The certified doula debate...

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If you have been a doula in the last 10 years, the topic of certification has been a prominent one. It is met with varying opinions and discussions concerning philosophy and equity. Let's begin with the main point of training. There are many certifying entities in the doula market. Like religion there are many philosophies and scopes of practice. It is during the pandemic that the microscope on these differences is magnified. Why? 

As laboring persons struggle to have more than one support person in hospitals during these times, it often means either putting the doula on the back burner or seeing the doula as essential and limiting other family members. This has caused a bit of panic! Imagine not being invited into the birth space as a grandmother, sister or cousin if this was the original plan? Imagine being the doula who has spent months nurturing the relationship with a client only to be called "non-essential".  Many states have been flip flopping with the decision to allow doulas in hospital spaces. Just recently NY signed an executive order deeming doulas essential to the birth process. It is expected that NJ will follow suit eventually. This is good and bad news for some doulas. (But that is a different story).

SO why bring up certifications? Simply put the doula industry is expected to save laboring persons from disparities, to educate, to support, and to advocate for families concerning all things birth. Now that the word "essential" is added to the mix, ensuring a person who claims to be a doula is ACTUALLY a doula is paramount! There are desperate families trying to gain access to hospital and birth center spaces posing as doulas. There are also frauds who seek monetary gains to exploit families by claiming to be a doula. How do we differentiate between those persons and a real doula? Proof of Certification! It upholds the integrity of the profession and does not allow those who think it's just about massage and hand holding to do it a disservice. 

Doulas know we have come a long way when it comes to being called "essential". Many organizations have studies that prove the presence of a trained and professional doula can improve birth outcomes. We can not afford to take steps backward now that we have been given an arena to shine.  Many would argue that this leaves the doula in training on the proverbial side of the road. How will they ever obtain the necessary experience and births required if certification is needed to enter the hospitals? I submit that certifying entities provide these doulas with other types of completion certification.  Or some other official document that allows them access and that hospitals abide by these newly formed documents.  Or they should rethink their certification processes that require birth attendance before certification altogether. If a doula is properly trained he/she should be able to do their job day one! On the job training should not be left to the student who is paying hundreds or thousands of dollars to be certified. Reporting and obtaining evaluations can still happen, if necessary. But seriously,  simply taking a seminar or workshop does not make one a doula. The time to create a fully educated doula is one that most of these organizations do not want to invest in, thereby requiring "on the fly" training. This does not do the laboring person any good if their doula is asking questions on Facebook..."help, this mamma is....what do I do now?"  Where's the mentoring? What tools have they been provided? Some agencies just take their money, expect them to self-train and offer no support along the way. 

The other piece of this puzzle that needs to be addressed is the seasoned doula who decided never to certify with organizations because of some of the reasons mentioned. Where do they fit in? Here I think letters of recommendation from midwives or OB's could suffice. If you have been around the block, you are known! Your work may very well speak for itself. This category of doulas obviously does not like the requirement of certification. It's all tricky, I know. I am also not equating certification to regulation either. (Again that's another story) Doulas aren't medical professionals, we fall back on this often. We can't have our cake and eat it too, though. We want to have insurance companies accept our fees of service, we want to be viewed as essential but we don't want to be regulated or certified. Going back to the religion analogy, we want government funding but we don't want to pay taxes. 

As a certified doula with renewal fees each year and continuous education courses and exams, I proudly submit my certification when requested. Like my degrees, they hold a sense of pride and accomplishment. As the doula coordinator for The Birth Center of NJ, part of my job is to ensure that doulas entering the center are ready for the task at hand. That they understand the difference of their role in the Birth Center versus a hospital and that they have some experience. In protecting liabilities, it makes the most sense to choose doulas with certifications as well as experience. To reduce surprise at the hospital or birth center door, when hiring your doula please inquire about their certifications. It might be OK for you if they don't have them or they aren't up to date. But know that they may not be allowed to doula you in some places. So it is critical to be a savvy consumer. If you are a doula in training, ask if your certifying entity offers credible and reputable certifications. Ask if your certification is lifetime based and how will/can that be updated to show you are current? Not renewing every year may seem like a bargain but if you certified in 2020 how will that be viewed 10 years from now... If other organizations are updating annually? Also ask them how do they support you when you have questions at future births? Will you too have to resort to Facebook groups for help? A dear doula friend who counts every single birth she attends said that she felt she hadn't fully known all there is to know until she attended over 100 births. The moral of the story here is that there is always something new to learn.  Unless we have a sure fire way of weeding out those who pose as doulas, certifications will and should be required in many spaces. 

Doulas and doula organizations should want to do all they can to protect this industry. We should have a way to fast track those who have already taken doula trainings but want to certify with someone else based on philosophy and support. We should have a way to mentor and protect new doulas in the industry so they can grow and feel ready when that phone rings! And we need to do all of this BEFORE state regulations start to pick and choose specific doula organizations as the role models that do NOT serve all populations nor doula philosophies. There is no ONE right way to be a doula, all cultures and styles should be available. All certifications should have value. But all organizations should be held accountable when their "trained" doula is left hanging looking for answers. 

I welcome your respectful comments!