So you're thinking about becoming a doula...great! Let's talk!
At least several times a month I receive questions from women in my inbox and Instagram messages about becoming a birth doula. Most often it's young women who have had a wonderful birth(s) who feel a passion growing within them to help other women experience a beautiful birth themselves but sometimes it's women who have had a traumatic one and want to help prevent that from happening to others. Both see the problems in the current system and want to play a part in helping solve them so they begin wondering if doula work is for them and how they can begin the process of serving women in the birth space.
Doula work is a beautiful reclamation of the sisterhood and feminine support during pregnancy, birth, and postpartum time that permeated nearly every other time and culture but that has been lost in our current one, much to the detriment of mothers and babies. We also desperately need more Catholic and Christian doulas, serving women during pregnancy, birth, and postpartum so it's wonderful there is more interest. There's a lot to think about when it comes to doing this in its current form and understanding so it's good to take it on with discernment and with a humble and open heart focused on service.
There is so much that could be written on this whole topic but in the interest of having an easier way to respond to and direct these messages, here are the most frequently asked questions they include:
What certification program do you recommend?
I don't have one that I universally recommend anymore. Years ago when I got this question I directed women to the bigger organizations like DONA or CAPPA. However, we've all seen the last few years how many organizations and companies have fallen to disordered agendas, even those focused on pregnancy and birth. It has been incredibly disappointing as more and more doula and birth advocacy groups have erased the word woman and mother from their birth and breastfeeding programs replacing them with "birther", "birthing person", "chest feeder", and more neutered, utilitarian, and frankly, offensive language. More and more are promoting surrogacy, IVF, abortion, and pushing agendas that ultimately harm women and babies, ones that intentionally deprive children of their natural right to their a mother and father (CCC 2376-2378). So those organizations are now off my list as trustworthy sources and no longer recommended for women hoping to honor and serve other women through the uniquely feminine rite of passage that is birth.
Another issue is that there are dozens of smaller doula trainings popping up seemingly every month. Some of them may be wonderful but I would exercise a tremendous amount of caution. There are at least a few known ones founded and taught by someone with next to no in-person experience attending births. The online world has made it incredibly easy to posture oneself as an "influencer" creating dazzling images and an aura of expertise and authority that is not actually backed up by real experience or wisdom, both significant to being an authentic teacher, especially of doulas. There are hundreds of online courses and coaching now in all sorts of fields being offered by people with shaky qualifications but also a bravado and confidence that are compelling. Imagine being trained to teach by a person who has never stood in front of a classroom of kids or being trained to be a therapist by someone who doesn't know what it's like to sit in person with someone sobbing in trauma. Imagine training EMTs but having no real life experience in the raw and gritty encounters you will have, never actually having participated in a resuscitation or inserted an IV, nor experienced the grueling reality of what it's like to be on-call 24/7.
That's not to say that one cannot become a doula with no experience, of course. You need to start somewhere! But if someone is TRAINING others, then they should have years of experiencing walking **in person** with women through pregnancy and birth, supporting all sorts of differing labor scenarios, gaining a wisdom and depth of intuition that only being in the room with dozens and dozens of laboring mothers will offer.
There has been a lot of interest in Made for This Birth starting a doula training or mentorship and while it's on the table longterm, there won't be anything like that soon! For now, I'd refer you to the following programs that seem to be worth looking into, though there are likely other great ones out there. Feel free to let me know of any others!
Do I need to be certified?
All that talk of certification but a lot of women don't know that you don't actually need to be certified to work as a doula, at least as an independent one! Some type of quality training is absolutely helpful but being certified is not actually required to work as or call oneself a doula (for better or worse). I know amazing doulas who have been working for decades who have never completed any official certification. And I know many more who have certified but then never actually ended up practicing or proceeding on to doula work or stopped after a handful of births. (The burnout and turnover rate is very very high with doulas.) I can actually count on one hand the number of times in twelve years a potential client asked if I was certified. And now with training organizations a dime-a-dozen and not regulated at all, certification can mean incredible preparation and training...or the opposite. Self-led learning and training is absolutely an option as is apprenticing under an experienced doula.
