Thursday, March 12, 2015

What to Look For in a Doula Training

Having been in the birth biz for 13+ years I’ve attended my fair share of trainings.  While I’ve always received lots of great info, I’ve come to realize a successful in-person training is about more than content, it’s about how the information was relayed. Lecture alone won’t cut it. What was my experience as a participant/learner?

 With this in mind I can confidently say, we’ve led another successful workshop.

Why? Because the participants…

-Asked lots of great questions. They knew their questions and comments were welcomed and encouraged. Learning should be interactive.

-Were attentive and engaged. No one was scrolling through their phones or off daydreaming. They weren’t bored with overly long lectures but involved in lots of small group activities, role playing, problem solving “what if?” scenarios, watching relevant DVD clips etc…

-Had connected with each other. When it was time to practice hands-on comfort skills, they had already spent 10+hrs together –they weren’t touching strangers, they were practicing with friends. When the workshop came to an end they were sad to part and made plans to stay in touch.

-Shared their knowledge.  Far from feeling competitive, they want to see each other succeed and were happy to share tips.

-Left feeling confident, prepared and eager to get started!

Now for a few words about this wonderful group of women…I’m always amazed at the diversity of those who are called to this work. Among our participants we had: students (pre-med & nursing), aspiring midwives, a dancer, a member of the military, and highly successful meditation coach-just to name a few.  They all had one very important doula quality in common-commitment!

During the course of the training, their commitment was challenged in at least 3 ways..

Challenge #1: Treacherous journey

The day before the training, winter gifted us with one last snowstorm. Our participants had to travel icy roads with bouts of blinding sun glare. For some this drive took more than 2 hours.  Several had to pull over multiple times to clear salt from their windshields and one unfortunate soul slid through a railway crossing as the gates were coming down! Still, everyone arrived. (And what doula hasn’t had to drive in less-than-pleasant conditions?)

Challenge #2: Lack of sleep

After 2 full days of learning, our participants had to wake extra early on the third day when the start daylight savings robbed them of an hour of sleep. Regardless, everyone was on time. In fact, 1 arrived early and managed a quick nap in her car before training started and another woke even earlier to prepare some notes she wanted to share. (And what doula hasn’t had to work while tired?)

Challenge #3: Physical discomforts

Regardless of how comfortable the surroundings, remaining in the same room for 8+ hours per day takes its toll. Of our participants, 2 were pregnant, 1 was lactating, and 2-3 were battling allergies-perhaps someone else had a headache or backache? If so, it didn’t show. They changed positions often, expressed milk,  and came armed with plenty of tissues.  (And what doula hasn’t experienced and worked through her own discomforts during a birth?)

I am proud and confident that these women will be reliable and provide excellent support.
***For those of you who have taken in-person trainings, what was your favorite part of the experience?***







Friday, February 27, 2015

Our Road to Trainer Certification, Part 2

Our apologies for the 4 year cliffhanger...

Like most things in life, our plans took longer than anticipated but the time and effort was well worth it. We attended our training in Boston of 2011 where we had the distinct honor to be trained by the original doula, and author of The Birth Partner,  Penny Simkin.

We came home brimming with ideas and inspiration-and then came the overwhelming task of creating 16 hours of curriculum, complete with: learner objectives, modes/methods of teaching, session outlines, handouts, etc… but after many many hours, we did it! We mailed in our curriculum  and waited to hear about the revisions we would need to make –as we had been forewarned  that the majority of submissions required some tweaks ,so you can imagine our joy and surprise when, on December 18th, 2013 (my birthday!) we got the call…our submission was accepted AS IS and we were officially BDTs (aka Birth Doula Trainers).

Birth Ball Blues…

We planned our training and decided to give each of our 12 students plenty of goodies to get them started. This included a birth ball. The problem with planning to USE 12 birth balls for a training is having to INFLATE and STORE 12 birth balls. We’d been ordering from the same company for years (as we provide them to every childbirth education student), without a problem but as luck would have it this last shipment was off, the included pumps didn't fit into the balls. After several unsuccessful purchases from Sports Authority and Home Depot, we came to realize we had the Cinderella’s shoe version of a birth ball, it seemed that only one pump would fit, if we could only find it! Thankfully my husband came to rescue with a heavy, loud, but blessedly fast compression pump. Finally the balls were inflated…and promptly took over the space:
Murphy’s Law of Labor:
If the weather is bad, your child is ill or you have unbreakable plans, someone will go into labor. The night before our training Dorothy received THE CALL; a client was in labor. While Dorothy provided labor support all through the night and into the morning, I woke early and set up for the day.
A precious baby entered the world around 8:00am, the same time I welcomed 12 women to our very first training. I hoped they wouldn’t notice my nerves, the way I was talking too fast, the way I paused during the section that Dorothy was to do and then, at 9:30am, Dorothy arrived! She was up all night and came to the training straight from the birth-now THAT is dedication, a quality I was happy we were able to authentically model for our students.   
Our “Flying Horses” (the nickname chosen for this group)
Dorothy and I had the privilege of teaching and sharing with this diverse group of intelligent, compassionate and enthusiastic women. It was an amazing 3 days, filled with instruction, discussion, meaningful interactions, laughter and some tears (the good kind that happen when you witness birth). It was such a rewarding experience that we cannot wait to do again.

