Becoming a Doula

Some of us feel it was a spiritual calling, others were motivated by their own birth experiences-both positive and negative. There are women who attended a birth of a friend or daughter, and saw how much their help was needed and valued. While our reasons for becoming doulas vary, all doulas I know share a philosophy that birth is a sacred event which has, "a long lasting impact on the physical and mental health of mother, baby and family." (Doulas of North America, 1998).

Doulas come from all walks of life. While many of us have children of our own, some (myself included) do not. You do not have to have given birth yourself to be a good doula, though having gone through labor and birth certainly can provide a helpful perspective. An open heart, a willingness to serve women and their families, and quite a bit of flexibility and patience are characteristics that are important for doulas to possess. Some women become doulas because they felt disempowered by their own birth experience. Doulas in this situation may need to be especially conscious of their emotions and personal philosophies when working with clients, being careful to let each woman define her own birth experience.

In my opinion, one of the most challenging aspects of being a doula is the flexibility it requires. When I'm working with a mother, I have to be "on-call" for the two weeks prior and two weeks following her due date. A woman's labor usually begins sometime during this four-week block. I also have to be willing to drive and meet a laboring woman during the night or early morning, even if I have not slept well. Doula often have to miss holidays such as birthdays, holidays, et cetera if they choose to schedule a birth around these times. Labor can be unpredictable, and especially with first time mothers, long. Before becoming a doula, you need to realize that labor can last 16 hours or more, and that when a family hires you, you commit to being present from when labor begins (or they call you) until about 2 hours postpartum. If you have another job and/or family responsibilities, you need to make sure they support your doula work and allow you this kind of flexibility. Other challenges include sometimes having to work with difficult providers and hospital personnel, difficult clients, and many others depending on the situation.

These challenges many seem overwhelming, however most doulas deal with them and love what they do despite the difficulties. Birth is a life-changing event few people witness in our culture. Doctors and nurses do not have the same experience as doulas, because they rarely are with a woman and her family prenatally, continuously during labor and birth, and postpartum. As doulas, we witness a the transformation of a woman from pregnancy to birthing to motherhood. Some describe the experience with words such as "holy," "awesome," and "transforming ." Though the financial rewards many not be outstanding, being paid to do something you truly love is a gift.

Currently doula practice is not regulated by the state. This means that anyone can call herself a doula and educational and practical experience vary widely. Most doulas choose to receive training and certification through one or more organizations, including Doulas of North America (DONA), the Association of Labor and Childbirth Educators (ALACE), or the International Childbirth Education Association (ICEA), just to name a few. There are advantages and disadvantages to being certified. The process usually includes reading/studying, attended doula training, and attending a certain number of births towards certification. It can cost upwards of $300 or more, plus membership to the certifying organization. Representing yourself as a certified doula of an organization means that you agree to abide by their code of ethics and standards of practice. Benefits of certification are numerous. Many parents who hire doulas for labor support ask about training and certification, and certified doulas often command higher fees (though experience is just as, if not more, important). Many certified doulas feel strongly they are professionals, much like nurses and social workers, and should be treated as such.

The vast majority of doulas are self-employed, meaning we do not work for a hospital or other organization. There are some doulas, however, that work for such organizations and they pay varies depending on many factors. Unfortunately, doula work is not an extremely lucrative career for many of us. Because of the nature of doula work, there is a limit to how many clients a doula can carry at a time. The hours are unpredictable and require a great amount of flexibility that is often difficult. Some doulas form "practices" or doula in pairs to deal with these issues. Some insurance companies reimburse for doula services, but again, this varies widely depending on the state and region. Doulas usually base their fees on several factors, including education and training, experience and number of births attended, the state/region she is practicing in, etc. Of course, any doula can set her own fees as she desires, but most doulas charge an all-inclusive fee that includes a certain number of prenatal and postpartum visits, and continuous attendance at the mother's labor and birth, regardless of length of labor.

There are abundant resources available for aspiring doulas. I would encourage you to take your time, shop around, and learn all you can before committing to an expensive and lengthy certification process. If you live in Minnesota, a great place to start is the Childbirth Collective. Find your local chapter and attend an event. You can also email one of the current members - don't be shy! Many of us are happy to share our experiences, and meeting other doulas is important for networking should you continue on your path to becoming a doula. If you don't live in Minnesota, go to DONA's website at www.dona.org and click on "find a doula." There, you can find a listing of doulas in your area. You also can attend a birth as a support person for a friend or family member. While education and training are certainly important, helping someone through labor and birth is truly the best education. This is a great way to see if doula work truly is your "calling." Remember that everyone has to start somewhere, and no amount of reading and training can totally prepare you for the experience of helping a woman through childbirth. Some of the best doulas are those who learned through experience, before doula training ever existed!

For upcoming doula trainings in Minnesota:

Marla Lukes, certified DONA trainer:
612-272-6725
marla@sylvanstreet.net

Gail Tully, certified DONA trainer:
952-888-6929
www.spinningbabies.com