Today I read on www.doulamatch.net that there are 67 different doula organizations listed on their site. Wow. While there has been an increase in recent years of different certifying paths I had no idea there were that many.
As with just about everything in life and business there are pros and cons to this explosion of new ways to train doulas. Respectfully I submit a few of my thoughts on this matter:
- More professionals and parents are seeing and reaping the benefits of doulas
- Easier access to training, along with likely various payment methods
- Doula has become a household name
- Being a doula does not have to be synonymous with charity work; more doulas are rightfully charging a living wage, which in turn allows for more pro bono or volunteer work when their own financial needs are met
- Teams of doulas can partner up or create agencies which can lessen the hard work of being on call
- Fresh organizations can bring fresh ideas and instill new energy
- More families are being served
- The trusted and well known organizations who have been around for years have a well crafted method of making sure they are creating professional doulas, do the newer organizations also have the same ethic or are they jumping on an opportunity to sell an online program to as many people as possible?
- Clients and professionals may find that there is no standard of ethics, codes, or grievance policy — essentially there is no national standard for doulas.
- A person seeking to become a doula may not be able to tell the difference and spend their educational budget on a program that is not suited to them or does not equip them to be a doula. They may choose one solely based on ease of training, location, or budget price.
- Doulas who are fresh out of training, in my opinion, require mentoring from their organization as well as continuing education and hands on experience. Will they receive this from a course that only includes a booklet of skills they check off and submit?
- The doula profession has a high burnout and turnover rate. The initial interview process and reference check can save an applicant much time and money — sometimes being a doula isn’t a good fit for everyone or it isn’t a good fit for a particular time in someone’s life. If it isn’t a good time or fit for the doula it is not going to be a good fit for their clients or the professionals they are in contact with.
I mentor newer doulas in our area who reach out to me and go through an application process and are a good fit. My view is the world needs more doulas. Experienced doulas should be available to help the newer ones where possible but one of my requirements is for my mentees to have completed a training through an approved certifying organization and either to have been certified or actively working towards that certification. Certification is for everyone’s benefit. It demonstrates the doula understands and is committed to a scope of practice and follows it. It gives any families and medical personnel a place to file a grievance should that ever be necessary. It gives the doula ongoing support through the certifying organization and continuing education. I myself trained and certified through CAPPA (Childbirth and Postpartum Professional Association) and kept my certification active for many years. Eventually I moved my certification over to Hypnobabies once I became a Hypno-Doula but I still attend CAPPA conferences when I can and I was an ICAN (International Cesarean Awareness Network) leader for 7 years and received extensive training, support, and continuing education through that organization as well.
So if you are considering becoming a doula, carefully consider who to train through. How long has the organization been around? What do they offer in the way of not only training and certification but also in ongoing support and continuing education? Their low training fee may not be a bargain if their philosophy does not mesh with yours or if you are getting an incomplete education. My advice is to always try to round out any training with local volunteer opportunities such as a Birth Network or La Leche League, etc, in your area.
If you are considering hiring a doula, how can you know if they have had a good training? Ask who they trained (and hopefully certified or are working on certification) through. Google the organization and see if there is a public scope of practice listed, if there is a grievance policy, if the organization has been around for some time. There could be a new organization that is wonderful and has just begun so also listen to your instinct! Was there any in person or hands on training or was it completely on line? Do they connect their trainees with any mentors? Do their trainees attend yearly conferences or continued educational opportunities? Are there clearly defined guidelines of how to achieve training goals (ex: a set amount of births in a set time frame with satisfied clients as well as satisfied medical personnel giving reviews). Do they do background checks or at minimum, call references? (you probably wouldn’t want a doula with an arrest record, for example).
Growth is good and at times it can be messy. For the first half of my career I usually had to explain what a doula was. Rarely do I have to do that now and I love that! Few people are going to go into birth work unless they have a desire to help families. I feel most of the newer organizations are trying to make it easier to have training easily accessible and are trying to bring in fresh ideas to improve on trusted outlines. We just have to make sure there are some professional standards and that everyone is getting the training and the trained doula they expect and deserve. Happy doula-ing and birthing!
All Rights Reserved, 2017, Kimberly Sebeck, Knoxville Doula.
Note: This post is not about your medically necessary cesarean, or even one you chose. The author of this post respects all births and philosophies.
As more education and advocacy spreads about high rates of cesareans many natural birth advocates will encourage women to ask for their doctor and/or hospitals cesarean rates. Sometimes it is hard or impossible to find these rates as they are not always maintained by each physician, hospital, or even in public records. It is usually easier to find your state or region’s cesarean rates.
What is a woman to do when she searches and cannot find anything but internet reviews and anecdotal accounts? What if she asks her obstetrician and they say they do not know what their cesarean rate is? What happens when a woman finds out that the hospital she has chosen to birth at or the obstetrician she is using has a 30%, a 60%, a 25% rate of cesareans? What does it all mean?
