Doulas--help me understand

[MsBlack]

I am a hbmw. I have worked over the years several times with a doula also present at births, and this has been great, I recommend hiring a doula. The doulas I've worked with were quite experienced when they participated with my clients--but recently I have come across a newbie doula wanting me to refer my clients, who has prompted some questions for me:

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

If you shadowed, or were present at some births as an observer only--no doula work involved (say, for friends who didn't want a doula but were willing to have you there for your training benefit), do you count those births as part of your resume? Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

That should cover it...hard to boil it down to simpler questions. I'm trying to understand the professional and ethical standards of doulas--you can help me get the range of opinions. My hackles are raised over the issues above, and this might be out of line with current doula standards. I want to be fair...but if the limits of honesty are being strained in this newbie's self-presentation, then I can advise my clients on specific questions to ask prospective doulas, so they can be clear on just who they are hiring. I'm committed to supporting newcomers to birthwork, and generally participate in community building among us (mws, doulas and cbes)--just want to be sure that my support in any case is in line with realities, if you know what I mean.

In great appreciation for your time and thought,
MsBlack

[CMcC]

[QUOTE=MsBlack;8244695]I am a hbmw. I have worked over the years several times with a doula also present at births, and this has been great, I recommend hiring a doula. The doulas I've worked with were quite experienced when they participated with my clients--but recently I have come across a newbie doula wanting me to refer my clients, who has prompted some questions for me:

I am a student doula. Have only done 2 births so far.

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

No, but I do let them now what kind of experience I've had. I read Birthing From Within cover to cover many times and used it for my last birth. For my first birth as a doula, the mother used hypnobirthing. So while I don't consider myself by any means an expert, I do have some knowledge about these 2 methods.

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

I am taking all of my training by shadowing certified doulas and midwives. We meet once a month for an overall meeting to discuss topics and births. But they are always just a phone call away at anytime. My first birth was with a certified doula/ appprentice midwife. My second birth was a homebirth with 2 midwives. The upcoming birth is up in the air right now as she is trying to decide whether she wants to continue with a hospital birth or go for a homebirth. We also are required to read certain books, attend meetings, and attend birth classes given by the midwives/ doulas. After 10 births, we are evaluated and tested. If we pass, we get the title of certified doula.

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

Yup, my first 10 births are free as long as my co-doula is also a student. (We have unlimited access to call the midwives and doulas at anytime.) If I attend a birth with a certified doula, the certified doula gets half price as they only attend half the prenatals and maybe only a partial birth. (I'm still free.)

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

Like I said, I am still a newbie. Yeah, I let them know I am a student. I will probably call myself certified when I get to that point. But I'll probably still tell them I'm still newly certified....

If you shadowed, or were present at some births as an observer only--no doula work involved (say, for friends who didn't want a doula but were willing to have you there for your training benefit), do you count those births as part of your resume? Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

Well, I don't know. At the homebirth technically I was more of an observer... she just didn't need hands on support. (Especially since there were already 2 midwives and a hubby there.) But they are letting me count it towards my certification. I learned SO much for the homebirth, though!



All in all, I would make sure the clients know exactly what her experience is especially since she is new. I think experiences whether personal or as a doula is very helpful, but I would never represent myself as a professional when I'm not. There are a lot of doulas that take courses by mail. Then there are doulas that have no formal training. When I become certified, it won't be through a big organization like ALACE or DONA.... but I'll probably have more technical skills than the average doula. Since I work with midwives, they are going to teach us how to do a vaginal exam in the event a client wants one before deciding to go to the hospital. Which is a big "no no" to most doulas. Some doulas don't even want to attend a homebirth. So there really is a broad range of doulas. As a student doula, I do 6 prenatals... more if needed. We do a lot of education on what the client's options are (especially if they can't attend a childbirth class given by the midwives.) We encourage and support breastfeeding and have 2 -3 postpartum visits. But I've learned that some doulas only meet their client once or twice before the birth and don't do any education or postpartum visits. So like I said, not all doulas are alike and there appears to be a range of "services" you get when hiring a doula. If you think the new doula and client would be a good match...then I see no reason not to recommend her. She does need to be upfront about her experience and training, though.

[nimblemama]

I'm not a doula, but training as a CBE with ALACE. I have researched many of the certifying bodies for doulas/childbirth educators and like to lurk at forums such as alldoulas.com. I understand your concern because there are so many kinds of doulas out there. Many doulas advertise the birthing method with which they trained (bradley, hypnobirth, etc) Most doulas go through a workshop to learn these methods. Various books/manuals are read and exams are usually involved. Of course, doulas need their certifying births, as well. Depending on the certifying body (CAPPA, ALACE, DONA, BirthArts, etc) 2-6 births are needed. This means (in the most basic sense) that some certified doulas may have only attended a handful of births. I think a doula should be truthful and open about her experience and services (as well as midwives). Some have been doing this for a long time, but others just starting. We all have to start somewhere, though. Some say that doula work can be a fad. I think many women think being a doula (as well as a CBE or midwife) is "cool", but in the long run, they just fizzle out. So one has to watch out for those, but there are also plenty of very supporting and professional women out there.