If you are not looking to do this often or as a job, it's absolutely valid to learn as much as you can and simply take a few births serving friends and family who might want your help during birth. In some ways this "organic" way of doing it is more in line with what has been done for millennia...women supporting each other during birth isn't anything new! The role of the doula is in some way, an attempt to reclaim what was lost when birth overwhelmingly was moved to the hospital and out of the community. However, if this is your hope, in our current birth system and culture you do need to learn as much as you can about normal physiological birth, what that particular mother is going to encounter during hers given her plans, and common ways and techniques that can help a mother in labor. Entering a birth space without that can end up harming a mother rather than helping.
How do I do it with kids?
If you commit to be a mother's support during her labor and birth, you need to be available to leave when she needs you, day or night. You are on call 24/7 during her due time and you can't abandon her if she is counting on you to support her unless you've made it abundantly clear that your presence is dependent on childcare. If you have young children, you will need someone who is also on call and able to come quickly to care for them or a husband who is available and willing to take over when you need to go. This was a lot trickier when I first started and had only younger children. There was absolutely no way I could have done it in the early days without the complete support and help of my husband. He was behind it all 100%. At his office he had the ability to leave or not go into work if I had to go to a birth. Now that I have older children it's worlds easier to just leave them here in charge and they can hold down the fort a few hours until my husband or I are back.
Most women go into labor during the night and that's actually really helpful for most women because you can slip out during the night with your husband already there. There was only one instance in those early years when the kids were little when a labor was moving so quickly that I had to ask a neighbor to come over until my husband got home. I also make sure my clients know to give me updates that things may be starting even if not time to come yet. So they text me if they notice early labor contractions, mucous plug, their water breaks, or similar. This gives me the heads up I need to make potential plans for the day.
When it comes to having my own babies, I take a long break from doula work and don't commit to any clients until I have an idea of the baby's temperament, needs, how I am doing, etc. If you are a mother your first obligation is to your own babies, not others'. So when baby and I were both ready for me to be able to leave for a few hours or longer and I knew he would do just fine with my husband, I would start attending births again. If necessary, I also inform clients that during a longer birth I may need to pump milk or even head home to nurse the baby. But I've also gotten better over the years at helping women navigate early labor so that I'm not showing up until my in-person support is needed and that has greatly helped with the amount of time I am gone. In some situations doulas bring their own babies to a birth but that would obviously have to be something the mother is comfortable with and not something possible in a hospital. I never felt like I'd be able to give the mother the attention and support needed doing that.
When it comes to meetings (at least 3 for each client), I've always planned them on weekday evenings when my husband is home. There are many nights I'm heading out the door when I'd rather be putting on my pajamas but it's also really good for me to get out, too. Meetings are typically only 1-2 hours so I'm usually not home too late and I usually schedule only one to two a week.
We've always homeschooled so that has made the doula gig a bit easier than if we were beholden to an outside schedule. I don't have to get anyone anywhere the next morning! We can take a day off if I was gone all night and can't manage lessons the next morning. I can schedule vacations and breaks around due dates and not worry about also having to factor in a school schedule.
How is life being on call?
It's hard. Truly. Being on call is a giant part of why there is so much burnout among new doulas. I would guess that about 80-90% of women who train or want to be a doula don't end up doing it after a couple births. It doesn't sound like all that big a deal until you're living it 24/7. Living life on call takes a big emotional and mental toll. It can absolutely be more sustainable if you have a partner you work with but that has never been an option for me for various reasons.
It's hard to be on edge when you know a mom will be calling you any moment or day. It's hard to sometimes have had to miss events for my kids, though thankfully, that has been rare for anything very significant. It's very hard and draining to have the phone on and near me all the time. It's hard to not always be able to stay up late and hang out with my older kids when I want to because there's a good chance I might be called in that night. It's hard to not always be able to commit to plans with friends or family. "As long as I'm not at a birth" becomes a routine phrase. I've become better at letting a client know as up front as possible if there is a day or weekend where I absolutely cannot be there, like for a weekend trip, a child's graduation, a family wedding, etc. For those and just for any emergency situations that could come up, it's essential to have another doula who could be there that you can call and back you up (unless you make it clear to the mother that in that situation, she would not have a doula there at all).
