The Many Hats of a Postpartum Doula - Part 2

 Part 2

So just what does a postpartum doula do? 

Remember, not all doulas are made alike.  Since doulas are an unregulated occupation, many women call themselves doulas without any doula training or certification.  Find someone who is not only a Certified doula, but also has references to help you be assured she's got the skills and integrity your families needs to rely on during this vulnerable, and blissful time in your life.

In addition to what we already mentioned in part 1, a postpartum doula’s hats can also include:

4. Peer to Peer Counselor. Is mom feeling stressed, anxious, depressed, or just simply overwhelmed with her new role? Mom’s postpartum doula is there to guide her through this time of transition. Giving birth is a huge feat to accomplish! Recovering not just in physical but emotional ways is crucial for any mother. Her postpartum doula is there to counsel her through this time.

5. Personal Assistant. With dad heading back to work and mom still transitioning, wouldn’t it be nice if someone else could go get the milk? A postpartum doula is more than happy to run errands for mom and dad including grocery shopping, picking up baby items, and more.

6. Newborn Nanny. Another dirty diaper? Postpartum doulas can assist with feedings and diaper changes. This is especially wonderful at night so that mom and dad can catch up on much-needed sleep. No need to wake -- baby will be taken care of by the loving arms of the postpartum doula.

The ultimate goal of any postpartum doula is to be a professional mother. No, not a mother to the baby, but a mother to the new mother.  She is there to support, guide, nurture, and love mom as she travels this sacred journey. Even seasoned mothers can gain from the experience and assistance of a postpartum doula as the family transitions into life with a new baby.

Would your family benefit from a postpartum doula? 
Contact Tranquil Seasons where we will gladly serve you and your family’s needs during this exciting time! 

Call 210-548-8800 
www.tranquilseasons.com 
or email annecwj@gmail.com for a consultation.

The Many Hats of a Postpartum Doula - Part 1

The many hats of a postpartum doula, part 1

Okay, now the labor is over. 

The easy part of child-rearing begins, right?

Oops! Did no one warn mom about her wacked-out sleep schedule or late night feedings? That dishes still aren’t cleaning themselves? That eggs still come unscrambled and bread still comes untoasted from the grocery store?

Being a new mom is a glorious time, but it comes with challenges. Having a trained, and CERTIFIED postpartum doula there those first days after birth can be a life saver for any new mom!  Not all postpartum doulas come with all these skills - so make sure yours is certified and not just "trained" which could mean anything.

A postpartum doula wears many hats as she assists mom and dad in those early days with baby.  Here are just a few of her "Hats":

1. Breastfeeding supporter. New to breastfeeding? Postpartum doulas are there for mom to assist her during those first stages of breastfeeding. It can be stressful or difficult to breastfeed at first, but mom’s doula will make the process more enjoyable. Difficulties will not faze an experienced doula who will lovingly guide mom and baby until they reach success.

2. Health coach. Is mom getting enough to eat and drink? Postpartum doulas make sure that the mother is having well-balanced meals and plenty of liquids to keep her energy up and health in prime condition. This in-turn will ensure baby has a well energized mommy to care for him or her.

3. Maid. Remember those dishes that are piling up in the sink and those eggs that can’t seem to scramble themselves? A postpartum doula will make sure that the kitchen gets cleaned up before the next morning. Mom will wake up smiling when she walks into the kitchen to find dishes done, countertops clean, and a hot breakfast on the table.  A postpartum doula can also do the other things that pile up, like laundry and basic nursery organization tasks.  You will wonder at how one little person can produce so much dirty laundry every 24 hours!

4. Chef.  Speaking of eggs that don't scramble themselves.  A new mom is a hungry mom.  Particularly if she's breastfeeding!  A postpartum doula will make sure mom has something to drink every time her baby feeds.  She will prepare snacks to keep mom nourished which helps with recovery as well as milk supply.

A postpartum doula wears these hats as well as many others! 

Stay tuned for Part 2! 

New Mothers Speak Out

What do you think?

The New Mothers Speak Out (PDF) report presents postpartum results from both surveys and gives a ground-breaking view of experiences of mothers with young children in the United States at this time. The surveys were conducted by Harris Interactive and carried out in partnership with Lamaze International.