[eviesingleton]

From where are you posting, if you don't mind me asking?

I am starting the process of becoming a doula. I fully intend to be upfront, honest, and specific about my experience (or lack thereof). I also intend to work with individuals such as yourself who can give good guidance.

[MsBlack]

Thanks, Ladies--

I am in the midwest...pm me for more info, evie--I'm not the most internet savvy of people so it might be easier for you to initiate pm comm.

I'm not so concerned with certifying through an org., tho of course that lends a certain degree of certainty about knowledge/standards of care, just as midwives being CPMs, or licensed or whatever, lets people know something about what to expect. I *am* concerned about honesty, and letting people know the real facts rather than on creating a professional image that leaves too much to the optimistic and trusting imagination of people who might not be experienced enough to sort things out clearly...heck, I even tell people planning an OB/hosp experience to ask about OBs and hospital's csec rates, bf support, etc--and they often are so surprised to consider that that could be a good idea, rather than just trusting those fine little certificates on the wall, or the cute advertising about 'special moments' that hospitals have!

I'm a self-taught mw and have no certifications of any kind. For me, it was utterly crucial that people know exactly what I can and can't do, where I got my knowledge, what my experiences have been specifically. So I will say, 'I've been a primary mw for x # of births, an assistant at x #, an observer at x #, etc.' I do feel that my assists and observes have been quite valuable to my training, and I want my prospective clients to know that--but still. I *could* just say, 'I've attended x# of births', which would make me look pretty much more experienced, and leave it to people to assume that I've primaried that often...but it doesn't seem quite honest.

I might also say, 'I've read BFW, and love the concepts and have a background in psych and counselling, so I believe I could work with you on that style. But I've not been certed in BFW or anything...' And so forth. To me, if a doula in training has read BFW, and then offers to do some birth art work with one client and it seems to go well, to me it is premature to post a resume that says she can offer birth art work...to me, that is something you would earn the right to do later, once you've experimented several times with clients who go into it knowing that you're not certed in BFW or art therapy, and are still learning. And then, when you've learned what does and doesn't work, refined your understanding, your presentation, and learned how to deal effectively with the sometimes intense emotions that can arise from such work and you have established replicable success...well THEN it's appropriate to post this on a resume (with or without a cert of any kind). I could even see 'developing a service of birth-art work' or 'in training re birth-art'...but again, for me it's about honest representation not to mention humility and a birth worker's need to know her own limits.

It is great to hear these different approaches, I had no idea and I should.

Anyone else with input, please do jump in!

thanks.

[1stimestar]

Originally Posted by MsBlack

I am a hbmw. I have worked over the years several times with a doula also present at births, and this has been great, I recommend hiring a doula. The doulas I've worked with were quite experienced when they participated with my clients--but recently I have come across a newbie doula wanting me to refer my clients, who has prompted some questions for me:

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

Thanks for looking into this part of being a doula and investigating your concerns. I advertise that I have experience with unmedicated and medicated births, hospital, home, and birth center births, vaginal and surgical births. I have had clients interested in hypnobirthing so have read a few books on it but have yet to have a client that was really committed to that program so have not felt the need to train in it further. We have limited access to it here in Alaska.

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

When I started there were no other doulas around to shadow. I had to drive out of state (from Montana to Washington) to attend my original training. I would have loved to have had the opportunity though.

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

I strongly urge doulas to NOT do free births. They end up not getting called for the birth after spending countless hours doing prenatals etc. It is very easy to get burned out if you are not getting paid something. I do recommend doing those initial births at a reduced fee. But really, they must be able to cover their expenses at least. I don't remember at what point I started charging what would be considered full fee.

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

I don't think many people consider you an experienced doula after attending 3 births. Being certified does not mean experienced. I did feel the need to tell people that I was a beginner when I was but I don't know that others would feel the same need.

If you shadowed, or were present at some births as an observer only--no doula work involved (say, for friends who didn't want a doula but were willing to have you there for your training benefit), do you count those births as part of your resume? Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

For DONA International certification, the births that you simply are present for do not count towards certification. One must be the main support person and be in attendance from the onset of active labor for it to count (among other requirments.) So for the example given above about "just being there to see it" would not be able to be counted as a certifying birth with DONA. I have told clients who asked that I attended my original basic doula training in 2000 but was accompanying friends and family to their births before the term doula was very well known. My first birth was in about 93-94. I was hooked after that.

That should cover it...hard to boil it down to simpler questions. I'm trying to understand the professional and ethical standards of doulas--you can help me get the range of opinions. My hackles are raised over the issues above, and this might be out of line with current doula standards. I want to be fair...but if the limits of honesty are being strained in this newbie's self-presentation, then I can advise my clients on specific questions to ask prospective doulas, so they can be clear on just who they are hiring. I'm committed to supporting newcomers to birthwork, and generally participate in community building among us (mws, doulas and cbes)--just want to be sure that my support in any case is in line with realities, if you know what I mean.

