Not sure about keeping my certification as a doula - Mothering Forums

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#1 of 17 Old 02-16-2011, 09:28 AM - Thread Starter
 
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OK, I know that might sound crazy...but I am not sure that I want the restrictions that are placed on me by my certification.  I don't plan on practicing medicine at all...but, as a doula I know a lot of things and have a lot of resources that my certification says I can't do or know.  I have thought of just changing certifiers...but I'm also not sure that it would impact my business at all to not have certification.  Thoughts?  I know when I first became a doula I really felt that it was VITAL to be certified, I'm just strugling with the concept now, and I need to get geared up to re-cert. if I'm going to stick with it.  I would love to hear from those who don't have certification as a doula.


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#2 of 17 Old 02-16-2011, 05:33 PM
 
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I have never been a certified doula.  It has never been an issue with clients or hospital staff.

 

One reason I chose not to certify is because I knew I wanted to monitrice care.  I didn't want there to be an issue with a certifying organization questioning my practice.  I have two contracts, one for doula service and one for monitrice service.  When I interview with clients I am VERY clear as to what I will and will not do with each service.  


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#3 of 17 Old 02-17-2011, 09:07 AM
 
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In my area one of the most referred to doulas is not certified. Nobody seems to care once your name is out there and other people parents trust (midwives, cbe's, etc) give your name. I think it comes more into play when you are new or people are finding you through your website,etc.

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#4 of 17 Old 02-17-2011, 10:25 AM
 
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I know several doulas who purposely let their certification lapse for just that reason.  They are very busy, with thriving businesses, so it does not appear to have changed their level of success, but I haven't specifically asked them about it.

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#5 of 17 Old 02-18-2011, 06:44 AM
 
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I purposely let my certification lapse.  It has not hindered my business at all.  

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#6 of 17 Old 02-18-2011, 09:55 AM
 
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One reason to keep current on certification is that insurance companies won't always pay a claim for uncertified doulas, and where I work, the main employer's healthcare spending accounts will only reimburse for certified labor and postpartum doulas. The doulas around here who don't have doula cert. do have something else like they are LMTs or CBEs, some other category that will get paid out by these spending accounts. That's the main practical difference I can see from a client's perspective, aside from them having the complete assurance that you have been trained (I have NEVER had anybody ask for my doula card though).

 

I know people who will work as doulas and as monitrices, but they are careful not to go outside the scope of practice if they are wearing the doula hat (no internal exams for mom, for example). If you have skills like using a TENS unit, I know DONA wants you to have trained on this if you offer it, but once you do have the training, it's not outside scope of practice. For things like aromatherapy or monitrice services, I think that you could offer these services as what they are, just have a separate package and make it clear that you are not being hired as a "doula" if you offer them. If you aren't certified with DONA or CAPPA or whatever, then all it really means is that you do not have a parent organization that dictates what you do. But then I think you have the burden of making sure that you are not gettin' all crazy and doing things that will besmirch your whole doula community's reputation with birthing women or the HCPs with whom you have to work. 


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#7 of 17 Old 02-18-2011, 09:34 PM - Thread Starter
 
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Quote:
Originally Posted by kcparker View Post

"One reason to keep current on certification is that insurance companies won't always pay a claim for uncertified doulas, and where I work, the main employer's healthcare spending accounts will only reimburse for certified labor and postpartum doulas. The doulas around here who don't have doula cert. do have something else like they are LMTs or CBEs, some other category that will get paid out by these spending accounts. That's the main practical difference I can see from a client's perspective, aside from them having the complete assurance that you have been trained (I have NEVER had anybody ask for my doula card though).

 

I know people who will work as doulas and as monitrices, but they are careful not to go outside the scope of practice if they are wearing the doula hat (no internal exams for mom, for example). If you have skills like using a TENS unit, I know DONA wants you to have trained on this if you offer it, but once you do have the training, it's not outside scope of practice. For things like aromatherapy or monitrice services, I think that you could offer these services as what they are, just have a separate package and make it clear that you are not being hired as a "doula" if you offer them. If you aren't certified with DONA or CAPPA or whatever, then all it really means is that you do not have a parent organization that dictates what you do. But then I think you have the burden of making sure that you are not gettin' all crazy and doing things that will besmirch your whole doula community's reputation with birthing women or the HCPs with whom you have to work. "

 

 

 

I am really nuts that way, there is no way I am about to allow an insurance agency any part of my business.  As soon as they are paying for it they have a vote in how things are done and I will never accept insurance because of this.  I did not celebrate with my sister doulas when they started covering doula care. 

 

And I do want to start my own certification program of some sort, but I'm not sure what that would look like yet.  I just know that I am comfortable with the few out of the box things I do and I don't want to be in trouble for them when they are known to be safe and still truly non-medical.  I am leaning toward monitrice work too, so maybe that is a direction to look into.  BUT, no matter what - I do not plan on becoming so cruchy that I'm scary and wild-eyed...I know how that looks to medical professionals and I would never want to cross that line, even if it were more who I am.




