Some thoughts on doula certification and DONA inspired by maia

Maia from Guerrilla Mama Medicine has some greats thought up from the International Center on Traditional Childbearing Conference. She also talks about her own experience with DONA, the primary organization that trains and certifies doulas:

but i never finished getting my DONA certification.  something about DONA rubbed me wrong when i was in my 3-day workshop.  i guess, it was the protocal.  the protocal that says i am not supposed to contradict the doctor or midwife or nurse.  the code of ethics and the scope of practice that describes ways to communicate that are presented as ideals of respect when they are really white culture-centered forms of respectful expression.  also the workshop and training programs never require for doulas to deal with issues such as race, class, sexuality, etc.

but i kept convincing myself that i needed to complete my DONA certification because i had already invested so much money and time and energy into DONA.  even if i did feel a little dirty inside about it all.

DREAMS

i have been having dreams of birth sisters…women who support women through birth, no matter what. revolutionary sisters.  women who will go to jail for a birthing person.  someone who will support you as much or as little as you need.  through an herbal abortion. a miscarriage. on the phone during an unassisted birth.  without insurance.

when i told midwives while i was preggers that i wanted an unassisted birth, they thought that it was because i didnt have the money to afford a home birth.  it wasnt that at all.  i wasnt desperate.  i was confident in my body.  and the level of racist and classist condescension i received from midwives in minneapolis (which is supposed to be such a mecca midwifery in the states) makes me cringe for the future of professional legal midwifery.

help me think of a name…and we can start a fire that burns all of the pretentious midwives who go to mexico as midwife students, but then return to the first world and finance their upper middle class lifestyle by giving birth to upper middle class women’s babies with the skills that they learned from the bodies and strength of brown women whom they only see now washing dishes and pushing strollers.  brown women who usually cannot afford such professional expertise birthing professionals.

I have had similar thoughts and feelings about DONA over the years. I did my training with a DONA certified trainer (the now famous orgasmic birth advocate Debra Pascali-Bonaro). I really like Debra, and I think she is a great birth advocate. But what Maia says is true. We never talked about race, class or other issues that impact the women we might work with. There was also a focus on the “business” side of doula-ing. I never had any interest in being a professional doula, in making money from the work. For me, it’s a form of activism, a way to support and accompany women through their labor. Women who are in need, immigrant women, young women, low-income women, incarcerated women. I think that all the doulas out there who work for professional women, with class privilege and the ability to really choose their birthing environment are great. Necessary. Important. All women deserve to be supported during their births.

But I, like Maia, yearn for a community of radical doulas who want to use their doula work as a way to impact the larger systems that oppress us. Who want to empower women of color, young women, incarcerated women. Who want to talk about systems of racial oppression, sexual oppression. Who want to support and be supported by radical queer, trans and gender non-comforming doulas. Who want to re-center our medical system around the needs and wants of the people in our community, who have historically been abused, marginalized, manipulated.

I did my DONA training, but I never completed my certification. This process takes a few years, a significant amount of money and A LOT of paperwork. The paper work was my biggest deterrent. The only doula work I have ever done was as a volunteer. After offering my services to women in a public hospital, I felt that it was unfair of me to then ask them to fill out paperwork about my role as a doula. I didn’t want to do my doula work in a way that was self-serving. It wasn’t about me, it was about them. So I never became certified, and I hope that the day I begin my work as a doula again, this will not stand in my way.

Doulas on the Today show

From the MSNBC website:

By the eighth month of my pregnancy, I had become accustomed to the blank stares and raised eyebrows I received at each mention of my doula. Maybe it was the “doo” or maybe it was the “lah,” but there was something about the tone and feel of the term that rendered the uninitiated people in my life either instantly confused or quickly judgmental.

If a rain-stick dance is what I felt I needed to enhance my birth experience, there’s a good chance that a doula would deliver. But my reasons for enlisting the services of a doula were much more simple, going back to the origin of the word.