In great appreciation for your time and thought,
MsBlack

Do you know what organization she is certifying through? If it is DONA (and probably it would be similar for other organizations) you can contact her State Representative with your concerns so that they may be addressed. You can direct your clients to our "How to Hire a Doula" at http://www.dona.org/mothers/how_to_hire_a_doula.php
You can read our Code of Ethics and Standards of Practice there as well. I am the Alaska State Representative and would be more then happy to help you brainstorm more ideas on how to get this doula on the right track.

[DoomaYula]

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

I wish there were those options in this town! There's ONE childbirth class here (taught at the hospital) and I've sat in on that twice. I have only gotten one client who wanted specifically to use a certain method. I told her that I'd attended one birth where a client had used that method, and I'd read the book, and I would be happy to re-read it and help as much as I could. When I was pregnant with #3 I took "Birthing From Within" and I've read the book, so I tell people that too. If there were a need for experience with XYZ method, I'd be happy to learn about it, but I get 99% hospital birthers who just want to get through it.

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

I shadowed at 2 births. I would have been happy to shadow at more, but there was only one other doula here in town, and she moved after soon I got here.

*I think I'm not a great person to answer these q's, as situation -- being the only doula in a VERY small mainstream town -- doesn't lead to a ton of opportunities, ya know?*

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

I did a free birth once, and it was an awesome birth, but it cost me $150 in babysitting money, so I realized that wasn't so brilliant. I charged $100 until I passed my ALACE written exam and had enough births to be considered certified. Six. After that I started charging $400, with a sliding scale down to $250. Also, we have a women's shelter and I've always offered to help those women for free (as my only real expense is babysitting, and my best friend does it and would be happy to babysit for free if I were helping a woman from the shelter).

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

I'm still in my early days! Prior to being certified, I said I was trained with ALACE, and when I became certified, I said I'm a certified doula. Luckily, my first 10 births have been a real variety of moms/babies: VBAC; med-free; med-full; c-section; homebirth; hospital birth; primip; multip; grand multip; dh deployed; lots of family there; and a variety of fertility situations. And I've birthed twins vaginally, in a hospital; and a singleton at a birth center; and I'm planning a hb. So I say, I haven't been doing this forever, but I have attend a large variety of birthing situations.

[BirthFree]

Originally Posted by MsBlack

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

No. I feel that I can work with any type of birthing method - if a couple was using a method I had not worked with as a doula before, I would let them know in our preliminary meeting.

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

There were no doulas to do this with when I was training so no. I would have died and gone to heaven if there had been - even ONE birth would have made me feel more prepared. Though it's not like "if you've been to 100 births you've seen it all and are now prepared for anything".

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

I did, but I think it depends on the doula if they are in a financial position to be able to do this. It can be hard to put in the amt. of time to be a doula and not get paid (and if, like me, they have kiddos, pay someone to watch them if they need to is an additional financial loss). I did free for 8 births, partial-pay (reduced fee) for another 3 and then full-fee. I am just now raising my prices now that I have 2 years of experience and extensive (well, in this area anyways) VBAC-doula experience.

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

To get 20 births may require someone to work for 2+ years... so those are not early days for a doula. I told people how many births I had as a doula - and now that I am more experienced both in my interview processes and a doula, I don't bother. I let them know I have referrances if they want them, and that I feel it is most important for them to be comfortable with their doula first and foremost, so if I am not a good fit, I will be happy to give them other referrals to local doulas.

If you shadowed, or were present at some births as an observer only--no doula work involved (say, for friends who didn't want a doula but were willing to have you there for your training benefit), do you count those births as part of your resume? Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

This did not happen as it was not a possibility, but I would say that, yes. Being a part of someone's birth is very unique in my area... most people are (understandably) private about it and not often is there an opportunity to just be there.

To be honest, let her know that you would be happy to add her to a list of doula options that you keep in case anyone is interested in a doula. You don't HAVE to give out her information or promote her with your practice - but I would warn you against warning others or trying to avoid them choosing her. I wanted to use a doula for my birth a few years ago and my hbmw's did not jive with a local doula - so they told me they could both be my doula and my MW.

As I'm sure you know, they are two VERY separate jobs and not something that is done simultaneously (as when the baby is crowning, your JOB is the baby - not Mom's emotions). I still to this day am angry they did not get over (or deal with, if getting over it was too much) their bias against this doula. There were other options for me to choose but b/c they didn't like ONE doula, they didn't want any chance of anyone choosing one. How lame is that??

SO, this doula probably needs some time to grow into the responsibility that is doula-ing. She likely will cut her teeth with her first few births and realize that it's a big job and not something that you take lightly.

