One International Doula Org

[ctowndoula]

I am really enjoying the disscussion from the DONA survey thread and wanted to see if we could take the point of whether or not having one international organization would be a benefit or if it is better to have several separte entities.

My own (I will clarify that this is my personal opinion): I have been of the opinion that one of the reasons that midwives don't have more clout is that they have problems bridging the gap btwn CMN and DEM. I think there are those out there that are working on that, but it isn't there yet. That has lead me to idea that perhaps doulas would have greater power of advocacy if there was more cooperation btwn certifying organizations.
I think when there are several different certifying bodies that they will inevitably compete with each other. We have many different kinds of doula in town and most of us don't worry about competing with each other, we get the births we are ment to have. But there are those that do see others as a threat to their bottem line. How is this different from certifying orgs?
It seems that OBs benefit from this fragmentation in "doula power". . I do think that having different orgs to fit the philosophy of different doulas is a good idea, but think that cooperation btwn organizations is essential to really getting to word about doulas out there. Or maybe we just need more doulas to come here to alldoulas where we bridge these gaps!

I am not so certain how I feel about the severity of the rules for certification. I know of number of doulas who have choosen not to certify. I think that number would go up if the rules got tighter. But I do see some (not most or even the majority, but a small amount!!) of uncertified doulas that really shouldn't be calling themselves doulas. Those few make it hard for other doulas some times by giving us a bad name.

Where do you fit in? Do you think we need one certifying organization? Who would have the leadership? Are different orgs essential?

[tlcdoula]

I think having one certifying body would help to unify the doulas and create a united front, but I honestly don't EVER see that happening. The reason for that is because like you said the certifying bodies are competing against one another. Plus, if you think about it they all have different scopes, views, etc and I don't see them coming together and unifying!!

[heathenmamaof5]

[CatieDoula]

I like the idea of one body and I believe it will unify us. I just read the scope of practice for ALACE, CAPPA and DONA (I know there are others, I just did these three) and, with one exception, I don't find them to be that different. But that is how I read the different scopes, someone else might read them differently.

The exception being: "ALACE labor assistants/birth doulas are encouraged to create their practices to best fit their own interests and the needs of their communities. ALACE supports the choice of labor assistants/birth doulas to perform assessments such as palpation, checking fetal heart tones, or vaginal exams if they are already a midwife, physician, or labor and delivery nurse or have received specific training qualifying them to perform these assessments. In order to maintain the integrity of the profession and of the ALACE organization, all ALACE trainees must signഊan agreement stating they understand the ALACE training and certification program does not train them to perform physical assessments." (emphasis mine) The others don't agree with this but I think this is something that could be compromised on in some way.

As far as certification being harder/easier, I don't know where I stand. I am an ALACE trained doula and decided not to certify AFTER I did all the work (and there is a lot to do for ALACE). I don't know why I didn't certify, part of me feels like it doesn't matter if you are certified or not unless you are certified by a certain organization. I feel like I would rather not label myself if I'm not with that organization...though I have nothing against them and would even consider certifying through them if that became a "requirement" for doulas in the hospital. I think some organizations are really hard and others are rather easy. There are always going to be women that choose not to certify and I don't think there is anything that can be done about it.

[syncreo]

Thanks Tamara for posting a seperate thread so we could discuss this. From the other thread it is obvious I think that having one unifying body would be a good thing. I think there is fragmentation in the doula world between certifying bodies and that this creates problems for us professionally. Having different scopes of practise allows a variety of approaches to doulaing but it also creates issues because 'what a doula is and does' is confusing to other professionals who we work with. We also have different credentials after our names, once again creating confusion. I think both of these things diminishes our professionalism. As a profession I don't think it is unreasonable to think we could agree on what is within our scope and what is beyond it - although I realize this is probably one of the greatest sticking points for creating a unifying body.

I also believe we could advocate better on behalf of doulas if we came under one organization. In my view there could still be multiple organaizations that train doulas but we would all have to meet certain standards for certification that are agreed upon. Many other professions do this by having a professional organization. It wouldn't have to be ACOG (especially because I am talking about International standards not American) and really it could be an existing organization or a new created by the existing certifying bodies.