Information is always useful. But consider a few things. If your state or regions cesarean rate is 30% but a certain hospital has a cesarean rate twice that — it could give you pause. Or you may consider if they only accept high risk women and are staffed by all or mostly high risk women’s specialists. Perhaps your provider is a large supporter of women who are attempting VBAC (vaginal birth after cesarean) and this skews their overall cesarean rate because there is always the chance a previous cesarean will result in another cesarean for the same woman. Large hospitals may not have accumulated statistics any more recent than a few years ago or even longer.
A rate will not guarantee you will have the information about choosing a hospital or provider.
Some suggestions for finding out deeper information are to ask these questions:
- Ask your ob/gyn if they can provide a recent cesarean experience concerning their philosophy on birth. Was it due to a time limit? Was baby or mother not faring well?
- If the birth facility itself has a seemingly high cesarean rate ask if this is due to specialists, high risk situations, hospital policies, or something else?
- Has the doctor or facility implemented any measures since the most recent statistics that could help lower the chance of an unnecessary cesarean? Such as welcoming doulas, adhering to ACOG recommendations about reducing non medical inductions and considering active labor as beginning at 6 cm instead of the outdated 4 cm, utilizing midwifery care, and updating the tools provided to laboring women?
- Does your hospital or doctor keep current on certain methods that can reduce unnecessary surgery by providing peanut balls for women with epidurals, having wireless monitoring for mobility, water labor options, etc.?
- Does your hospital or doctor support VBAC?
- Does your provider speak with compassion and understanding when you ask these questions or are they defensive or minimizing your concerns?
I hope some of these questions have helped to show that a rate is not always just a rate. Again, information is useful. It is a good starting point to ask more questions to make sure your provider or place of birth is in line with what you want for your birth options. Ultimately labor and birth is an unknown and you can only do the best with the information you have at the time.
All Rights Reserved, Knoxville Doula, Kimberly Sebeck 2016
Recently I had the wonderful experience of hiking up House Mountain, which is the highest point in the county I live in. It has an elevation of over 2000 feet. It was a pretty ambitious hike considering that I am not an avid hiker. I went with my friend, Erin, my daughter, Andin, and our two Great Pyrenees dogs.
As we drove to the area we could see the mountain rising up and a bit of anxiety arose in me that I may have bitten off more than I could physically manage. Fortunately we had fueled ourselves with good coffee and breakfast. We had snacks packed — fruit, trail mix, and of course water. I brought a walking staff for support.
As we started the hike it was a gentle slope with beautiful scenery and little streams. How easy was this? No worries here! Then we got a little lost. The trails were not clearly marked and we had to make some decisions of which way to go while not knowing if it was the correct way. We eventually found a trail we wanted to get to the summit and it got hard. The terrain was rough and uneven — full of roots and rocks. After most of my practice hikes and walks being on pavement or at least well maintained trails, this was a surprise and a challenge. Our large 80+ lb dogs never wavered in their support and having them pull on the harness actually gave extra support when needed.
After a few hours of this, however, I really began wondering why I was doing this or if I even could. I kept looking up to see if I could see the end but it just looked like an unceasing uphill climb. I was getting discouraged and tired. Ah! I thought — I will employ the skills I use in being a doula and supporting women through birth. I began to breathe as I needed — focusing on breathing faster through the hard parts and slowing my breath to a calmer state when we had a plateau or break. My companions and I kept each others spirits up. We took a break for water, trail mix, and oranges. We sat on a bench and looked at how far we had come and reminded ourselves to enjoy the scenery along the way. And I began a mantra in my head through the rough parts — “You are strong. One step at a time to your goal. Your body will give you what you need. Stay in the moment.”
We did reach the summit, of course. It was wonderful. I could feel the endorphins from my body working hard. We took photos and explored the amazing views and exulted in our hard work.
I cannot help but draw the parallel to labor and childbirth.
- You need a good team to support each other and cheer each other on
- You need to prepare as much as you can but know the experience requires flexibility
- You might know exactly which way to go or what is the “right” answer — but you’ll find your way
- You need fuel — food and water to stay nourished and to help your body
- You may need extra support, as I did with my walking staff
- You need to know it’s okay to feel that it is hard or to be discouraged or wonder if there is an end in sight — but keep taking one step at a time and you’ll get there
- Labor and birth has some easier terrain and some rougher terrain — try to enjoy the scenery and use your breathing and relaxation skills and support team as you need in the moment.
- You will find exultation, pride, and endorphins at the summit, the birth of your baby
All Rights Reserved, Kimberly Sebeck, Knoxville Doula, 2016
More details to come but it will be a fun and informative event with samples and goody bags available first come, first serve. Hosted by myself and Candy Scarborough, IBCLC.
Doula services, pre-pregnancy consultations, childbirth education provided by me.
Lactation Consultant services provided by Candy Scarborough, IBCLC.
Kimberly Sebeck, CLD, CCCE, HCHD, 2015
If you’re looking for a quick childbirth class that hits the highlights of labor and how to stay comfortable during them, I have the class for you. It is also a good refresher course if it’s been a few years since you had a baby or if you want to do things a little differently this time. While the class promotes natural childbirth we do also cover different types of medical for pain management. Please check out the link for more information. The class will be held Saturday, September 19th, 2015 at 9:00 am in my new office.