One of the hot topics among doula forums is the topic of doula certification. There exists within the doula world at least two camps. One that values the process and accomplishment of certification and one that feels that certification is unimportant and often too expensive or restrictive.
I fall into the camp that values the process and accomplishment of certification. I love to learn. I’ll attend every workshop and training that I can afford to get to. In ten years I’ve taken a host of workshops that offer certification or just continuing education. In the three years after I first certified as a doula I had over 78 hours of continuing education! In ten years I’ve maintained every certification I’ve achieved except for one. I suppose part of me is also very driven to finish what I start as well. Some members of the “unimportant” camp see the cost and time involved with re-certification as one more reason for their dislike or disagreement with the certification process as a whole.
The certification process varies from organization to organization, but typically a doula must attend a doula workshop, read a certain number of books from a required reading list, write a certain number of essays, attend a minimum number of births and the total time spent working with clients during labor must be at least 15 hours combined, and provide at least 9 total evaluations from clients(3), nurses (3), and OBs and/or Midwives. The number of evals and who they must be collected from will also vary from organization to organization. There are other requirements such as signing and agreeing to certain organizations Standards of Practice and Code of Ethics.
As a certified doula and childbirth educator I am required to re-certify every three years. When the requirements are combined this means that I must:
- Obtain at least 15 hours of continuing education in pregnancy and childbirth, the CEU’s I obtain can almost always be used for both organizations.
- Provide evaluations from at least 3 doula clients and 2 childbirth education clients.
- Maintain continuous membership with the doula organization I’ve certified with and maintain continuous membership with the organization that I certified as a childbirth educator with.
- Submit evaluation fees to both organizations at the time of re-certification to review and process my re-certification packets.
- Submit at least 2 letters of recommendation from former clients or other childbirth professionals in the community.
While it goes without saying that there are doulas that chose to not certify that are terrific doulas, the value for me in having a doula achieve certification is that we know that she:
- Has completed a minimum course of study and training in the role of a doula.
- Has worked in a professional capacity with clients, nurses and providers and has received positive evaluations from them on her role. AKA we know she can play well with others.
- Has a set of Standards and Codes that give both her and her clients very clear guidelines as to what her role is and what she should and shouldn’t be doing.
- And one of the more important ones to me is that clients and providers have recourse should a doula violate her Codes or Standards via the grievance policy that most certifying organizations have in place.
I’ll admit, it causes me concern when I hear about doulas who express that they don’t want anyone telling them how to practice. I’ve been a doula for 10 years now and I’ve worked very hard to build a positive reputation not only for myself but for doulas in general. I’ve worked through deeply troubling times when doulas are out there, acting outside the accepted definition of a doula as a non-clinical care provider and doing things like giving clients herbal supplements in labor, performing vaginal exams, telling women if they just take this supplement or eat more protein they can ignore their providers concerns about a certain complication.
There have been doulas who have stepped over the line of advocacy, speaking for their clients, causing direct conflict with hospital staff that result in the contemplation of banning doulas from the hospital entirely. While I acknowledge that certified doulas may also be guilty of this behavior, in our community it has been those who are resistant to certification that have clearly crossed these boundaries and put us all in jeopardy.
I won’t pretend to profess that my way is the only way. Each of us must travel this path and find our own way and while I’ve spoken in generalities I do recognize that there are doulas out there that aren’t certified and are truly awesome doulas, for the most part I believe that certification benefits everyone involved.
What do you think?
I posted this to my Facebook- I just agree with you so much. Certification seemed like a big hassle to me at first, and it is a hurdle, but now that I’m almost done, I’m so proud of the work I’ve done.
And I’ll admit it- I’m a WAY better doula now for all the schoolin’. I feel like I have so much to offer my clients now
I followed this from AllDoulas, where I’m starfireming. I have to say that I really admire your posts, you’re always bringing some strong sense to the table.
Thanks Susannah! I really believe that every workshop I attend makes me a better doula. I assist at DONA approved workshops 2x a year and even then I always learn something new!!
Hi there.
I have to say that, although the tone was kind, I think you made some very broad judgements and assumptions about certification v non-certification. I think it is a narrow, one sided view of the process and considerations that others have put into the choice.
Basically, I see you saying ‘my way is best and this is why their way is wrong’. It only perpetuates the schism that is already developing in the childbirth field among doulas, midwives, and childbirth educators. As long as we are divided, we are not nearly as strong as we could be.
I am not certified, but I don’t think I am any less competent or educated as you are. I did 3 months of book work and reports, completed a pre-test, attended a 4 day workshop, completed my 3 provisional clients and taught my provisional class… and left feeling cast into a shark pool.