It doesn't really matter to me if every doula certifies - but I do believe if we are certified it should mean something and with mutliple bodies it really doesn't mean all that much. There is no standard.

Why I think certification should be more difficult is that many doulas feel their role is to educate women on their choices in labour and birth yet most organizations do not prepare doulas to understand evidence-based research. I think many doulas feel that they have a lot of knowledge and as a group we often question medical professionals decisions and philosophies - this has value but it is also important that as doulas we recognize that we too have biases, assumptions and that often time we may use our 'experience' as opposed to what the evidence says to inform how we practise. Stricter certifying standards for me would include teaching some of the above things and it would also weed out those who come to this work because they think it is easy.
Yes, doulas come and doulas go and some that go made a great contribution while they were practising but for me I want our profession to have credibility and to make the greatest impact we can - having so much attrition in our field and having the reputation of an easy process is not going to get us there.

Enough from me...next...

[AmandaB]

Can someone maybe explain the split? I mean to say, why did CAPPA chose to start? Why did other certifying bodies feel that DONA was not meeting their needs? From what I understand DONA started it all, if I am wrong, please correct me. I guess I understand it from a religious point of view (being raised Catholic and all), there was ONE church and then somebody said "I can do it better, or I don't agree with your doctrine, blah, blah, blah." So there was a split, and then another split and a other ... on and on for centuries. So obviously something like this happened in the labour support world too.

I also feel that one certifying body may disswayed some from certifying because then you aren't giving people much choice and the funny thing with that statement is that "we" as Doulas are supportive of our clients choice, but we ourselves wouldn't feel supported in our choice.

I also feel that we are all on such different ends of the spectrum ... some of us are really into the business and governmental (not to be confused with soapbox political) aspects of this field and others are for protecting the sanctity of birth and would like to see it return to its origins. All of those philosophies are valid and should be respected, the only thing is that those glaring differences are what are perhaps postponing recognition and leading to confusion amongst the other proffessional we encounter. We need to be speaking the same language and viewed as united before our respetive governments see our worth and I believe that certification will help this. We had a discusion sometime ago about certification and I was uncertain as to whether or not I wanted to finish (I was extremely frustrated), but then Christy said something that changed my whole perspective on it: :I have another perspective to add. One reason I chose to certify and intend to stay certified is I believe in the power of numbers. Our certifying organizations are more powerful as a unit than we are as single doulas and I feel that being a part of one and paying my portion of the fees does help the cause. We are all in this business because we want things to change for mothers and babies and without the larger organizations helping us to become more credible in the mainstream public we would never get anywhere. When CAPPA (for instance) puts out a press release taking a stance against/for something it holds weight. If I put in add in the local paper taking that same stance it wouldn't go very far. So...this is my "doulas unite" speech about certification. It is more about belonging to a cause and an organization that you believe in than making yourself look good to potential clients.". Here is what I said: "Hear, hear Christy! You just got me thinking ... if not for me, for the greater good! As Kennedy said : "ask not what your country can do for you, but what you can do for your country". So in Doula terms "do not certify for you, certify for the community!" We are in this together, that is one of the reasons I do this, not only to be a part of a community but to stimulate community as well. Certifying and remaining certifying can bring about change, could make us essential, could make birthing and breastfeeding back to the women and about the family as a whole! Power to the Doulas! May we raise our voices together, may we affect change, fuel discussion/debate and make this world a better place for us all to have and raise our children. ". So that is it for me, I think I have said what I can and I would some clarity on why the different orgs came to be ... I am not judging, I am wanting to know.