Since they focus solely on nonmedical care, doulas can spend their energy comforting and encouraging the mother and her family and helping them navigate the slew of questions and decisions that often need to be addressed during labor and delivery. “When I’m working with parents as a doula I want my role to be uncomplicated by the clinical aspects of birth,” says Young. “I’m there to meet their emotional needs, physical comfort needs, to help them with information.”

New York City Abortion Doula Project Launched!

I’m really excited to be writing this post, announcing that NYC has a new abortion doula project. I’ve written about the idea of abortion doulas before (see these old posts). Also I wrote an article for RHReality Check a year or so ago about some other abortion doula projects around the US.

Doula care is expanding across the United States as more people become familiar with the concept and more women seek out their services for labor and delivery. As this expansion continues as a part of the wider movement to change the standards of maternity care in the United States (by lowering intervention rates, increasing midwifery care and educating women about birthing options), there are doulas trying to apply their skills to another arena of women’s reproductive lifecycle: abortion care.

While I was living in New York City, I connected with two other doulas, Mary and Lauren, about the idea of starting an abortion doula project in NYC. I thought it could be a great way to provide this service (on a volunteer basis) to women receiving abortions in New York City, and also serve the political purpose of broadening the scope of doula care. We worked together on the foundations of this project up until I left NYC in February and I am happy to say that the project is almost up and running! They are going to be training a group of women in a few weeks and have begun providing support to women receiving abortions at Bellevue Hospital.

Stay tuned for more updates about the project, and a Radical Doula profile about Mary!

Interested in learning more about the project or getting involved? Email marymATprotectchoiceDOTorg.

Great piece about the Birth Attendants and prison doulas

From the Seattle Times:

The doulas, members of an Olympia-based doula group called The Birth Attendants, work with the entire prison population as well as the prison’s Residential Parenting Program, which helps pregnant inmates and new mothers maneuver their way through childbirth and beyond.

“We’re not there to pass judgment,” but to educate, said doula Zimryah Barnes, who is part of the prison-doula project. “We don’t deny anybody support who requests it.”

Barnes and other members of The Birth Attendants have become a familiar resource around the prison since they brought the concept to prison officials in 2002. Barnes said the program is based on a similar one in prisons in the United Kingdom.

The doulas offer one-on-one counseling sessions and courses on sex education and family planning. Some doulas even are present when inmates travel to a Tacoma hospital to deliver their babies. Many of those inmates are allowed to raise their children inside the prison as long as they follow strict behavior guidelines.

Read the rest of the piece here. Yay Birth Attendants! Luckily I have heard rumblings of a few other projects like this one cropping up, which is really important. I also learned recently that while the United States only accounts for 5% of the world’s population, we are responsible for 25% of the world’s prison population. Scary.

Thanks to Feministing reader Amanda for the link

Upcoming Doula training in Atlanta

Information about upcoming doula training:

SisterSong is pleased to partner with the International Center for Traditional Childbearing (ICTC) to provide a Full Circle Birth Companion/Doula Training. The training will be held at the Mother House, SisterSong’s national office in Atlanta, Georgia on April 24 – 27, 2008.

ICTC’s Full Circle Birth Companion/Doula Intensive will train you in cultural awareness and sensitivity, infant mortality prevention, high risk pregnancies, medical terminology, inter-uterine growth retardation, nutrition, comprehension, prenatal support, labor management, massage therapy, HIPPA and much more:

Do You Want to Be A Full Circle Birth Companion or Doula? Would You Like to Meet Outstanding Midwives? REGISTER NOW!  Application form is available online at http://www.blackmidwives.org. Training fee is $375 for ICTC or SisterSong members and $425 for non members.  For more information about the training, please contact Shafia Monroe, Trainer at 503.460.9324, email sistahmidwife@msn.com.

Scholarships will be available. All are Welcomed.

Thursday Evening is an Orientation and Welcome Reception; Friday, Saturday and Sunday are training days.