So, I began auditing childbirth classes from many methods, asking doulas if I could shadow them for specific clients that I hadn’t had the chance to work with, paired up in an apprenticeship/partnership with a chiropractor and massage therapist, collaborated with a yogi, and took many continuing education courses and classes, including (to name just a few): advanced ribozo work for birth, acupressure for labor and birth, postpartum subluxation resolution, breastfeeding 301, cloth diapering seminars, birth trauma counseling, placental encapsulation, malpresenations and their impact on labor and birth, and so many more. I have compiled an additional resource of all of the birth centers, hb midwives, hospitals, chiropractors, massage therapists, acupuncturists, reiki masters, reflexologists, yoga studios, and master herbalists/homeopaths in my area. I have interviewed a number of mother- and baby- friendly doctors, midwives, and other practioners, and helped to define how I can best help support women in mother- and baby- friendly practices as well. I work within the scope of practices outlined here: http://www.motherfriendly.org/MFCIb
I then began an apprenticeship with a midwife and began offering myself as an assistant to home birth midwives. I received my CPR/AED certification and my NRP certification. I took some advanced workshops through The Farm Midwives and Pam England.
BUT, after 11 years, I have never regretted my decision to not be certified. Historically, doulas/godsibs learned through apprenticeship. The only thing I would gain from being certified is the backing, and restrictions, of a nationally certifying program. And I don’t want those restrictions put on my practice.
I will labor with women at their home (some certifying agencies won’t allow that)
I will do VEs and FHTs if I think something is wonky about a birth or mom wants me to (and I am skilled to do that as an apprentice midwife and assistant – and some certifying organizations don’t want you to)
I DO contradict a medical person if they are outright lying to a mom (after all, I work for the mom, not the hospital and again, some certifying organizations won’t let you) but in a tactful and non-confrontational way.
I DO advertise that I am experienced in a number of childbirth methods (and CBE certification programs will make your life a living hell if you do that while you are certified with them, I know, I have been in their firing range before)
and on and on….
I know that you SAY “I won’t say my way is the only way” but you did a fine job of painting the ‘others’ as bad.
You said “… completed a minimum course of study and training in the role of a doula.” – OK, but by whose standards? Current ones? Again, historically, there was apprenticeship.. women attended women when they were well versed in hands-on and personal experience, not a governing body.
“Has worked in a professional capacity with clients, nurses and providers and has received positive evaluations from them on her role. AKA we know she can play well with others.” – so have I and others who are like me. Just because we don’t have an organization leaning over our shoulder to keep us in check does not mean that we aren’t professional and mature. We are adults after all.
AND, I know many certified doulas who DON’T play well with others.
“Has a set of Standards and Codes that give both her and her clients very clear guidelines as to what her role is and what she should and shouldn’t be doing.” according to your organization. DONA states, basically, that a doula is there for physical and emotional support only. I don’t believe this is a good enough definition. We also educate, remind, encourage our clients to ask the more fully informed questions… AND offer emotional and physical support. My clients, OTOH, can take a look at my personal qualifications, contact doctors, nurses, midwives, and families that I have worked with and worked under and see that, although they are hiring a doula, they are hiring someone who has experience and qualifications beyond the minimal scope of a doula and I am competent and qualified to provide them with the additional support that I offer, WHEN I offer.
“And one of the more important ones to me is that clients and providers have recourse should a doula violate her Codes or Standards via the grievance policy that most certifying organizations have in place.” Again, see above.
“I’ll admit, it causes me concern when I hear about doulas who express that they don’t want anyone telling them how to practice.” Why? I am a grown woman with strong ethical and moral standards. I don’t feel the need to be managed by an organization when I don’t agree with some of their standards. If I found one that I DID, perhaps I WOULD.
“I’ve been a doula for 10 years now and I’ve worked very hard to build a positive reputation not only for myself but for doulas in general.” And so have I in my 11 years.
“I’ve worked through deeply troubling times when doulas are out there, acting outside the accepted definition of a doula as a non-clinical care provider and doing things like giving clients herbal supplements in labor, performing vaginal exams, telling women if they just take this supplement or eat more protein they can ignore their providers concerns about a certain complication.” And I have worked through troubling times of CERTIFIED doulas back biting other doulas, outright lying about other doulas, leaving clients when they get epidurals, not completing their contracts with their clients, and STILL doing all of the above you mentioned, WHILE certified.