[MothertheMother]

I don't think one organization should oversee but there is no reason the heads of the major (and minor for that matter) organizations couldn't get together and decide on a basic list of guidelines for all doula training. The only problem with that is I can't see anyone bending on their beliefs of what the requirements for certification should be. For instance, I can't see CAPPA agreeing to the 4cm rule for a birth to count. I personally don't agree with it either. You can have someone go from 3cm to birth in 2hours as easily as you can have someone go from 7 cm to birth in 5 hours. I also think that the time you spend with a couple during labor isn't the only experience you are getting. A big part of being a doula is equiping parents with the tools to manage early labor on their own. I think most of us tell our clients to call when they feel they need us there not when they start to feel contractions. I think if they don't need me there until she near transition that I have done a good job at prenatals. Make sense? All of that rambling was to point out that I can't see agreements on the steps to certifications. What would be nice, though, is an agreed upon doula training manual. Everyone is learning the same stuff that way. One of the reasons I chose CAPPA was because I liked the concentration on the medical side of things. I really believe you need to know why a woman might need to certain interventions to effectively support her in her decisions.

sheesh...that was way to long to make a simple point

[MothertheMother]

Quote:

Can someone maybe explain the split? I mean to say, why did CAPPA chose to start?

I trained with Tracy Wilson-Peters (co-founder of CAPPA) and she told us the history. Basically she was very involved in DONA as a doula. She was a state and regional rep if I remember correctly. Really enjoyed her time with DONA. Well, she had a vision of what CAPPA now is...a network of women helping women. The vision included the umbrella of certifications by one organization. Kind of like what we are discussing with doulas only with other birth professionals. As a CAPPA doula, ideally I should have a network of contacts like cbe's, lactation educators etc so if I have a client that needs a referral I have this resource to offer. For instance, there is a CAPPA cbe in town and I would automatically refer a client to that class because I know what she is teaching etc.
Tracy said after she had this idea she took it to the DONA leaders and they were not interested in taking DONA in that direction so she and Donna created that vision.

Quote:

but then Christy said something that changed my whole perspective on it

I feel so honored to be quoted!!

[b'earth angel]

I'm still not convinced that an umbrella organization covering certification groups is going to stay 'doula' centered.
Look at what happened to herbalist here in our own country. Late 1800 to early 1900 there were huge numbers of herbalist 'Doctors'. They were a threat to allopathic Drs so the AMA was formed. They eventually imposed education standards and licensing requirements that forced most herbalist out of business. Finally they are making a comeback. But look at how long it has taken. And even now a lot of insurance companies don't cover them. (my summary)
I agree with SOP. But I think it is a very fine line to walk so that you don't fall into more red tape so to speak. Remember, Doulas have been around for centuries. It's just in the past 'few' years that we've even considered 'certification'. I think it just medicalizes something that doesn't need medicalizing.
It seems that in our society you have to have some extra letters after you name to get any recognation. I think that this is a huge problem. Life experience means less and less to some folks.
And I am all for evidence-based research. But sometimes the research is behind times. I mean look at how long it has taken to get research to tell us that epi's are harmful to infants! When common sense can tell you the same thing.
I guess my point here is all of these ideas are good, even great in theory. The problem is if they fall into the wrong hands, so to speak, then what will you have?

[ctowndoula]

Wow, I have to say that I am just blown away by all the deep thought going on in here! I am so enjoying this. There has been something in each post that made me nod my head and say "great point."

This is a point I have struggled with lately. I like the idea of separte orgs coming together on certain points to make a national stand...I like the idea of keeping it out of the wrong hands and not creating MORE red tape...I also thought the point of becoming more organized as doulas making it all more medical was a good thought too. How do we work within the gov't/health care system and not become a PART of it?

Wow, as I said, I am impressed.

[syncreo]

Hi,
I think that just because something might be difficult - creating common standards, not creating more red tape, ensuring the roots of doula work are respected and practised, not medicalizing what we do etc. doesn't mean we shouldn't aspire to creating it. To me the differences between the organizations are minor and almost irrelevant - and the strength and impact that could be made by coming together would be so much bigger and greater.

[Stacie]

I am not for it. Most of the doulas in my area don't even certify, so where would that leave those who don't want to be "under" an organization?

[CatieDoula]

Quote:

Originally Posted by Stacie I am not for it. Most of the doulas in my area don't even certify, so where would that leave those who don't want to be "under" an organization?

Do you know why they decided not to certify? Again, I chose not to because I felt it didn't matter if I was certified unless I was with a certain organization. I'm curious as to what some other reasons are.

[earthgirl]

We've had so many new members since this thread, I decided to give it a

[DoulaYvonne]

Yes, so thought provoking. C'mon ladies, get yer thinkin' caps on!