New Mothers Speak Out reports that life is challenging for many women at this time, who Report highlights include:The report also includes dozens of comments from the mothers themselves about these topics.· experienced new physical and emotional problems following technology-intensive births with high rates of surgery and other interventions:

· struggled to get exercise and rest, eat a healthy diet and manage stress

· did not return to their pre-pregnancy weight

· got limited support from husbands/partners and others

· were unable to start or continue breastfeeding as they wanted

· wanted but did not have the maternity benefits that women in other affluent countries take for granted

· returned too quickly to employment due to financial pressure.

Extent to which mothers experienced 26 health conditions as a new problem in the first two months after birth, and extent to which the problems persisted to six months or more

 Net weight gain above mothers' weight just before pregnancy over the first 18 months after birth

Results of two validated postpartum depression screening tools

First national data about post-traumatic stress with reference to women's childbirth experience, using a validated screening tool:

· Breastfeeding patterns and whether mothers achieved their goals for exclusive breastfeeding and for duration of breastfeeding

· Baby co-sleeping with mother or others in first six months

· How women and their husbands or partners shared child care

· How women rated the support they received from their husbands or partners and from others

· Extent to which women who were employed in pregnancy received paid maternity leave benefits versus their ideal length of paid maternity leave

· Patterns of staying home with baby and transitioning to employment over the first 18 months after birth

· Whether employed women were able to to stay home with their babies as long as they wanted

· Challenges in the transition to employment after birth

What do you feel about these assessments?

http://www.tranquilseasons.com

210-548-8800

What is a Postpartum Doula?

Postpartum Doulas

Tranquil Seasons provides postpartum mother-care, newborn-care and support to families with newborns, including multiples, preemies and special needs babies. This service goes above and beyond what is offered by Overnight Baby Nurses and Newborn Nannies.

Postpartum Doulas that work with Tranquil Seasons are highly trained, skilled professionals, with an ethics board and international certifying association behind them, which "newborn nannies" and "baby nurses" don't have.

We use an International Board Certification Body for all of our postpartum doula training and certification

Certified Postpartum Doulas assist the new mother and her family in:

     - breastfeeding support,
     - emotional support for mom,
     - Postpartum Depression/Anxiety care and recovery
     - Assistance w/Multiples, Preemies and Special Needs babies
     - newborn care and education,
     - comforting techniques, and teaching how to soothe a crying baby,
     - stimulating your baby's intelligence and learning abilities,
     - circumcision care and bathing,
     - feeding, burping, and holding techniques
     - household maintenance such as dishes, laundry, etc.
     - meal preparation
     - sibling care
     - overnight newborn care so parents can get the rest they need
     - preparing your home for baby & Going GREEN!

In-home support is vital to a new family’s success - whatever form it takes.  We make sure the mother is getting enough rest and eating well so she can produce enough breast milk to feed her newborn(s). If the mother is bottle feeding her baby, the doulas are trained in sterilization and in preparation of formula.

To learn more about this special kind of care for your family,
Please give us a call 210-548-8800
or visit our website:  http://www.tranquilseasons.com 

How to Choose the Best Doula

How Can You Choose the Best Doula?

This can be a stressful, and exciting part of your lives.  Don’t allow yourself to feel rushed or pressured to make a decision about your care, by your OB/Midwife, by friends, family, or the caregivers you interview.  Take time to ask questions, do your research and get to know the doula you will hire to help you birth and care for your newborn(s).

“Postpartum Doulas are higher skilled professionals, and more specifically trained than baby nurses or newborn nannies and every mother deserves one!” 

Your health insurance will not pay for a baby nurse or nanny, but they will help pay for a certified postpartum doula.  How do you find one your insurance company trusts?

What do parents need to know when it comes to hiring a Doula?

1.       What makes a good doula?

a.       She’s certified by a reputable organization.  She should also be trained in breastfeeding support as well as has the right philosophy to match your family.  So ask her what her views on things like “breastfeeding”, “vaccinations”, “cry it out” and “sleep training” are, among other hot topics.  A good doula will not have an agenda to push, but will be willing and able to support all parenting styles.  She will have a lot of experience, honest credentials as a doula, and she’ll be an active part of the local birth community.

b.      When you first interview potential doulas, it should be abundantly clear who has the most knowledge and experience  and who will be able to support your parenting style best.  Ask a lot of questions.  Don’t be afraid to take plenty of time getting to know her.  This is an important decision and even if you’re hiring her after the baby is born, you should not rush the process. 

c.       Finally, a good Doula will know how to navigate the insurance world for you.  She’ll work with you to get reimbursed as much as you possibly can for her services, from your insurance providers.  If she’s not able to bill insurance, look for another Doula.  Insurance billing knowledge and experience is another indicator of professionalism, credibility and overall superior care. 