“There have been doulas who have stepped over the line of advocacy, speaking for their clients, causing direct conflict with hospital staff that result in the contemplation of banning doulas from the hospital entirely. While I acknowledge that certified doulas may also be guilty of this behavior, in our community it has been those who are resistant to certification that have clearly crossed these boundaries and put us all in jeopardy.” Yeah, we have one of those in this area… and she is certified. BTW, I have never spoken FOR my clients, but I have no problem asking a doctor why he came to xyz conclusion… or telling a mom that it didn’t sound quite right and that either a more in-depth explanation of his reasons, or a second opinion, might be in order.
Bottom line, certification does not automatically = personal integrity of character and practices.
For the other side of the coin and to understand where others are coming from, perhaps you would be interested in these links:
http://radicaldoula.com/2008/11/30/some-thoughts-on-doula-certification-and-dona-inspired-by-maia/
http://wonderfullymadebelliesandbabies.blogspot.com/2011/03/throughout-time-throughout-world-birth.html
http://wonderfullymadebelliesandbabies.blogspot.com/2011/08/interviews-aka-getting-to-heart-of.html
http://judgmentalhippy.blogspot.com/2011/01/doulas-scope-of-practice-and-in.html
And, on Sept 19th, my blog will publish an article about the harm we are doing by perpetuating this type of ‘why I put a lot of thought into this and did it my way and my way is best’ arguments. This post was written because of our own version of this topic in our area. Some doulas say ‘don’t call yourself a doula if you haven’t been trained by a nationally recognized organization’, ‘naughty naughty for attending a mom who is choosing an unassisted birth’, and, my personal favorite ‘your not really a good doula if you have a cesarean rate comparable to the national average’ (to name just a few)…. yep I have heard it all in our local doula network (and I am not saying these are even directed at me)…
People should feel free to interview and research their own doulas without their choices being influenced by bias’ such as this. I am a firm believer that there is a type of doula for every woman… and we NEED these differences to provide women with all options. I hope this didn’t offend, and I’m not angry, I am just frustrated to see yet another post that, whether you mean it to or not, paints your way as the better way and details ‘concerns’ about the ‘other doulas’…. which, again, whether you meant to or not, WILL influence families seeking a doula and bias them against one and toward another.
Cole,
I appreciate your comments. And I can see how my words may look judgmental to some.
I certainly don’t believe that my way is the only way. It takes all kinds to make the world go round and I’m not the doula for every woman for sure.
I think that we all have our own bias and mine is certainly in favor of certification. In 10 years as a doula I have never felt that the Standards of Practice or Codes of Ethics set forth by my certifying organization have impaired or restricted me from serving women and their families fully.
I’m unaware of any doula certifying organizations that prohibit doulas from laboring at home with clients. I’m also not aware of any that prohibit doulas from attending unassisted births. I’d be interested in who they are. I know there are a lot of misconceptions about what some orgs will allow.
There are many points to consider in your post and I thank you for sharing them and hope that they stir up further discussion.
Meh, I really don’t know why doulas even get themselves hyped up enough to bicker. I was trained in the UK, 7 years ago, when there was no such thing as being called ‘certified’ by a particular organization or not, I’d not even heard of it, at least not in London. I worked for that organization, as they forwarded me clients, but when I moved abroad it simply became working for myself. I’ve never felt a need to be re-certified by any particular organization, and I have never been challenged. I’ve continued to train through workshops and classes over the years as a good doula ought to, keeping on top of current research/topics, networking with other doulas, and studying midwifery books. I never question a dr or a midwife, the parents know that if they feel uncomfortable or before any decision they can ask for 1/2 an hour (or any other appropriate time) to think about the decision, and we can talk in private without the ‘agressive doula’ issue. I hold to the belief that I’m there to help a couple feel cared for, loved, and informed, and that that constant presence gives them the confidence to have a strong, good birth experience. Good old basics! Getting het up over bureaucracy is distracting.
I am a doula that is not certified. My main profession is not a doula, it is a computer scientist. I only take 3 or 4 clients a year in addition to my volunteer work at a local hospital. Although I have completed the requirements for certification, I chose not to certify for two reasons: First, it is not economically feasible to certify and re-certify if the bulk of my clients do not pay me, and if it is not my main profession; and second, the organization through which I trained (and which would certify me), one of the biggest doula organizations in the world, does not have a professional-looking presence. There are misspellings in the “doula packet” and certification certificates, and the online presence (website and related media) looks like it came straight out of 1992. I just can’t affiliate myself with such blatant unprofessionalism. Maybe it’s because I’m into computing. If I were hiring a doula, and I looked up her organization, and it was riddled with typos and/or had the online look and feel of this organization, I would seriously doubt whether she kept up to date with current trends and standards. If the organization can’t take the time and effort to put up a good face, how do I know that it takes the effort to truly gauge the quality of the doulas it certifies? You are judged by the company you keep.