I don't say these things to scare women away from trying it out by any means but they are just realities to consider when it comes to living the doula life. Taking a few births is a good way to find out the reality of living life on call. This is where the idea of it being a calling and a life of service is important as well as constantly reevaluating if changes need to be made, when we need a break, or how I can make it more sustainable for my mental health and my family.
Do you take virtual doula clients?
No, I don't. Because I don't believe there's such a thing. One can be a virtual birth coach or consultant and I can do that on a limited basis for a mother during pregnancy or even during for labor and birth. However, despite this opinion possibly rankling some feathers, I don't think there can be such a thing as a "virtual doula". Doula means handmaid. It means servant. It means someone willing to very literally be *with* the mother supporting her physically, emotionally, mentally, and spiritually during her labor and birth. Imagine Mary telling Elizabeth she'll just FaceTime her when the time comes ;)
Authentic doula work requires being THERE with a mother in person. Our bodies matter and there are some things that just cannot be done virtually. It's nearly impossible to effectively gauge a situation via Zoom or over the phone. It takes watching the whole body of the woman, reading the room, doing things *quietly* to facilitate the labor and make the environment more conducive to labor and birth. It means touching her when necessary, whispering to the husband or signaling to him with no words how he can help. It means guarding the bubble of space around her, seeing things happening by staff that I can explain to her or inform her about so her plan is honored. It means seeing that the water bottle is empty, feeling that mom is really hot and needs cool washcloths, and real life hands to press on her back, squeeze her hips, or fill the tub. There are dozens of things I do in the birth room that could never be replicated through a phone.
I just don't think it's possible to serve in the capacity of a true authentic doula from a phone and I would rather have women find a local doula who can support her authentically in all the ways needed (even if it means sacrificing what could be a lot of money for me). I can see a time where having an on call virtual birth coach or consultant absolutely may be helpful in a birth. But I absolutely take issue with calling that a doula. A doula is by definition in-person support and women deserve that in-person support if they desire it. I cannot serve her in a way my conscience requires especially if she can find another experienced woman to be present in the room with her.
What's the hardest thing about being a doula?
One of the other reasons the burnout and turnover rate for doulas is so high is because of the mental and emotional toll of seeing what can happen during a typical medicalized birth, what could even be considered secondary trauma. Seeing a mother coerced into decisions she doesn't want, watching as her baby is torn away from her for no good reason, feeling like you can't adequately protect this woman you've grown to care for, and seeing poor outcomes that were the direct result of a provider's impatience, disrespect, or abusive behavior is really difficult and disturbingly common. A doula can't save a woman from her own choices or step in when inappropriate or when she has zero influence or authority in a situation. And even in the best and most respectful of birth spaces, some births are very emotionally intense, difficult, and draining.
As you attend more and more births you gain a wisdom in how to better prepare mothers for what they will encounter, counsel them more effectively on choices before birth, navigate the system yourself, and you gain more confidence in how you're able to help in (or far better, to prevent) those situations. You also gain a better perspective and learn to create your own boundaries over what type of birth you want to support and what kind of client is right for you. You learn strategies for protecting your own mental and emotional health. But it is really eye-opening for newer doulas to experience the the reality of birth within the medical system and feel genuine trauma, helplessness, or overwhelm unable to continue in it.
As I said, there are pages I could write on this topic but I hope at least these answers are helpful for women out there considering this call and work! It is an absolute privilege and blessing to serve women in this way and we do need more Catholic and Christian doulas. I'm so glad when I hear more and more women discerning this call. But it's also something that requires the right season, situation in life, family support, knowledge, temperament, and spirit of service. If you feel the nudge, continue taking it to prayer, start learning, talk to local doulas to get a feel for your area, discern with your husband or in your life situation, and then see if you have a friend or someone who would be open to you supporting her during her birth. A good doula can make a gigantic difference in a woman's birth outcome and experience. The more amazing doulas we have, the better birth will be for all women.