If I were you, I'd keep a list of questions to ask a potential doula like:
~How were you trained (b/c it doesn't have to be a program, there are good doulas who did not train with a program and bad doulas who did)?
~What is your level of experience?
~Do you have any references I can contact?
~Do you have a back-up doula if you are unavailable? What types of situations would this doula cover? (Some doulas are unavailable while they work certain days of the week, and some just need back-up for the very rare occasion).
~What drew you to being a doula?
~What were your own birth experiences like? (This can sometimes tell you a lot about where they are coming from experience wise).


And honestly, experience is how you learn a lot. There have been more than a few times where I walked away with another trick in my bag - b/c the birth drew out something new. It's not that new doulas are not good b/c often they have more desire to do EVERYTHING they can because they know they are starting fresh - and someone has to be willing to help them learn.

I may ask her - "As you build your doula practice are you offering any sort of discount (like 15%) to new clients?" when you add her information. If you have most of her information, call and see if you can get her website info (if you don't have it (even if she doesn't have one)) so you can get an excuse to talk to her further.

Those are just my thoughts...

~Julie

[MsBlack]

Thanks to the latest posters to this query--lots more good info and food for thought. Much of it really jives with my own earliest experiences of being a doula--way before the word became known, certainly before training or books of any kind! Altho I will say that I took a distance program for basic midwifery (from what has now become ALACE) and cbe, and it included lots of stuff on labor support--it was assumed that a mw would do the labor support (as needed if others weren't available, fam, friends). In any event, I too was in an area where there was no one to shadow, no example to follow, no local groups to meet with for discussion/learning. I jumped in and let experience be my guide--just making sure that all concerned were aware of what they were getting in me. There are situations where one just does what one can, whatever the circumstances allow and demand. No, I could not have done 20births as doula or beginner-midwife in a year or maybe even 2, back then. And I'm hearing that regionally, there is still a lack of opportunity for some doulas.

BirthFree--in the area in question, there are tons of doulas and many of them are doing a good trade (busy as they want to be). It would not be a question of telling folks to avoid this one, but of simply telling them about others I know, but not her. Certainly, my clients are free to do their own search for a doula, and may well hear about her from somewhere. Apart from this one newbie who stimulated my questions, I simply realized that I don't know much about doulas and doula training/standards/styles--that there is a whole world of doulas out there, not just the 2 I stumbled into over the years who proved to be so great. So it seemed good to know more, both addressing my questions re the newbie mentioned, but also more generally--as you have all most generously provided.

Probably what I will do is make use of the questions posed herein--to give to clients who are considering a doula....and let them make their own choices. It is no more or less than I would do concerning any provider, be that medical, chiropractic, alternative, that I myself did not already know pretty well. If a client asked me about any particular doula, there are those I could speak glowingly of, and those I'd have to say "I dunno".

I guess I'm kind of surprised that so many of you have not provided much by way of free services--to me, to pay the expenses while I was learning, was just part of the 'tuition' for my training--which needed to be experiential as well as books and workshops IMO. I felt lucky that people would utilize my services when I was so new at the work, and were willing provide the benefit of their being my 'guinea pigs', my training material--which did have benefits for them, but also was as much needed by me if I were to learn in real life. It is a risk to use a green birth helper! Of course, there should be a limit to that 'tuition', and now, many of you are paying handsomely for training sessions that were not available to me. Still--I guess my own attitude is that becoming really competent as a birthworker takes more than just study, it takes seeing and dealing with the variety of people and situations that can arise with birth...developing compassion and communication and understanding, staying steady when things go wrong and growing with the 'bad outcomes' (by any measure). That doesn't come from study--only from experience and time (tho surely some are born with gifts more easily called into service). Well, I'm a midwife and that was always my goal--so perhaps there are some differences there from doula work.

Anyway, great stuff, thanks all for contributions. Others, still welcome to add your 2cents!

[gemasita]

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

Yes, I tell clients about my experience when they ask. I have experience with Bradley, HypnoBirthing, and Hypnobabies. For Bradley, I have attended some of the classes, read "Natural Childbirth the Bradley Way" and have attended my clients at their birth. For HypnoBirthing, I have attending two births and I read the Mongon Method book. For Hypnobabies, I have attended three births, am a certified Hypnobabies instructor and certified Hypno-doula. I have also read Lamaze books and Birthing from Within.

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

I tried to shadow an experience doula but never could find any. So my first birth was a solo birth. I have had a doula shadow me. I may not be that experienced but I know how valuable it can be to see someone in action. I wouldn't mind having the opportunity to shadow another doula but now that I have done 12 births, it is not a top priority.