Friday, June 10, 2011

The Next Step...

So what's the next step for Your Best Birth?

The Next Step:
Dorothy and Jessica will be attending the DONA Birth Doula Trainer Workshop being held in Boston in July 2011! This is the next step in our journey to becoming Birth Doula Trainers!

Here's a timeline of some events in YBB History leading up to this:
November 2007 - Dorothy and Jessica decide to become business partners. We brainstorm names and come up with Your Best Birth. We purchase a website and have a logo designed and register our business with the state of NJ.

December 2007 - We both become certified as Lamaze educators! We also start this on-again/off-again blog.

January 2008 - It's official - Your Best Birth is open for business! As we have for the past several years, we each take 1-2 doula clients per month.

January - March 2008 - We develop our curriculum for our classes and start advertising.

March 2008 - Our open house at Fair Haven Yoga, where we will be holding classes.

April 2008 - Our first class series! We have two wonderful couples as well as two student doulas.

October 2008 - We decide to offer classes in a second location closer to Middlesex county. Dr Tom of McGuire Chiropractic offers the use of his office space for teaching classes.

February 2009 - Our first class series in Matawan with three great couples!

August 2009 - We attend the DONA conference in Atlanta, GA and start seriously discussing working towards becoming doula trainers. When the location for the 2011 conference is announced to be Boston, we decide that our goal is to have all steps completed for the 2011 Doula Trainer Workshop, offered immediately after the DONA conference. There are a lot of steps involved to get approved to take the Doula Trainer Workshop, one of which is that we need to have at least 200 hours of teaching with at least 4 expectant moms in each class, so we start keeping track of which classes will actually qualify.

January 2010 - We attend TENS training with Penny Bussell-Stansfield, who is also a doula trainer with DONA. While there, we discuss the logistics of becoming doula trainers with Penny, who encourages us to go for it!

September 2010 - Fair Haven Yoga moves to a beautiful new location. We are happy to have this bright airy space to teach

Spring 2011 - We assemble and submit our application for permission to attend the Birth Doula Trainer Workshop.
June 8, 2011 - Dorothy and Jessica both receive this email:

I'd like to welcome you to take the birth doula training workshop in conjunction with the DONA International conference next month. I am notifying the office that you have been approved to attend.
Congratulations and I'll see you in July!

June 8, 2011 (approximately 6 hours after receiving the above email) - We mail in our registration forms to attend the Doula Trainer Workshop, to be held in Boston in July 2011.
We are both excited about this next step for us and for Your Best Birth.  We look forward to holding DONA birth doula workshops in the Central NJ area.

What does this change mean? For our clients - not much will change. We will continue to take doula clients and  teach childbirth classes, and our commitment to our clients will stay the same.  One benefit to our doula clients is that by teaching the doulas trainings, that information will be fresh in our heads when we work with our own clients.

For those who have taken our childbirth classes, you know that we make our classes fun and relevant, with lots of laughing and good practical information. We are looking to bring that same element to our doula training classes.

We will both be blogging throughout our journey to becoming doula trainers. At this point, we expect to be offering our first DONA-Approved Birth Doula Workshop in the Central NJ area sometime in Spring 2012.

We encourage you to follow us throughout our journey, and if you have ever thought about becoming a birth doula, consider joining us next spring!


Sunday, August 1, 2010

A month of surprises!

July was a busy month for Your Best Birth.  Some surprising things that happened this month:

Lots of Births!
 Between the two of us, we had six clients this month give birth - 2-3 births more than usual.   We had 4 clients scheduled this month (a normal YBB workload) but add a June client and an August client whose babies decided to come in July, and there you go.

An Early Baby!
One of Dorothy's clients went into labor 5 weeks early.  Surprise! This was their second baby and there were no risk factors for preterm labor.  (Baby and mom are fine!)

And going to the other extreme, we had...

A Baby Who Came At 42 weeks!
One of Jessica's clients went 2 weeks past her due date.  And although labor took a long time coming, once it started it didn't take long!

The client who went to 42 weeks was also was in the next category:

Two Fast Babies!
Dorothy and Jessica each had a client this month whose labor  lasted less than two hours.

Moving on to the other extreme, we also had...

Two Babies Who Took Their Time!
Dorothy had a client this month who was at 6-7 centimeters at 11:00 AM.....and 15 hours of active and transition contractions later,  was still in labor. A long labor and an incredible mom who worked through an incredibly long unmedicated labor.