Update on NYTimes doula piece: Letters

The Sunday NY Times article on doulas created a large response from the doula and birth community. You can see the letters to the editor that were published in response. Not surprising that there were no “right on! my doula sucked too!” letters.

I even saw a comment on a listserve from someone who knows the doula mentioned in the first portion of the piece, the one who supposedly walked out on her client. According to this person she left because of hospital policy (no one allowed in the room when the epidural is being administered) and came back afterwards. It’s all very secondhand, but would not be surprising.

A birth story to brighten up your friday

Some of you may remember a while back when I posted a call for radical doulas. A woman (who I will call J) had reached out to me because she was having real difficulty finding a doula for three reasons: 1) She was serving as a surrogate for a gay male couple 2) She had had a “selective reduction” of the resulting twin pregnancies to just have one child 3) She wasn’t sure if she would forgo an epidural.

This is quite amazing timing considering the doula article from Sunday’s NYTimes. It shows that yes, there are some doulas out there who allow their personal beliefs about lifestyle as well as birth choices to direct who they work with. But the overwhelming response to my call for radical doulas also shows that there are just as many (if not more) doulas who are willing to support all sorts of women with all sorts of birth preferences.

J was awesome enough to share her birth story with me and you all will be happy to know that she eventually found a great doula who supported her through her birth. Her story made me tear up, and reminded me why I do this work (and why I bother fighting anti-doula ignorance in the blog world too).

Happy Friday everyone.

From J’s email:
Hello!
I don’t know if you remember me but a while back I wrote to you to ask for help in finding a doula for when I gave birth to my surrogate child. After I found a doula I told you I would update you after I gave birth.
Well, my surro-child is here! He was born on Feb 12, two weeks before his due date. My doctor felt that it would be best to induce labor since my blood pressure had been creeping up slowly over last month of my pregnancy. He wanted to err on the side of caution and I was ok with that because I knew the baby’s dads were starting to get nervous.
Thank goodness for my doula! I was started on pitocin around 8 AM and she got there at 10 AM just as I was starting to feel contractions. For the next 8 hours she would only leave my side once and that was just to go to the bathroom. She helped me through every single point of what ended up being a hard, painful and occasionaly scary labor. At one point in my labor the baby’s heartbeat started to drop and my doula was the one who got me to move into different positions just in case the baby’s cord was getting pinched. Turns out she was right! After I moved around a few times the baby’s heartbeat was just fine. I wonder what would have happened if she had not been there to suggest something as simple as changing positions!
At another point my doula rubbed my back for two hours straight. She always seemed to know just where I needed to be touched. If I was tensing up in my back or shoulders she would gently rub them to remind me to relax my body. She also seemed to know when not to touch me. If I was tensing up my face she would remind me to feel the contraction in my belly, not in my face. Sounds like a no-brainer, I know, but just having her say those things helped me make it through.
The rest of the birth story after the jump

Continue reading

Bad press for doulas from the NY Times

Sunday’s article in the NY Times Fashion & Style section (again, why do women’s issues always get shelved in this section?!?) presents some bad press for doulas. The title, “And the Doula Makes Four” already implies the three’s a crowd mentality that doesn’t bode well if we think about the hospital delivery room.

The piece goes on to share the story of one mother who was less than pleased with her doula:

Then labor began — and went on and on — and Ms. Myers’s opinion took a nose dive. Though the doctor recommended that Ms. Myers receive intravenous fluids to hydrate her, the doula, eager to avoid medical intervention, insisted that Ms. Myers ignore the suggestion, causing her contractions to spike. When she ultimately chose an epidural, her doula walked out. “She was so set on my having a natural birth, she offended me, she offended the nursing staff, she offended my O.B.,” Ms. Myers said.

These types of stories are disappointing to see, especially in the mainstream media. Doulas get so little press (how many people have never even heard of one?) but of course stories like these are what makes the news. As I’ve talked about a lot on this blog, I don’t support doulas who do not support women’s choices. In my opinion, a doula who pushes a woman to do something she is not comfortable with is not doing a good job supporting that woman. There is a fine line between pushing someone and giving them options or encouraging them to try different things.

