Who is Anne Doula? (Part 1)

Client:  "Hey Grandma, come meet Anne.  She's my doula!"

Client's Grandmother:  "Hello Anne Doula.  That is a curious last name.  Is it French?"

hahahahaha
and so I became Anne Doula.

Doula is actually a Greek word.  It's used in the Bible when describing Jesus, as He washed his disciples' feet.  He took on the form of a "Doulos" or male servant.

Doula generally referred to the woman servant, who helped the mother of the household with pregnancy, birth and childrearing in the early years.  She was a hand-maiden, a personal assistant, a second mama, a close friend, confidant, and often she was also a wet-nurse.

These days, there are women who call themselves doulas, yet have no training, or even any idea that doula = servant.  They hear the term, want to attend births cause it sounds exciting, and then off they go, calling themselves a doula...  hmmmmm.....  not cool.

Why is it not cool?  Well, for several very good, very important reasons: 

1. Mothers hear about doulas in the media, or from books about pregnancy, and they kind of have an expectation of what sort of value and skill-set a doula will bring to their experience.  If all doulas are on different levels as far as education and philosophy, how can mothers know who to choose, what is a reasonable amount to pay, what to expect, etc.?
2. Birth isn't always easy, fast, or safe.  Don't get me wrong, I birthed my last 2 of 5 babies at home, and one arrived before the midwife, so I'm probably what you'd call a "Birth-Truster" and I believe that birth is normally safe, and that interference and intervention is normally risky.  However, we do know how bad information can lead to bad choices which can lead to bad outcomes.  This is a HUGE reason why doulas - who give advice and help mothers to educate themselves - need to know their role, when to refer moms to a specific professional, and what is a silly trend and what is serious medicine.  Untrained, uncertified women who call themselves doulas are not qualified, and often do not know or understand the bounds of what their role entails as a complementary care provider.  Because of this, you often find they lack the information parents really need, and sadly, they also lack the ethical standards as well.
3. Unfortunately, women who feel they don't need training, or are above attaining a certification, are many times, the same women who have their own birth trauma or other serious personal issues to deal with.  I was just speaking to a dad yesterday, who said he had interviewed half a dozen doulas in our city, and each one revealed through their philosophy, personal stories, or unsolicited advice their own resentment toward a doctor or nurse during their own experiences.
4. Women who claim to be "trained" but cannot provide you with their credentials are basically women who are shortcutting the system.  They took a workshop, but they didn't have the integrity to complete the rest of their training.  In my opinion, they should not be calling themselves "trained" simply because they did not complete the entire "training process".  Parents are getting savvy to this however, and more and more families are turning down doulas who don't have those coveted letters after their name or a certification award to prove they completed a course to become a true doula.
5. When a woman cannot afford doula care, there are a few states where it is mandated for insurance companies to reimburse a portion of their care expenses.  Why would insurance companies want to reimburse for care that has no value to them?  Saving them money is how doulas look good to the insurance company.  How would having a doula save them money?  By lowering the cesarean risk, for starters.  So it's important that certified doulas continue to seek out insurance reimbursement.  That, and the fact that mothers who want doula care, but cannot afford it will be more likely to receive that care including better outcomes for themselves and their babies, if insurance companies were on board with paying a portion of that expense.  Some states like Minnesota and Pennsylvania already do.
6. The last and perhaps most upsetting reason (to me) of why it's not cool that women take on the title "Doula" without completing a certification process is that is blows the stats of good doulas out of whack.  For example, the Cochrane report from the 1990's showed that having a doula by your side reduced the rate of cesarean by almost half.  In the late 2000's, after being a doula became trendy, that rate in another Cochrane review showed that the stat was now hovering around 25%  Why?  Because women who are not properly trained are out there practicing and mothers are not getting the benefit of having a skilled woman by their side.  Those numbers, by the way, tell me that having an uncertified doula means your rates of cesarean is no different that those of the general public without a doula.

Part 2 coming soon............