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

I did two free births and then started charging a reduced fee. I upped my fee a little after a few more births but I started charging my "full fee" as soon as I was certified. I set my fee at the bottom of the range that I found in my area to make room for the more experienced doulas and as I have gained experience, I have upped my fee a little more.

n the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

I don't call myself a "beginner" - I am just honest about my experience. If someone asks me how long I've been doing this, I say a year and a half. If they ask me how many births I've done, I say 12. I guess I don't go out of my way to call myself a beginner. I know that there are things that I haven't seen or learned yet but this is my job. I am a professional. I have been through my training. I try and learn as much as I can from more experienced doulas and from my clients, books, and articles. I don't think if I were an accountant, I would go around calling myself a "beginner accountant." But if someone asked, I would be honest about my experience. I guess I am coming from the perspective that I am relatively young (31) and have always felt in jobs that I didn't know much but I realized that that was MY problem. People didn't need for me to make excuses about my inexperience. I think it's better to be confident and realize your strengths and advertise your strengths and then also to know you have room to learn. It's just like any other job. You don't go out of your way to call yourself a beginner but we all know that the more you see and experience, the more you learn. I guess I just don't think I have to put in "X" amount of years before I can consider myself a "real" doula or something. (Not that you implied that MsBlack - I'm just explaining how I think about the whole thing!)

If you shadowed, or were present at some births as an observer only--no doula work involved (say, for friends who didn't want a doula but were willing to have you there for your training benefit), do you count those births as part of your resume? Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

I haven't shadowed but I have been graciously invited to attend one birth as an observer and have also attended two births for friends - one as a doula and one just as a friend. I used to try and explain all of that to people but it just got too difficult so now I just count them all. I was a doula when I attened them so I observed them as a doula would - trying to learn more about birth. I would be honest if someone asked about this but usually people ask how many births I have been at and I just tell them the total.


I guess the bottom line for me is HONESTY. There's a doula out there for everyone. Some people like a more experienced doula, some like a doula closer to their age, etc, etc. I don't even have children yet and some people mind and others don't. I am just honest, no matter what and this always ends up being the best policy.

[Sileree]

Originally Posted by MsBlack

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

I still provide it for cheap - I've done 14 births now, all of them for free through a volunteer organization. I've recently begun to charge about $100 if clients don't qualify for a volunteer doula.

Originally Posted by MsBlack

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

I didn't say I was a beginner or expert, I just was honest about how many births I had been to and whatever other experience I had had.

Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

I was able in high school to observe a CNM at UofM deliver 4 babies, but I don't count those as doula births, since I was only there for pushing and postpartum.

I think honesty is key for a client-doula relationship. I've also not had kids of my own, and I am very upfront with that. All of my clients have not cared as well that I started this at 19. They don't feel its a problem and that a caring, committed person is more important than experience.

[courtenay_e]

answers included in body!

Originally Posted by MsBlack

Do you specifically advertise your ability to work with the various birthing methods--lamaze, bradley, birthing from within, hypnobirth, etc? If so, can you tell me what, if anything, you did to prepare for this--read a book, sit in on a class, other?

Yup, I sure do. I attended hypnobirthing classes and used hypnobirthing for both of my personal births. I have also attended hmmmm...maybe three or four hypnobirths (as doula). I read the hypnobabies book, listened to the CD, and attended one birth as a doula. To me, the process behind the methods (deep relaxation) is similar enough that I am confident supporting either "model" and tell them all of what I just said. I also sat through a series of Bradley classes, sit in on several Bradley classes to co-teach them (when she has clients she wants specific info from an "outside" source...ie: doulas, birth plans, specific stages...whatever), and have supported Bradley couples for a good half of my births. I say that, as well.

Did you do any shadowing of experienced doulas before taking on your own clients? If so, how many births did you shadow before you felt 'finished' w/shadowing?

Did not KNOW any in the area when I started, so...no.

Did you provide free or very cheap services, while you were still gaining some practical experience as a newbie? If so, at what point did you start charging 'full fee'?

I did my first six births (my certifying births) for free. Although, I have to say that two of those couples paid me after the birth as a "tip" because they were so pleased with my work, and two others gave me what would be the equivalent of barter, for the same reason.

In the early days...say, within your first 15-20 solo experiences as a doula...did you tell people that you were a beginner? Or did you begin to advertise yourself as a full-fledged professional as soon as you'd done the required # of births for your cert (if you got cert'ed)?

Certainly for my certifying births I did, as I was advertising myself as such to get my cert'ing births "in" more quickly. After that, I never hid how many births I had done...and almost always the client asks me. For the first year, though, except for the month I took off, I really did about three births a month...so I got to a high number rather quickly, and worked allll over our area.

If you shadowed, or were present at some births as an observer only--no doula work involved (say, for friends who didn't want a doula but were willing to have you there for your training benefit), do you count those births as part of your resume? Let's say you shadowed/observed 5 births...and actually doula'd 5 more...do you say to prospective clients "I've attended 10 births", or "I observed 5 births in training, and have been the doula in 5 more"?

You know, I never thought to mention the births I'd attended as a friend or family member. I have only ever "counted" the births I have attended as a doula in my "experience"...because, well, it really wasn't my sole responsibility to act as educator, advocate, support (physical/emotional for mother and/or partner)...as I wasn't "doing the job" I guess I never thought to use that on my "resume" to a client.

