a couple drops of something in the pool. Later on, I found out it was clary sage. She is amazing. I didn’t know of essential oils back then, but I was so glad she used it in the pool. We got settled into the room and kept moving/ massaging/ going in and out of the pool. My midwife provided a carrier oil (probably sweet almond oil) for my husband to use on my back. DOULA TIP: I always have fractionated coconut oil in my doula bag when I attend births. A carrier oil helps hands to glide smoothly on momma’s back, even in water.
Both of our girls were born at BirthCare, Auckland – a primary birthing center across the park from Auckland City Hospital. No doctors, no epidurals… just large birthing rooms with pools and midwives and oxygen/ gas if needed. My main motivation for birthing here was that if you birth here (instead of the hospital), you get to stay in a PRIVATE postpartum room for three nights. Everyone else has to share a room with another momma + baby, or pay a ton of money for a private room. Looking back, the other part I love about BirthCare is that there wasn’t anybody else coming and going (no nurses, no lab techs). It was just Brad and Christine as my birthing team. It’s like a home birth, just in a comfortable space with more tools (and the freedom to leak blood and fluids and water from the pool/ shower all over the place). DOULA NOTE: find a birth space your are comfortable with
At some stage, my water broke (but I didn’t feel a pop or gush). My midwife noticed leaking and some meconium coming down my legs. Darn. She did a great job of protecting me from this information. She mentioned it, but did NOT say it was an “issue”. She let me keep labouring comfortably. My husband kept massaging my lower back. He only missed two contractions during the whole labor experience. What a champion. His hands must have been so tired. My midwife was on the phone with the Charge Midwife up at Auckland City Hospital. She was checking in with her decision making to keep me at BirthCare as she monitored the meconium situation. There was potential that I might need to transfer up to the hospital since meconium can be dangerous for baby. Did you know that I didn’t need to be on the fetal monitor until towards the end of my time in the birthing room? We used a doppler to check baby girl’s heart rate while I was moving in the pool and around the room. Due to the meconium, I was hooked up to the electric monitors to make sure Madam Blueberry was safe. DOULA TIP: you can request intermittent, portably fetal monitoring if birthing in a hospital.
I started to feel the urge to push! A couple of deep growly grunts were let out because I could feel my body taking over. I wasn’t fully dilated yet. So my midwife gave me some oxygen to breathe deep and regain control. The entire birthing experience was very calm, quiet. At this stage, I was up on the bed being monitored. I was checked again and given the go ahead to push. Another midwife came into the room to assistant mine. They had my legs up and coached me to “bear down” to push. My midwife wanted to get baby girl out as fast as possible because of the meconium. I was still oblivious to this being an issue. I took deep breath and pushed so hard that I burst a blood vessel in my right eye. Yikes! DOULA TIP: I now suggest that mommas “breathe” the baby out and spontaneously push instead of “bear down” coaching that most nurses and care providers use. But every situation varies.
Because I was so internally focused, I wasn’t honing in to my midwife's voice. With the last push, baby girl’s head came out at the beginning and I didn’t hear my midwife telling me to stop pushing… so out came the rest of her body all in one fast swoop. Whoops. That’s how you get tearing. DOULA TIP: listen to your lead maternity carer’s voice right at this moment. They are there to protect your perineum.
Baby girl was instantly placed on my chest for skin-to-skin time. She was born at 4:50pm, about 16 hours after seeing the bloody show. Talk about love at first sight. Whew. I didn’t know I could love a creature so much. It’s like loving a pet only times a billion. Baby girl was breathing fine -– she did have some meconium on her, so they wiped that off. My husband cut her cord, then my midwife waited for the placenta (we took it home and planted it below a lemon tree) and started my stitches. We started breastfeeding right away. I was able to take a shower in the birthing room before waddling over to my private postpartum room. Stitches on your bottom are sore. DOULA TIP: I recommend a blend of helichrysum and frankincense essential oils to help with perineum healing.
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.
Jenna Clarke is a doula in O'ahu, Hawaii. She is the owner of Malama Momma, where she shares "Mālama" is Hawaiian, and it means, "to care for, to protect." Jenna provides labor and postpartum doula services, as well as lactation support and education. She is the happy mother of two little girls, born in New Zealand. Jenna and her husband are passionate about natural health, the importance of reducing toxic load, the science and pathology behind illness, and how to treat illness with plant-based therapies, whole food, exercise, and reducing toxic exposure.
I once wrote how teaching about birth is like selling a house. I was happy to see Joyce's comparison here, and even happier how her points lined up with reality. We hear many analogies for the roles doulas hold. I think this one stacks up well -- what do you think?
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.
Joyce Dykema, MSc, CD(DONA), HCHD, became a certified birth doula in May 2012. She is also a trained Hypnobabies® Hypno-Doula, volunteers as leadership for ICAN of Lincoln, and is an Evidence Based Birth Instructor. Joyce is a woman-focused doula. While passionate about natural birth and what research shows is the best for moms and for babies, the goal she strives for with every client is for women to have empowering and positive births, as the woman defines it. In addition to her doula credentials, she holds a BA in psychology and an MS in biological sciences. She breastfeeds, uses cloth diapers, uses baby sign language, babywears, and homeschools because these choices made sense for her family; she encourages others to explore and find what makes sense for their families. Joyce and her husband have three children, and live in the Lincoln, Nebraska area.
Poetry ties in with birth work. So often, when moved (or tired), phrases that describe what I am seeing or experiencing come to mind. The way the words arrange themselves isn't linear, like normal, but often spiraling, like birth. Sometimes I write them down, and sometimes they float in, and then out, of my mind. I love that Bryna took the time, while exhausted, I am sure, to take note of the words that came to her this night.
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.
Bryna has 4 kiddos, a seafaring husband, and a sweet pup named Amelia Earhart. She loves to climb rocks, play in the surf, and camp in Big Sur.
She has been working with families since 2006, and became an IBCLC in 2010. She owns Doula My Soul, llc -- a private practice in the Portland, Oregon metro area. She works as a doula specializing in high-risk and surgical birth, a lactation consultant offering home, office, and online consults, and teaches classes through both Doula My Soul and OHSU Center for Women's Health.
Bryna has mentored many students through their IBCLC hours, and loves to share the joy of helping families meet their individual definitions of success!
Communication skills are of the greatest importance to me, as a doula, educator, parent, and person. I fell in love with this piece because it offers easy-to-follow ideas. There really is no place in life where we don't need to use communication skills -- so refining them will help us not only as doulas, but also as members of families, communities, and the world.
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!
Heather Scott is a childbirth educator and a doula through the Childbirth and Postpartum Professional Association. In more recent years Heather has expanded her practice through earning her Bachelor’s in nursing from Regis University and is a registered nurse in the birth center setting where she has worked since 2008. Heather graduated in 2016 from the Frontier Nursing University MSN program and is a Certified Nurse Midwife. Heather and her family live in the foothills southwest of Denver. When not attending a birth or teaching a childbirth class Heather can be found spending as much quality time as possible with her husband, four children and usually a furry friend or two in the background! It is with great enthusiasm that Heather seeks to provide families with quality support through Cocoon Birth whose mission is to nurture, empower and honor your family.
♥ four young boys and a boy dog (offspring)