DONA Certification Question - Mothering Forums

Forum Jump: 
 
Thread Tools
#1 of 10 Old 06-20-2009, 12:20 PM - Thread Starter
 
OMama's Avatar
 
Join Date: Feb 2005
Location: in the moment
Posts: 1,935
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I am already in the process of getting certified as a mentor and doula through Birthing From Within, which I LOVE! And I have been mentoring classes and attending births, but things have been slow going and I want to build my business. I want the recognition that comes with a DONA certification and I want people to find me, and I know that will be easier if I'm in the DONA database. But I have some questions.

I recently got my packet in the mail and I am excited to do it, but I also have some reservations. Perhaps I just need to accept them but maybe someone can explain some of the logic to me as well. I am bothered by how the emphasis seems to be on the medical or clinical aspects of birth. For example, why do we need to get evals from doctors and nurses? I can kind of see the nurse part of it since nurses are there for longer periods of time, but seriously, doctors? In my experience they are there for short periods of time and rarely acknowledge the existence of a doula, let alone how much she helped during the birth. And there is no eval from the dads? I think this is strange too. I also think it is weird that there is that labor progress sheet and list about interventions and medications. Like what doula is going to stop the important emotional and physical support she is doing to jot down numbers and drug names? I wouldn't want to have to ask a nurse or the anesthesiologist what drug she was just given and then how to spell it so I can write it down when I see my work as supporting the mama. I think it is strange too about how if you join a mom in labor after 4 cm that it wouldn't really count. What if she doesn't have a vaginal exam until later? What if I mother is simply farther along the first time she is examined. A doula could be attending the birth before hand but of course no one would know how far along the mother was unless she had had an exam. With both of my births the first time I was examined I was 8 cm and 7 cm so if I had had a doula my births they wouldn't have counted for her. Anyway, just wondering if you know what the thinking is behind all of this. It is just quite different from the Birthing From Within evaluation approach. I am trying to approach this with an open mind and from a place of curiosity, but it is just a little concerning to me. Perhaps if I understand it better I can accept it a little more.

Amazing Mama Birth Services
CD(DONA) and Birthing From Within Mentor and Birth Doula
OMama is offline  
#2 of 10 Old 06-20-2009, 05:54 PM
 
TO Doula's Avatar
 
Join Date: Apr 2009
Location: Toronto, ON
Posts: 130
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OMama View Post
I am already in the process of getting certified as a mentor and doula through Birthing From Within, which I LOVE! And I have been mentoring classes and attending births, but things have been slow going and I want to build my business. I want the recognition that comes with a DONA certification and I want people to find me, and I know that will be easier if I'm in the DONA database. But I have some questions.

I recently got my packet in the mail and I am excited to do it, but I also have some reservations. Perhaps I just need to accept them but maybe someone can explain some of the logic to me as well. I am bothered by how the emphasis seems to be on the medical or clinical aspects of birth. For example, why do we need to get evals from doctors and nurses? I can kind of see the nurse part of it since nurses are there for longer periods of time, but seriously, doctors? In my experience they are there for short periods of time and rarely acknowledge the existence of a doula, let alone how much she helped during the birth. And there is no eval from the dads? I think this is strange too. I also think it is weird that there is that labor progress sheet and list about interventions and medications. Like what doula is going to stop the important emotional and physical support she is doing to jot down numbers and drug names? I wouldn't want to have to ask a nurse or the anesthesiologist what drug she was just given and then how to spell it so I can write it down when I see my work as supporting the mama. I think it is strange too about how if you join a mom in labor after 4 cm that it wouldn't really count. What if she doesn't have a vaginal exam until later? What if I mother is simply farther along the first time she is examined. A doula could be attending the birth before hand but of course no one would know how far along the mother was unless she had had an exam. With both of my births the first time I was examined I was 8 cm and 7 cm so if I had had a doula my births they wouldn't have counted for her. Anyway, just wondering if you know what the thinking is behind all of this. It is just quite different from the Birthing From Within evaluation approach. I am trying to approach this with an open mind and from a place of curiosity, but it is just a little concerning to me. Perhaps if I understand it better I can accept it a little more.
I hear you! Those are some of my complaints about DONA, too. I've been told that the doctor eval is partly about us learning to deal with the docs - speak to them directly, build interprofessional relationships. Whatevs. Not doing it.

I'd be interested in an explanation of the 4cm rule, too. To me, unless I've got a client who reallyreallyreally wants meds as early as possible, I'd kind of consider it a fail if we got to the hospital before she was 4cm. The hospitals around here don't really want you there any earlier than that, either. You've gotta be a "4" to truly get a "diagnosis" of active labour - and so be bedworthy. (I don't tell my clients this, but for those who want a natural/unmedicated birth, my goal is to stay out of the hospital until she's a good 6-7cm. I'm guessing, since I don't do cervical exams, but it often works out.)