I have a lot of hospital experience outside of doula work. I have spent time "midwifing" my grandparents both to their death (and I mean support 8-10 hours a day for months for Lou Gherig's Disease and after a stroke), as well as with my husband who has had sarcomas removed from his gut twice, involving many systems in his body and all that entailed(lots of time in the hospital). So, I guess I'm comfortable in a hospital setting in a way that perhaps some doulas starting out might not be? I am also a daughter of one of 13 children, all of whom were born naturally, and my mom is one of 7 sisters, all of whom had myself and my cousins naturally. I read like a fiend before my first birth, as well. So I trust birth in a way that perhaps some doulas starting out don't. I'm saying this not to toot my own horn...but I also don't think that, just because you know somebody just started out, they should be discounted as not a "whole" doula. I worked from the beginning as an advocate, as support, as educator and resource...much the same as I still do. Yes, I know which units are better and which ones have the worst breastfeeding support, etc...but that doesn't mean that I work less hard at the good units or that I do ANY LESS breastfeeding support because I know that the nurses at a particular unit are actually capable of it themselves. Perhaps I'm unique? I would hate, though, to think that JUST because this woman is a "newbie" you might assume that she is not as capable as another, been around longer, doula...you just never know, unless you've observed her in action! So you know, I'm waiting on my 26th birth (it's been slow since January, I'm in Michigan, and the economy is really horrible...for every one paying birth I get, I get five women calling me asking for free births...which I am not usually against doing...but with gas at almost $4 a gallon, it's not a "free" birth, rather, I end up taking money from my grocery fund to attend them. I just can't afford this right now...so I am much slower right now than I was last year), which should happen some time around the first week in June.

[courtenay_e]

Oh, and, I guess I'll also add that, though I think I'm more than deserving of the going rate in our area (which starts at about $600), I just raised my rates from $500 t0 $550. I strongly believe that keeping my rates lower means that more women can afford me...and I HATE to turn women away when they're looking for support. THough we do have a free service in the area to which I often refer low income mothers.

[ldsapmom]

I don't know what I can remember, but I will try.

I think if you boil down all the "methods" out there, and pull out the basic message and idea, you would be hard-pressed to figure out which was which. While I have experience book-wise of all these methods, it is only through Lamaze that I have been trained. On the other hand, I very rarely have families ask, "Could you support our XYZ Method birth?" I think only once in 7 years (and about 50 births) has someone specifially asked, and it was Bradley.

The basics of being a doula are loving the mother and her birth partner through this life-changing experience. Trainings and certifications past that are just bonuses. Doulas aren't medical practitioners, and as such, if they have the skills either thought heart our through experience or through training, I don't see a difference.

It is the parents' responsibility to ask the questions that separate the wheat from the chaff. That said, if a doula has little to no experience, yet the family feels a connction with her, they should choose her over a doula with years of experience/hundreds of births who may seem harder to connect with.

There are many reasons doulas choose to collect payment/not to collect payment on certifying births. Many, like I, had already been working as doulas prior to attending a workshop and proceeding with certification -- the feeling is, it has been their livelihood, and to give these skills away for free in the name of becoming certified is an insult, as well as the practicality of sustainment through the process.

Others feel to be valued, even as a newbie, there should be a fee. I know of many doulas who offered their services for free and were not called to the actual birth. There can be an attitude of, "Sure, let's get a doula, since it's free."

Then there are doulas who choose to reduce their fees or forego fees during certification. The idea there is, this is a new doula trying to get her name out there and she needs experience and some help along the way.

Although I was a pretty experienced doula (getting paid, even) by the time I attended a DONA training and pursued certification, I did my certifying births for free. Now, I tell doulas considering this, to at least charge $100 for gas/incidentals. I was invited to all my certifying births, but two, especially, I felt the burden of just being there because I was "free." One client even said to the nurse, "This is our doula -- we got her in case I couldn't get the epidural." They weren't all bad, though. They weren't bad at all, but one couple, especially, were absolutely beautiful to work with, and I really felt valued.

As a doula, I do a lot of free and reduced births during the course of the year, and I am sure many doulas do this as well.

[MsBlack]

Another batch of great responses--you guys are great! I never imagined that I would inspire so much time and thought from you, and it's all been really really helpful to me, in understanding things about my original questions as well as thinking more comprehensively about various issues with doula work (and my own work, honestly, on various levels!).

On the topic of payment--I do hear some of you, that asking for nothing can mean that people won't value you as much. definitely been there, done that--UGH! Tho some of my early freebies/cheapies were among the sweetest experiences, too. Besides, I can see that there are doulas out there who have not just 'taken the training & read some books', but have also in their lives done things that most definitely contributed to their abilities as doulas before they ever became doulas. Yes, I consider 'midwifing a death' as extremely valuable experience to birthwork. I do think it is important to include the variety of life experiences in one's considerations/advertisments of preparedness--I know that for myself, there were lots of 'different but related trainings and experiences' I'd had, before ever deciding to be a mw, that contributed GREATLY to my becoming a good mw. Heck, I even consider my failed marriages something that contributes to my value as a marriage counsellor...sometimes called for in my work...I sure know now, what DOESN'T create a happy marriage ;-) (and it gives struggling couples a good laugh when I say this...and the struggling ones most always could use a good laugh).