A professional doula has a proven track record of insurance cooperation and reimbursement.  Ask all potential doulas if they will provide you with the forms and codes for insurance claims.  If they cannot, you need to keep looking.  Claims reimbursable doulas have proven to the insurance companies that their care is worth paying for.  You will be asked to pay up front, but part of your intake process with a professional doula should include a discussion about insurance, and they will ask for the details on, or a copy of your card for billing purposes.

 

2.       What are the MUSTS when interviewing a doula?

a.       Run a background check, or hire a doula through an agency that will provide one to you as part of their services, and it should be free of cost.

b.      Make sure she’s certified.  Contact the organization she’s earned her credentials with and verify her status is current and in good standing.  Many doulas claim to be “trained” but they never completed the work to be certified.  “Trained” and “Certified” are very different things when you consider the integrity of the doula and her practice.

c.       She should have current, honest credentials as a certified doula and she should also be certified in Adult and Infant CPR as well as First Aid.  Ask to see those certifications as well as any others she holds.

d.      Find out who she is accountable to.  Don’t be afraid to ask her, “If I have a grievance over your services, who would I contact about that?”  Independent doulas can be wonderful, but there are doulas out there who answer to no one and this can be a real problem for families who encounter issues later.

e.      Contact all her references and ask the tough questions like was she ever late, how did she invoice you, did you trust her, did she always follow through with things, where there ever any red flags while she was caring for you or your baby?

f.        Ask to see a list of care duties and also the contract, BEFORE the interview.  You should never feel pressured to sign the contract until you’ve had time to read it over and discuss with your partner.

REMEMBER, getting a word of mouth referral is great, but it’s not a failsafe way to hire a doula.  Make sure she is trustworthy by doing the above things before you bring her into your home to care for your family.

Written by: Anne Croudace, CPD, CPDT, CLD, CLDT, CBE, CLSE, CNPE, CPR

How to reach Anne Croudace:

Tranquil Seasons Doulas in San Antonio, TX

www.TranquilSeasons.com   or 210-548-8800

 

Anne is also the founder of the ethics-based “San Antonio Birth Collective”, which seeks to serve parents through education and practical support.  Take a look:  www.sabirthcollective.com

Am I Making Enough Milk?

Breastfeeding and the New Mom

Something I haven't mentioned that I also do for families is I support breastfeeding for many mothers, and as a postpartum doula client with us, you will receive free, ongoing breastfeeding support as part of our care. If you choose to bottle feed or formula feed, don't let that stop you from getting help.  We support all families, but we DO have the ability to help you through all phases of breastfeeding - should you decide that is how you want to nourish your little one.

This isn't the norm for doula care.  I've received special training and certification as a Lactation Support and Educator.  Not all doulas have this additional training, but many are still wonderful when it comes to the basics of breastfeeding support.

Like the mother I met with today, at times, you might also find yourself wondering if you are making enough milk. Babies go through growth spurts that can trick us into thinking we aren't producing enough because they are gobbling it all up and wanting more - which is good, because in the end, it will increase your supply.

Think:  More Demand => More Supply. 

 

So today, I was visiting a lovely mama who is adjusting to life with her new baby.  She asked me to visit because she was concerned about her supply.  I offered to bring my newborn scale so that we could do a little experiment... 

 

We were able to weigh the baby after waking and a diaper change (9 pounds, 3 ounces), then she fed from both breasts for a total of 25 minutes (he was efficient, relaxed and happy when he was done).  Then we weighed him again (9 pounds, 6 ounces). 

 

Low and behold! Even though he had been eating like a crazy little monster and acting like he wasn't getting much, he was actually eating 3 ounces total from both breasts - which is a lot for a newborn of his age (3 weeks)!! 

 

He has also grown over a pound since I last saw him, we discovered. So that answers a lot of questions for that mom, and reassures her that she is doing everything right and he is just growing super fast and that her breasts WILL catch up to his demand for more milk. :)

 

My #1 piece of advice for new moms who are experiencing what feels like a set-back in their breastfeeding relationship, is to seek out qualified help.  Do you have a breastfeeding consultant who can come to your house?  Those are the best.  We have support available, and if a situation goes above and beyond our expertise, we have resources in the community that we are happy to direct you to, in order to get your needs and the needs of your baby met, in a timely, professional manner.