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#8 of 17 Old 02-19-2011, 02:14 PM
 
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I've noticed that people are usually more interested in my PhD than my CD.  I know many non-certified doulas who have viable practices and little trouble finding clients and respect in the local birth community.  You could always drop your credentials from your advertising and see if it makes any difference to your client base before actually dropping the certification.


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#9 of 17 Old 02-19-2011, 08:49 PM
 
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I chose not to be certified for the reasons you stated. There are certain things that I like being able to do (belly mapping, for example) that at least through DONA (who I took my training with) would be considered out of my scope of practice. I don't honestly think I'll ever get certified, and it really hasn't made a difference for me at all, no one has ever asked about it.


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#10 of 17 Old 03-12-2011, 09:38 PM
 
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I never certified with anyone.  I tell potentials that my previous clients certify me and offer references to call. Never hurt my business at all as far as I could tell.  Having had one scary transport that could have potentially been a stillbirth if I had not gotten my doppler out when she said she felt a big strange move down in her pelvis (but before we would have normally headed in). I never want a certifying organization to prevent me from doing what I feel in the moment I need to do.

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#11 of 17 Old 03-12-2011, 10:04 PM
 
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From what you've said, it doesn't sound like you need it!

 

I'm not certified and don't ever plan to be.  I haven't been to many births because my kids are little and I'm pregnant again, but it has not been an issue yet.  I may get certified to do prenatal classes, since the marketing would be very useful, but as a doula it definitely doesn't suit me to get certified.


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#12 of 17 Old 03-24-2011, 01:41 PM
 
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I am not yet certified, but I am planning on certifying through a more open organization. It has been a difficult to be without certification in my community for the simple reason that there was only one established practice in my area when I began nearly 3 years ago and that practice has certified doulas.  When expectant parents, especially in a smaller community, research professionals, they do tend to look for letters behind one's name.  It is a comfort to them.  That being said, I feel that a doula's true worth goes beyond whatever paperwork she (or he) may have.  The right doula for one person may not be the right doula for the next.  Everyone needs something a little different based on their desires for birth, their comfort level, and what they respond best to.  In a perfect world we would be judged by who we are and not by what we have.  Education and experience are key, certification is a bonus.  Being able to practice in accordance with your beliefs is also vital!

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#13 of 17 Old 03-30-2011, 09:33 PM
 
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I just sent of my certification packet to one of the largest certifying organizations this past December (still waiting to hear back, by the way) but have seriously been thinking of calling them up to recall my certification request for the very reasons you are questioning not re-certifying.  I have been disheartened to hear of some of the things this particular organization considers out of the scope of practice for a doula, things that I feel very strongly are important for families to have at their disposal during birth.  I have also recently received an wonderful offer from one of the most well known midwives in my area to train me for monitrice services, but this definitely falls outside of my potential certifying organizations description of a doulas scope of practice.  I, like you, am now thinking that perhaps to offer the kind of care that is near and dear to my heart, as a doula, I should probably not be certified. 

 

To add, and for what its worth, in the three years that I have been practicing I've never had one client ask who I am certified with.  

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#14 of 17 Old 04-03-2011, 11:02 AM
 
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how is belly mapping outside DONA's scope?  At my DONA training we received the fetal compass rose, though not much else was said about belly mapping.  It was definitely not mentioned as one of the things that are out of scope...

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#15 of 17 Old 04-03-2011, 06:03 PM
 
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You don't need to recert. If clients question why, be honest. If they are more concerned with your paperwork than your experience and what you have to offer, then they need alot more education!

 

And I also am with beccadoula on the insurance issue. Just rediculous to me to expect a "non medical" service to be covered by medical insurance. But I feel the same way about billing insurance for midwifery care.


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
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#16 of 17 Old 04-04-2011, 02:00 PM
 
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I couldn't agree more!  I don't like the idea of asking insurance companies to reimburse doula services because they we wind up being held to a standard that is determined my the medical field, which ultimately limits our ability to advocate to and for our clients. 

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#17 of 17 Old 05-16-2011, 10:41 PM
 
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I am not certified, but I also am very careful about how I practice. I have intentionally chosen NOT to learn about supplemental therapies because I am not qualified to suggest these things to clients. As a result I've learned a lot about helping clients figure out what they need to know in order to choose what to do next, rather than getting mired in the legal responsibilities that come with recommending therapies I am not qualified to be addressing.

 

I am not certified because frankly I do not think the process is worthwhile, and I think it is extremely misleading to clients. I still adhere strictly to a scope of practice that no organization would take issue with, for my own protection, and for the empowerment of my clients.


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