That said, I also think there may be some important facts missing from this piece. There is much more to be said here, and this article really does present a one-sided view of the issue. Things that the piece missed:

 1) The perspective of the doula. In many of these cases with doulas in the hospital setting, the doula is put into a really difficult position for a number of reasons. First, medical staff (nurses and doctors) can be really hostile at times, even when the birthing mother advocates for the presence of the doula. The staff can feel threatened by the doulas presence, treat her with disrespect and make their disapproval of her presence clear to everyone involved. Also many of the techniques that a doula encourages are outside the scope of OB practice–things like massage, acupressure and visualization can be things that doctors and nurses don’t believe in, creating more animosity.

2) Most doulas work from the preferences and desires of the birthing mother. The parents may design a birth plan or at least outline the kind of techniques and strategies they want to try during their birth ahead of time. It is these preferences which guide most doula’s practice. Often things happen during a birth that change these preferences, but also frequently the hospital staff and their influence on the mother can change these as well. It is a very difficult balance to strike.

3) Being a doula in the hospital is hard. I say this one from experience. The hospital environment is far from welcoming, and when you have opinions and philosophies (as well as experiences) about what birth should look like, it’s really difficult to stand by and watch that be violated. As a doula you have practically zero control over what is done and what happens in that delivery room, and many times you are the only party involved who is specifically focused on the emotional needs of the birthing mother.  

4) Not every doula is right for every woman. Just like not every doctor is right for every woman, not every doula is a good fit for every woman. It is best when the doula and birthing mother realize that ahead of time so a better match can be found. Things like philosophy about birth and medical intervention are important to discuss ahead of time.

I think the bottom line in all of this is that the increase in doula presence at births is ultimately being driven by the women giving birth. Modern OB practice is going to have to adjust to accomodate the needs of birthing women, who are not going to stand idly by and accept a 1 in 3 c-section rate.

Mile-High doulas

I was on a Frontier Airlines flight to Denver yesterday, and out of boredom I started flipping through the onboard magazine, GO Wild. To my great surprise there was a short piece under their “Thrive!” section entitled: Resolve Isn’t A Swear Word: These remedies are just what the doctor, the doula and the debutante ordered. Are doulas reaching the mainstream? The remedy they mention in the piece is Erbaviva’s Organic Quease-Ease Lip Balm, something originally created to help women with morning sickness. Not so doula relevant. So maybe they just picked doula cause it went with the alliteration, but still! The more visibility the better, I’d say.

The Business of Being Born

I finally got to see the movie that has been garnering a lot of attention in these past few months tonight.

I’ve seen my fair share of birth movies, but The Business of Being Born is definitely worth the hype. I highly recommend it. It does an incredible job of summing up a lot of what is wrong with birth today, particularly in regards to hospital-based maternity care. There is also footage from a couple of really beautiful home births (no matter how many births I see, whether in person or on tape, I still tear up every time).

I have to say that even after all this time in the birth activism world, it still gets me so fired up to hear about just how absurd it has all gotten. 70% of births in Europe and Japan are attended by midwives, compared to less than 3% here. Maternal and infant mortality rates are not good compared to other developing countries. Interventionist hospital practices create a domino effect that ends in an “emergency” c-section that is actually a result of the interventions in the first place–for one in three births. I could go on and on. Ricki’s movie does, and everyone should see it.

While it doesn’t say anything new, or anything that hasn’t been said by midwives, doulas or activists in the past, she does have the possibility of reaching a new and broader audience thanks to money and fame. Hopefully more women, men, doctors and medical students will start to see the light on this epidemic.

I’ll leave you with my favorite quote from the movie, from Marsden Wagner, the author of Born in the USA:

The best thing to do if you want a humanized birth is get the hell out of the hospital.

Amen.