 

Keep checking back, because soon, I will be posting another segment on how to make your best milk.  Quantity AND Quality.  :)

 

For now, keep loving those babies, mamas!

Anne

 

Postpartum doulas and lactation support in San Antonio

 

 

 

Simple Summary of Our Care

So, you've probably read a lot about doulas by now...
Not all doulas are the same.  Tranquil Seasons Doulas have specific, ongoing training in several modalities.

What is a good, simple summary of our care?

During Childbirth…

During labor and delivery, we support you at all times with emotional, informational and physical care.  We provide you with education and resources before and during your childbirth experience to help you stay comfortable and to relieve anxiety.  We provide non-pharmacological pain relief including massage, and maternal/fetal positioning to help keep you relaxed and to allow the baby to descend quickly, easily, safely.  We never take the place of your partner.  In fact we encourage participation and offer reassurance and guidance so that this experience is positive for both parents!

After Childbirth…

After birth, Postpartum Doulas help with breastfeeding, infant care, and understanding newborn feeding and sleep habits.  The calm, loving, gentle presence of a doula alleviates stress and helps mothers recover from birth

 in a positive, healthy way.  This assists in preventing or recovering from Postpartum Depression and Anxiety as well as Post-Traumatic Stress - which some mothers and babies experience after a difficult birth.

To speak with Doulas in San Antonio:
www.TranquilSeasons.com
210-548-8800

Birth CommUNITY - Can we all just get along?! :)

Over the years, I've taught many different aspects of birth work.  I've taught maternity care ethics, doula certification workshops, midwifery prep courses, parenting classes, gentle infant "sleep training", childbirth preparation and lactation education, support group facilitation, small business marketing and even helped form a few birthy co-ops along the way... 

There's a lot to be said about the birth communities I've become acquainted with.  The variety is astounding.

Some are catty and awful - like a corporate scene where everyone steps on the others in order to get to what they imagine is the "top" of the pile.  Others are peaceful, encouraging, cooperative and truly sisterly.  What is interesting is that all groups want to see birth practices change.  They want to see improved outcomes.  They all would stand up for women's rights.  So how can they be so different in this thing we call a COMMUNITY...?

I think the main answer is where did they come from, and what's the undertone of the "oldies" in their area?  Let me explain.  If they are moms who come from a high-level corporate background, they are more likely to treat this new career with the same growth and glass ceiling mentality as their previous corporate America jobs.  So back-biting and one-up-manship is the norm.  Likewise, if the women who have been around a long time, doing birth-work in your city have a superiority complex or a corporation complex, you will see the younger, newer women taking on that same mentality.

Isn't it interesting that as women-servants - whether midwives, doulas, childbirth educators etc. - we are meant to be modeling love, acceptance, nonjudgmental attitudes, and most of all, self-sacrificing promotion of the best in others.  We "oldies" who have been around a while should really be the best models of this since we have had more time to practice.  :-)

So, how do we do it?  Practically speaking, what does this kind of care model and commUNITY model look like?

First of all.....
1. Stop the gossip.  Don't do it and don't listen to it, or you'll be tempted to share it.  This is the number one problem, tearing apart birth communities today.  People can smell a gossip a mile away.  You're only spreading a stinky reputation about yourself.

2. If a client tells you something about a previous caregiver, GO to that person, and encourage your client to be honest with them as well, if appropriate.  Don't text the other provider or email them, for heaven's sake.  Set a time to sit down over lunch or coffee and tell them directly, what the client's concern was.  How can we grow if we don't know where we failed?  When you speak directly about an issue to another provider, it shows that you are committed to not gossiping and that develops trust.  If you don't have the nerve to talk to them, you certainly should have the scruples to keep it to yourself.

3. Have a humble heart.  Serving requires humility.  Be willing to look at faults and mistakes and change.  The last and least helpful thing you can be is defensive.  It makes you look bad, too.

4. A BIG one - Stay out of other people's drama.  Even your clients' - if you can help it.  Don't expend your energy on anything that is not uplifting you, your family and others close to you.  You don't want to be labeled a busy-body or a drama queen. (this also applies to sharing your drama with others who aren't in your tightest circle of family/friends - just don't do it!)