On the topic of being a 'beginner'--well, I really phrased that badly I can see. No, no one should totally qualify themselves by saying that, especially if they have training of some sort, and/or some success-experiences as a doula. This mainly gets back to the idea of honesty in general--because anyone can create (or hire someone to create) a website or promotional lit...and, advertising can be misleading if not outright false. So I wouldn't necessarily say 'you need to call yourself a beginner', but rather to be explicit about the work you REALLY HAVE DONE and not try to fluff that up to make yourself seem more competent/experienced than you are. Observing births is of great value, and yet is not the same as actually being the doula for that birth....the issue for me (for me as well as any of you) is that of balancing necessary self-respect and self-promotion with necessary humility and honesty. Espcecially when people are starting out in any work, some people would not hire you on the basis of '5 observes, 5 actual assists', but they just might hire you if they believed that you had done 10 actual assists--and to me this is important info to provide. I can't help but think that a new doula who has resume that says "I've attended 10 births" is perhaps feeling herself to be more competent than she has a reason to feel, and just hopes that the public will not ask any specific questions about what she did at those births. Maybe that's just me...but realize too, that not everyone has those supportive 'other experiences/trainings' that give her perhaps a more quickly developed competence as a doula that some have had. Each person has to figure this out for herself...I would just say that no matter how many books a person has read, or observes she has done, such 'study' is not enough, and does NOT make for a competent birthworker...only experiences do that (experiences of various types, to be sure).

On the various prepared-birth styles...well yes, at base there are more commonalities than differences among them. Again, are you saying "I'm willing to work with any birth-prep style" (and then ask to read/listen to what the parents are, etc), or instead implying you already know each style, have studied/worked w/each? Heck, as a mw I work with a LOT of different lifestyles, religions, birth prep styles, personal quirks...etc etc... have training/background in few, before I do. I just make sure that families know my level of experience, rather than implying I'm previously informed/prepared--tho I ALSO say that I'm quite flexible/adaptable, by way of persuasion/self-promotion. Seems you respondents choose to represent yourselves fairly/openly. I think one extremely valuable of any birthworker is the very ability to learn as you go, be open and willing to absorb new things readily...which requires owning that you have something yet to learn! It takes having enough self-esteem to be able to take in new things...and a degree of humility to know that you need to.

Again, deep thanks for all your energy, women. I'm grateful, and happy to keep hearing and discussing if anyone else is.

[1stimestar]

Originally Posted by MsBlack

I think one extremely valuable of any birthworker is the very ability to learn as you go, be open and willing to absorb new things readily...which requires owning that you have something yet to learn! It takes having enough self-esteem to be able to take in new things...and a degree of humility to know that you need to.

This is what I believe to be a key trait of good doulas. One NEVER knows everything. And the trainings are there to help assure that you don't cut off your nose to spite your face before you learn some of the things you need to know but can only be had by experience. Even as an experienced doula, I learn something or am reminded of something at every birth. Mostly though, I have come to realize that one of the main things I can use to be a successful doula is to realize the vastness of differences in human nature. Learning to discuss things with people who are coming from a different place in their life then I am, is also sooo very important. I don't have to understand why they make the choices they do. I only have to know that I provided them with the information they needed to make the choice that was right for them.

I have never been to a Bradley training or some of those other ones as they are not offered here. But I am confident that I can work with the majority of people and any one who chooses me to be their doula.

[sarahG]

I want to jump in too....
I've been earning my DONA certs for a couple years now (interrupted by pregnancy) In the beginning I called myself a newbie and advertised that I needed experience and was volunteering. I do not feel comfortable asking for money from someone who is allowing me to be at their birth when I am less experienced, and especially because I collect evaluations, which means I have to tackle down this fresh from labor woman's care providers and ask them to give their opinions of me. However, I've been to four births now, and while I only have two that qualify for certification, I do not advertise myself as a "new doula seeking experience" though I will do one more birth pro bono, then I'll start charging a nominal fee and increase it. I also consider this my college-equivalent, I'm training and studying for a career and that costs some money. The only problems I have run into w/ not charging is that when I am referred (which is, like, most of my contacts) I am referred as a volunteer, and I run into problems when I need to arrange a back-up (which hasn't been an issue until this year.)
I have gotten gifts, though, a total of $225 in Wild Oats gift cards, and that's payment!!!
I call myself "DONA trained," and I have sat in on some Bradley classes, and will familiarize myself with different "methods" but I don't plan to advertise a specialty or anything, unless my dear friends and competitors do, then, you know. I figure every couple will be different and I'll learn these methods on the fly, on an individual basis.
No shadow program here, but I'll start one when I'm qualified to!
I have to travel to trainings, which is okay cause I get to meet and learn from doulas and CBE's from different areas.
And complete honesty and full disclosure when answering potential client's questions is a must, I think it's tricky to appear confident and competent, but not mislead anyone.