Doula, CBE, Placenta Lady
TO Doula is offline  
#3 of 10 Old 06-20-2009, 09:16 PM
 
1stimestar's Avatar
 
Join Date: Jan 2005
Location: Fairbanks, Alaska
Posts: 1,716
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OMama View Post

I recently got my packet in the mail and I am excited to do it, but I also have some reservations. Perhaps I just need to accept them but maybe someone can explain some of the logic to me as well. I am bothered by how the emphasis seems to be on the medical or clinical aspects of birth. For example, why do we need to get evals from doctors and nurses? I can kind of see the nurse part of it since nurses are there for longer periods of time, but seriously, doctors? In my experience they are there for short periods of time and rarely acknowledge the existence of a doula, let alone how much she helped during the birth. And there is no eval from the dads? I think this is strange too. I also think it is weird that there is that labor progress sheet and list about interventions and medications. Like what doula is going to stop the important emotional and physical support she is doing to jot down numbers and drug names? I wouldn't want to have to ask a nurse or the anesthesiologist what drug she was just given and then how to spell it so I can write it down when I see my work as supporting the mama. I think it is strange too about how if you join a mom in labor after 4 cm that it wouldn't really count. What if she doesn't have a vaginal exam until later? What if I mother is simply farther along the first time she is examined. A doula could be attending the birth before hand but of course no one would know how far along the mother was unless she had had an exam. With both of my births the first time I was examined I was 8 cm and 7 cm so if I had had a doula my births they wouldn't have counted for her. Anyway, just wondering if you know what the thinking is behind all of this. It is just quite different from the Birthing From Within evaluation approach. I am trying to approach this with an open mind and from a place of curiosity, but it is just a little concerning to me. Perhaps if I understand it better I can accept it a little more.

Getting the evaluations from the care providers does a few different things. It does help you to find your voice when communicating with them. It helps build the relationships you need to be a successful professional. It lets them know that you are (probably) a newer doula so they can over look any faux paus you might make as well as help teach you. Have your clients introduce you the first time you meet. Normally you will have a few minutes to mention that you are working on certification and have a very short evaluation for them to fill out after the birth. That way they know what's coming.

The requirement is that you join mom at or before active labor starts. In your birth essay you can explain mom's behavior so you don't have to rush to the hospital to get a VE. This is the point that seems to be misrepresented the most, such as by the previous poster. If you talk about how mom was chatty though needed to pay attentions to contractions when you joined her at home, you labored at home for 4 hours, got to the hospital and found her dilated to 5 cm., you can still use that birth. If you get to her house and she is showing all the signs of transition so you rush to the hospital to find she is 9 cm., that birth can just be an extra experience for you. For most people, you will need to attend more then three births to be certified. This also teaches you to look for the physical and emotional signposts of labor, so that you do not need information from a vaginal exam to know where a client is at.

For the information sheet, DONA does not expect you to stop what you are doing to write down information. They do expect you to be familar enough with things that are going on, that you can remember some of the details until you have a minute to write them down. And if you forget something or didn't know it in the first place, it is fine to leave it blank. Keep in mind these requirements are for the certifying births only. Once you are certified you don't have to do them any more.
1stimestar is offline  
#4 of 10 Old 06-20-2009, 09:18 PM
 
JessicaE's Avatar
 
Join Date: Oct 2005
Posts: 306
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Regarding the issue of 4cm... They simply want to know that you have supported a mom from early labor on (e.g. not whisked in just before she started pushing, for example). So as I understand it, if your client has not been checked, you must simply indicate in your narrative her signposts that would indicate that she was in early labor, or just beginning active labor when you arrived. They want to know that you understand (and have supported through) the entire labor spectrum for at least three births.

I'm not in disagreement about the evaluation issue... All three of my cert births were with midwives, so I did not need to get anything from a NURSE or a DOCTOR. That sat much better with me. I think as much as anything they want to know that you can support your client without being confrontational -- being a "team player," as it was described to me. But I have run into some very hostile nurses (for no apparent reason!), and docs who as you said were only in the room for minutes before the birth. For what it's worth, the midwife evaluation process went very smoothly.

As for dad evaluations, although they are not required, you can certainly submit them! I know I sent in a couple with my packet.

About the labor progress sheet, I didn't find that too cumbersome, although I agree somewhat about the focus perhaps being too heavy on these medical details. I usually take quick notes for my clients anyhow throughout the birth, I don't find this distracts at all from my support. Don't the nurses/docs/midwives TELL your clients what drugs they are giving them? That in itself would be problematic for me, I don't think I've ever had a client where it was not clear what intervention/drug was being suggested, followed by questions/discussion.

The one thing I did have to go back for, in several of my cert births, were the baby's APGAR scores. That's just one thing I don't usually hear spoken in the L&D room, and everyone is so caught up in welcoming the tiny new person.
JessicaE is offline  
#5 of 10 Old 06-20-2009, 09:19 PM - Thread Starter
 
OMama's Avatar
 
Join Date: Feb 2005
Location: in the moment
Posts: 1,935
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Thanks for the response.