5. Commit to getting to know your fellow birth workers.  Join or start a local birth collective group where the community can be built up.  Working together helps immensely!  Plan events, educational opportunities, and ways to promote each other as well as healthy birth.

6. Don't segregate.  Midwives need to get to know doulas, doulas need to get to know childbirth educators, etc, etc.  The birthing community is smaller than you think.  You all need to know each other, learn about each others' strengths and offerings so you have resources to provide your clients and yourself as you seek to improve birth practices in your area.

There are lots more tips I could give, but the main thing to consider is how you view your fellow birth workers.  Think long and hard about this.  Is there someone specific in the community that you don't get along with?  Don't fall off your chair now... You should bless her.  Send her a card.  Take her out for lunch.  Invite her to an event you're going to.

It's possible.  We are obligated to be models of love and acceptance.  We should help create and then celebrate each others' successes and when we do, the birth community as a whole will be lifted up.

Looking forward to more UNITY in birth.
Anne

Doulas - San Antonio
http://www.sabirthcollective.com

Tips For An Easier Pregnancy, Birth and Beyond

Here is a great little article I wrote back in 2002 with a list of tips for pregnant mothers...
Enjoy!

To make life easier as a pregnant mother, we've put together some wonderful tips and reminders for you!

• Take time to pamper yourself. Relaxing benefits you, the baby, AND the new dad!
  
• Drink lots of water and fruit juice. Traditional Medicinals brand and Yogi brand (found in the natural foods part of the grocery store) have a wonderful pregnancy tea and Red Raspberry Leaf teas.
  
• Red Raspberry Leaf tea is also a wonderful uterine tonic, used by women for centuries to strengthen their uterus and ease/hasten childbirth.
  
• Buy lots of pillows and USE them in bed!
  
• Make sure to take your prenatal daily. A "green" prenatal is going to allow your body to absorb more nutrients because they are made with food, not synthetics. Some women even find that switching to a "green" prenatal lessens their nausea tremendously.  After the birth, sometimes those prenatals can be the source of baby's tummy discomfort. 
  
• Be sure to get plenty of protein. Your body needs lots of it to grow a healthy baby. High blood pressure can often be avoided by keeping your high quality protein intake high. Try almonds, yogurt, eggs, cheese and lean meats. Women struggling with high blood pressure will find help here.
  
• Read all you can get your hands on, and look at birth photos, videos, etc. Familiarity with what to expect can prevent anxiety.

• Hire a doula. Doulas are very knowledgeable about pregnancy and birth and can help you brainstorm to solve any comfort issues you may have.  When looking for a doula, consider her training, certification and make sure her credentials are legit and current.  Oh, and always, always do a background check!  Here's my agency's website:  http://www.tranquilseasons.com

 

• Journal. Your child will find your ramblings so precious and reassuring when they are having their own babies or as a graduation or coming of age present.
  
• Buy an exercise ball and sit on it as often as possible. This can relieve back pain, and also keep your pelvis limber for the big day.
  
• Find a local La Leche League group and plan to attend a meeting or two before the birth. These ladies will become a great resource for after the baby arrives.  If you find them too militant, seek out other local lactation support groups.
  
• Don't apologize for having to go to the bathroom all the time.
  
• Buy a reacher/grabber thing to get things up high and down low. You'll be surprised how off-balance that belly can make you.
  
• Buy slip on shoes. It's nice to eliminate bending over at the end of your pregnancy.
  
• Recruit your other children to help out around the house.
  
• Plan and ASK for help from family and friends for after the birth. Don't try to be Superwoman!
  
• Consider hiring a Postpartum Doula.
  
• Buy lots of paper plates - even one package can make a big difference.
  
• Store pre-made casseroles in the freezer.
  
• Don't go crazy decorating the nursery and buying tons of "stuff". Simplifying your life makes having a baby easier. Valuable baby equipment might only include diapers and blankets at first.
• Write a birth plan.  Ask your doula to help you.  This will help you to educate yourself on what is available to you as far as options and will also help you to narrow dow what you feel is most important to you, in regard to your birth experience ideals.