Dorothy had another client thus month who started having contractions early Saturday was born late Monday night. 

Some babies just take their time.

Two VBAC Births!
 Both of these clients worked hard to give themselves the best chance of success - and both had successful VBACs!  
Two Clients in Labor on the Same Day!
In the past 5 years, this is only the 4th time this has happened.
Three Births in One Week!
Also known as "The Week Dorothy Barely Saw Her Family"


The unpredictable nature of birth is one of the things that I love about birth.

The unpredictable nature of birth is also one of the things that I find to be most challenging about birth.

I am incredibly proud of our July clients, who all worked hard through their unpredictable and sometimes challenging labors and births.

Welcome July babies!

Friday, July 23, 2010

More Good News for the Future of VBAC

The tide keeps turning...

In my blog post of March 11, 2010, VBAC in the News, I expressed hope that the tide was turning with respect to VBAC.

This week ACOG, the organization that sets the policies that most obstetricians follow, has issued a statement calling for less restrictive policies for women attempting a VBAC (Vaginal Birth after Cesarean) This carries MUCH more weight with doctors than the previous statement issued by the NIH.

Here is the statement issued by ACOG:

Ob-gyns Issue Less Restrictive VBAC Guidelines

Now ACOG is not known for their progressive approach to birth. It is rare that we are giving them a shout-out and saying, "GO ACOG!"

So what do their recommendations mean for women who have had a previous cesarean and are considering a vaginal birth in a subsequent pregnancy?

Recommendation #1:
They have expanded the category of women who they feel are good candidates for VBAC to include:
Women who have had two prior cesareans.
Women carrying twins.
Women who have an unknown type of uterine scar.

Good News! Women in the categories above are going to have an easier time finding a care provider that supports them in having a VBAC.


Recommendation #2:

ACOG has also relaxed their recommendations for what type of emergency care needs to be immediately available for women attempting a VBAC. Their previous recommendation caused many hospitals to ban VBAC all together. My thinking is - emergencies can happen in any birth. The emergency care in place for any birth should be sufficient to support the rare emergency that arises during a VBAC - if not, then that hospital had better re-evaluate if they are in a position to handle any births at all.

So Yay! to ACOG for realizing that the result of their previous recommendation wasn't better emergency care - the result was the massive banning of VBACs and women unable to find a hospital to support them in for their VBAC.

Good News! Women looking to have a VBAC will have more hospitals and care providers available who are willing to support a VBAC birth.

Yay! More choices for women in birth is a great thing.

Recommendation #3:

If a hospital does have a restrictive VBAC policy, ACOG is recommending that it should not be used to force a woman to have an unwanted repeat cesarean.
Although individual doctors and hospitals can still decide to not support VBACs, if a woman shows up in labor at the hospital, ACOG is recommending that the hospital should support her in attempting a vaginal birth and should not force her to have a cesarean.

Good News! Women who don't have a supportive doctor/hospital have a much greater chance of their unsupportive hospital won't pressure her to have a repeat cesarean.

Recommendation #4:

ACOG is encouraging doctors to give women with a previous cesarean the benefits and risks of both a VBAC AND a repeat cesarean. The policy specifically states:

A VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery. It may also help women avoid the possible future risks of having multiple cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection, and abnormal placenta conditions (placenta previa and placenta accreta).

Good News! More women will be given the benefits and risks of both VBAC and repeat cesarean, instead of only being told the risks of VBAC. Women will be able to make more informed decisions, instead of picking repeat cesarean solely out of fear and not realizing it carries risks of its own.


Now ACOG is not law. These are not laws that doctors and hospitals have to follow. But ACOG is seriously listened to by obstetricians, and any statement from them carries a lot of weight and shifts the way many doctors and hospitals practice. The reason VBAC became so restricted in the first place was due to ACOG recommendations.

So yes, this policy change is really only fixing something that ACOG messed up awhile ago. But they are moving in the right direction. I am confident that these new policies are going to result in women getting more support for their VBAC, which will ultimately result in a decrease in the cesarean rate.

The most encouraging part of their statement is this comment:

"The current cesarean rate is undeniably high and absolutely concerns us as ob-gyns," said Richard N. Waldman, MD, president of The College. "These VBAC guidelines emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy. Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals, and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate."

Is there still room for more change - absolutely. But this is a step in the right direction. I am cautiously optimistic that these policy recommendations will ultimately result in a lowering of the cesarean rate.

I am hopeful that we will see more loosening of restrictions from ACOG in the future - in my fantasy world, maybe they'll give guidelines for reducing the induction rate, or issue a strong statement that doctors shouldn't even consider induction for post-dates until 42 weeks or they'll encourage less continuous monitoring, less interventions, or they will encourage eating and drinking during labor, walking around and using water during labor, or maybe they will even encourage pregnant women to bring a doula to their birth...

Hey, a girl can dream!