[ldsapmom]

One thing I keep feeling, and I am not saying this to put down our roles as doulas, but I see a huge difference between a midwife/hand's-on/I-am-responsible-for-your-health-and-safety and an I-am-here-to-provide-comfort doula. Their roles aren't even remotely related, their levels of training aren't comparable, and I think expecting as much from a doula in terms of actual number of births attended just isn't the same.

I guess I am not seeing the big deal about experience or training. I am not saying it is okay to lie or inflate one's history. But unlike a midwife, a doula is not seeing to a family's health and safety, so imo it doesn't matter if she has attended 8 births or 800 births. It doesn't take special training to support a woman emotionally through birth. I wouldn't say or expect the same from from a midwife, who needs years of training, education, and experience of many levels.

[MsBlack]

You are absolutely right, and this is one point that keeps coming home to me in this discussion. My thinking about this was very much 'as a midwife', and I've been adjusting that. Just one reason I have so appreciated the input!

Still--while midwife work is different from doula work, midwives also have to provide emotional support to women/families at birth. They both have to be emotionally stable themselves, and further able to give something to the family, if things get 'iffy' or go altogether 'bad'. Midwives give not just emotional support, but hands-on skills as well. Maybe a doula's role is tougher to manage than the midwife's in iffy/bad situations--since the midwife knows more about what is going on (hopefully!) and can 'do' more about it. The midwife also (hopefully) knows the difference btwn 'iffy' and 'bad'--also impacting emotional reactions. A doula has to keep her calm, and continue giving to the parents, even if she knows little about what is going on. From a recent other thread here started by a doula, it seems that some doulas do have this challenge of coping, and still remaining supportive, when things go 'wrong' somehow and the doula is afraid partly because she doesn't exactly know how serious the situation is (NOT a criticism, btw--same comparison could be made btwn mw and OB; we all have our 'specialties' and limits..besides, we all have 'firsts' in our work).

While knowing the elements of emotional support is less involved than the more numerous elements of midwifery practice, still--the more births one has been to, the better prepared one is, to help with a greater variety of situations. That also depends on the births you've been to! Maybe at your first 6-10 assists, every birth went as the family hoped for. Or, it could be that some/most presented great challenges of different types. The doula who had been part of the difficult situations was stimulated to learn more in general about birth, had the greater opportunity to learn how to stay calm and provide support even when things get scarey.

Let's say a doula has seen VBAC/HBAC; now she can say she is VBAC-experienced. If they all went well, fully supported by med/midwifery staff, she may have a false sense of confidence about her ability to support VBAC...she still doesn't know how she'll do when a woman has to fight for her natural birth, or when things don't go as expected otherwise. Or maybe she has worked w/a csec birth...well, there is a difference between a csec that mom agreed to, after first agreeing readily to a cascade of interventions, and one that is the result of a long struggle against interventions and med. coercion. And the pp period, and BF initiation, is also far different depending on whether mom feels 'ok', or 'ripped off', or 'totally traumatized'.

Anyway--rambling on as usual! I greatly value the role of doulas, and there are differences between doula and midwifery work that you all have helped me become more aware of than before. Appropriate expectations are a good thing! No, I don't think that there is a magic minimum # of assists required to call yourself a 'professional'. Yes, I do believe that every birth one attends is part of training, whether you 'worked' or 'observed'. As I hope you can see, I think there are numerous factors that impact preparation and 'experience'...and as it seems we all agree, there is a necessary component of confidence and giving oneself credit due, that needs to be balanced by humility and respect for the vast variety of situations possible at birth.

Thank you all, and if there is more to be said I would love to hear it.

[MidwifeErika]

I think honesty is important and I am honest about the numbers of births I have attended, if asked. And I make the distinction between when I have been at a birth as a doula and when I have been at a birth as an apprentice midwife.... they are very different jobs.

I went about getting my experience by taking a course a few years ago and then I started this winter with offering my services for free for the first 3 people. I have been lucky in the fact that all 3 couples valued my time and energy and called me for the births. I have heard though about people offering for free and pouring themselves out into prenatal care and then getting an email from the client saying that the baby was born a few weeks ago, sorry that we didn't feel like calling. I considered my expenses as "tuition" and "advertising costs" to get me going, but I certainly can understand the mentality to charge a small amount instead of doing free. Even with a small charge, it may still cost the doula to go to the birth, but at least there is a much better chance that she will get called.

Your example about VBAC.... I could see that happening..... but I could also see someone attending 15 VBACS and feeling pretty comfortable and then 1 VBAC comes along that the situation is just different and the mother is reacting differently and the staff is different, etc. Each birth is completely unique and the words and touch that help one woman may not help another. Emotional support is different for each person.