So Rean when you say you aren't doing the doctor evals how do you think that will work? Can you still get certified? Will they accept your packet as is? Do you plan to submit other evals in their place? I'm just really curious! I have heard from someone else that some doctors will refuse to fill out and sign a form like this, especially if they haven't been in the room for long. Then what do we do? Have any other doulas out there had experience with this? TIA! Oh and has anyone else tried to contact the DONA office and ask about this? What has their response been?

Amazing Mama Birth Services
CD(DONA) and Birthing From Within Mentor and Birth Doula
OMama is offline  
#6 of 10 Old 06-20-2009, 09:22 PM
 
JessicaE's Avatar
 
Join Date: Oct 2005
Posts: 306
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Posting at the same time as 1stimestar.
JessicaE is offline  
#7 of 10 Old 06-20-2009, 09:29 PM - Thread Starter
 
OMama's Avatar
 
Join Date: Feb 2005
Location: in the moment
Posts: 1,935
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It looks like two other posts were coming in just as I posted my last post!

Thanks everyone. This was very helpful. First I think I was forgetting about the birth narrative aspect of it. This will be great. It is useful for me to think about the evals as one part of the process, and not the whole thing. I completely agree about trying to develop those professional relationships! This is actually something we spend a lot of time talking about in my classes too, so I can completely get behind that. I'm sure I'll just need to find my own way in broaching the topic of evaluations with the doctors and nurses. I just don't want it to interrupt the birth in anyway or the important work I am doing with my couples.

Amazing Mama Birth Services
CD(DONA) and Birthing From Within Mentor and Birth Doula
OMama is offline  
#8 of 10 Old 06-20-2009, 10:50 PM
 
TO Doula's Avatar
 
Join Date: Apr 2009
Location: Toronto, ON
Posts: 130
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by OMama View Post
Thanks for the response.

So Rean when you say you aren't doing the doctor evals how do you think that will work? Can you still get certified? Will they accept your packet as is? Do you plan to submit other evals in their place? I'm just really curious! I have heard from someone else that some doctors will refuse to fill out and sign a form like this, especially if they haven't been in the room for long. Then what do we do? Have any other doulas out there had experience with this? TIA! Oh and has anyone else tried to contact the DONA office and ask about this? What has their response been?
I chose not to become certified. I got a couple of evaluations, but for a variety of reasons decided not to continue on with the process. One reason is that, in all the births I have attended, it is rare to have a doctor who is in the room long enough to accurately answer the questions the DONA forms ask of them.

I don't think I misrepresented anything in my previous post. It's been a few years since I looked at the DONA certification stuff, but I was under the impression that you needed to know where the client was in labour, as it seems are you. I have heard many other doulas talk about a 4cm rule, and you mentioned it in your initial post, but my paperwork goes back to about 2002, so I don't remember what it says with precision.

Doula, CBE, Placenta Lady
TO Doula is offline  
#9 of 10 Old 06-20-2009, 10:58 PM
 
TO Doula's Avatar
 
Join Date: Apr 2009
Location: Toronto, ON
Posts: 130
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by 1stimestar View Post
The requirement is that you join mom at or before active labor starts. In your birth essay you can explain mom's behavior so you don't have to rush to the hospital to get a VE. This is the point that seems to be misrepresented the most, such as by the previous poster.
Sorry - I'm having a bit of an issue here. The original poster mentioned 4cm, so that was the mark I used in my response. It's been a long time since I did the training and don't recall precisely how it was explained.

Quote:
For the information sheet, DONA does not expect you to stop what you are doing to write down information. They do expect you to be familar enough with things that are going on, that you can remember some of the details until you have a minute to write them down. And if you forget something or didn't know it in the first place, it is fine to leave it blank. Keep in mind these requirements are for the certifying births only. Once you are certified you don't have to do them any more.
I've now gone and dug out my training manual. The DONA SOP document I have says:

Documentation The doula maintains clear and accurate records of each client encounter and the birth.
Data Collection The doula collects and submits to DONA on a regular basis data on the clients to whom she provides services, and the outcome of their pregnancies and labors.

Has that changed? Does DONA no longer require submission of data collection forms from all doulas?

Doula, CBE, Placenta Lady
TO Doula is offline  
#10 of 10 Old 06-21-2009, 03:23 AM
 
mamato3cherubs's Avatar
 
Join Date: Nov 2004
Location: Little Town Oregon
Posts: 1,449
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
When I did my training jsut over 3 years ago, the "4cm" mark was made very clear, but if there are not exams, it can be explained just as well as to when you arrived to begin supporting the woman.

I also am a not taker. I just jot down small notes and always the time. Moms like to have this later for reference as well, without having to try to retrieve and decode medical records. Spelling is not important until you transfer notes to the final sheet.

I prefer to attend one prenatal at the end of pregnancy with the client. This lets me introduce myself and my position to the dr. BUT

I am also one of those who found certifying was NOT right for me, and never finished the evaluation process. DONA is interesting anyhow

Lisa~Was Aspiring Midwife~Now-AAMI Midwifery Student #2020~Mama to Zackery 3/29/96, Drake 9/22/01, and Selina 10/26/03...and here was the link to my new blog
mamato3cherubs is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off