 

 

Who is Anne Doula - Part 2

Part 2:
Finally, Anne Doula is a woman who is on a mission to challenge the ideas about what doulas are... When you walk down the street and see a pregnant woman, do you automatically offer her a drink of water? How about when you're in a store and you hear a newborn crying and the mother looks haggard. Do you have to refrain yourself from going over, picking up the baby and saying, here, I'll help you get through the last items on your list....?

A doula is a servant. We wake up thinking about how to take care of people and we go to bed exhausted every night, with a smile on our face knowing we gave every last drop of ourselves to those around us. We are love in action. We nurture. We help, we feed, we carry, we DO love.

If you're thinking about becoming a doula, consider an organization that we feel is the very top notch education and certification program: MaternityWise International http://www.maternitywise.com
They have a standardized curriculum, so your training will be as comprehensive as everyone else's. it's a stepping stone / midwifery prep program. The pricing is reasonable and the staff is flexible and friendly. The organization is owned by it's members and therefore you will not have anyone micromanaging your personal doula company, telling you what you can and can't say and do. They also teach how to start and build your birth business. From real life, successful doulas. There just simply isn't an organization like this out there.

Are you feeling led to become a doula? My aunt once told me that it was my "calling" to assist pregnant and birthing women. I wondered what that meant. Now I'm living it.

I have this cute little book that my kindegarten teacher Mrs. Baumgartner made waaaaay back when... It was a self-portrait on each page of all her students, and on a page in the back, she listed all our names and what we wanted to be when we grew up. Many children put president, or firefighter, or doctor or astronaut. After my name was 3!! ha ha She listed that I wanted to be a "Mommy, a teacher and a nurse."

As a doula, in a sense, I am kind of playing all 3 roles. Doulas mother the mother, and teach her how to love her baby and care for herself. She also has a knowledge of medical, anatomical and physiological processes involving the pregnant, birthing and postpartum mother as well as fetal and newborn internal mechanics.

It's so important, for the families we serve, to get a well-rounded education and complete a credentialing process from an internationally certifying body. You can help set the standard. You can be one of those special women who assit mothers to get the care they need, even when they cannot afford it. You can be the change in the birthing world. One of the ways you can do that, is to be pro-active in education.

We need more top-level skilled doulas in the world, to keep making a difference!!! So what's stopping you from getting certified? Start your program today! You are worth it, and the families you will serve in the future will be so grateful you took this step.

-Anne

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............

Becoming a Doula-Minded Birth Advocate

Many years ago, I was holding hands of friends in labor, and walking the halls with newborns so mothers could sleep.  I was changing diapers of babies with RSV and cuddling moms who cried over their birth stories. 

I gave birth to my first baby at age 17.  I didn't know anything.  I never had any idea that someone might think I wouldn't succeed at delivering vaginally.  I didn't know the cesarean statistic or that women still gave birth at home.  No one ever bothered to tell me that my breasts would fill with milk, whether or not I chose to breastfeed.  I didn't wonder how I would ever push a baby out or if I could manage the discomforts of labor.  Nor did I think about whether I wanted drugs or not for pain.  I honestly did not have a clue they were even an option.  I just figured you had a baby and that was that.  There was so much I was ignorant of.

There was so much I didn't know, that I had no time or inclination or reason to question the natural processes my body went through.  I didn't question my weight gain.  Never thought about how much amniotic fluid I had or if I might catch the flu.  I went on my way, carrying my baby and eating, eating, eating, dancing and walking and enjoying every kick and flutter.  Can you imagine a pregnancy like that nowadays?  That was only 1992/1993.  Not really that long ago.  Over the last 20 years, what has happened in our society, in our medical care system, in our circles of friends and family that has turned the perception of birth into such a frantic, frightening, and frustrating scenario?

Ask yourself these questions: 

• When I've heard about birth, what was a main theme in each story? 
• Did I feel fear upon hearing the story? 
• What has shaped my ideas about birth?  Mother? Aunts? Sisters? the Media?
• When I've spoke of birth, what has been the tone and intention of my story? 
• Have I told a Hollywood version of my experience, looking for the oohs and awws or have I told the boring details right along side the exciting ones? 
• Have I been truly, completely honest when talking about my birth with people?

Consider your answers and consider also what part you've played in influencing the women and girls around you and their perception of birth.  Perhaps you've built healthy ideals, or perhaps you are now recognizing that you can do better.

I'm interested to hear how you might make some changes in your own birth-speak, or how you feel we can better affirm our societies' positive ideas on birth.

-Anne