First Steps
So, you are thinking you would like to become a doula? Congratulations! For those of us who feel drawn to helping moms and babies, getting paid to do work we would do for free is simply amazing. Where to start?
Fast Track for Aspiring Doulas:
- Read over the DONA birth doula certification requirements or DONA postpartum doula certification requirements. We will review, in detail, all of the certification requirements during the Doula Training weekend and answer any questions you may have.
- Aspiring birth doulas can fulfill two requirements at once — a pre-requisite for Birth Doula Training and a certification requirement — by taking the Introduction to Childbirth for Doulas class prior to the Birth Doula Training weekend (offered the Friday immediately prior to the two-day Birth Doula workshop).
- Similarly, aspiring postpartum doulas can take the Professional Education in Breastfeeding & Lactation on a weekend prior to the Postpartum Doula Training and fulfill both a pre-requisite and a certification requirement.
- Take the DONA Birth Training or DONA Postpartum Doula Training.
- Begin reading from the required reading list (birth doulas, click here; postpartum doulas, click here) at any time prior to or after the training (some reading is a required pre-requisite for aspiring postpartum doulas). Book reports or written reviews of books read are not required. We are on the honor system here. The Center has multiple copies of all the books required for DONA certification in our lending library. You may borrow a maximum of three books at a time for a maximum of three weeks.
- Begin developing your list of local resources with contact information. Local resources are folks who offer any services or products that your clients may need, want, or benefit from. You may include web resources. To meet the DONA certification requirements, your list must include at least 45 listings in at least 30 different categories. Ultimately, your resource list can also become part of your marketing plan. If you are referring folks to these businesses, they should also be referring to you. Get to know your birthing/parenting community. None of us works in a vacuum.
- Aspiring birth doulas can complete the breastfeeding class requirement at any time, before or after the doula training. Check out our Professional Education in Breastfeeding & Lactation class.
- Likewise, postpartum doulas can complete the required CPR training at any time, before or after the doula training weekend.
- Aspiring postpartum doulas must complete one of the following before undertaking the postpartum experiences to be submitted for certification. If you have added an infant to your own family within the past five years, you can skip this step. You can get started any time on this requirement.
- Had experience as a postpartum doula (minimum of 8 hours)
- Had experience providing care to an infant less than 10 weeks of age (minimum of 8 hours)
- Attended an infant care or parenting class (see CCY’s Newborn & Infant Care class)
- Shadowed an experienced postpartum doula (minimum of 8 hours)
- Volunteered with infants in a daycare or with a new family
- After the doula training weekend, sign up for the next Volunteer Orientation Part I with the Doulas Care program. Through this program, you can be matched with low-income women who would like a doula. The births attended through the Doulas Care program can be used to fulfill certification requirements. Trained postpartum doulas are needed as well in communities throughout southeastern Michigan. How quickly you can accomplish providing labor and birth support to three clients after the doula training weekend is partly up to you (your availability, capacity, desire) and partly dependent upon the demand for doulas in your area that the program has been able to generate to date. Ditto for completion of the postpartum certification requirement of providing a minimum of eight hours of support to at least three families. Of course, you can also get yourself invited to births of sisters and friends or provide postpartum support to families in your circle of friends and acquaintances as well! The Doulas Care program simply provides an optional pathway to fulfilling certification requirements. You must be a resident of one of the counties served in southeastern Michigan in order to participate in this program.
- Purchase of the DONA certification packet can be accomplished through their website, but does not need to be done until you are ready to attend your first birth for certification purposes. Births attended prior to the DONA training may not be used towards certification requirements. We recommend purchasing the packet four weeks prior to the woman’s estimated due date so that you will have it in hand for the birth (required). Postpartum doulas must also purchase the packet prior to providing support to the required three families. You have precisely two years to complete all certification requirements from the time you purchase the packet. If not completed within that time frame, a new packet must be purchased with the possibility that some certification requirements may change. You have precisely four years to complete the certification process from the time of the training; after that interval, you would be required to repeat the doula training if seeking certification.
If you prefer to take it a little slower:
- Focus on meeting pre-requisites for the Birth Doula Training or the Postpartum Doula Training. These are listed with the course descriptions for each.
- Take it one step at a time. This is especially suitable for those whose family circumstances might preclude total immersion in their new-found calling. If it is too great of a hardship for you to attend a weekend doula training at this time (leaving young ones, separation from a breastfeeding toddler, financial concerns, etc.), hang in there. Does it make sense to devote yourself to helping other families get off to a great start while your family suffers to make it possible? There really is no rush. You can be slowly but surely working towards your goal.
- Look also for Birth Doula and Postpartum Doula Trainings offered through Washtenaw Community College (WCC) in 2009. At WCC, the trainings will be offered over a period of weeks on a specified weeknight, rather than the weekend intensives. We hope that this configuration may work for those of you who otherwise might not be able to attend doula training due to babysitting concerns, work schedules, or Sabbath observation. Check our website often as it will be updated, with links to WCC, when new trainings get scheduled in that venue.
Meet the Doulas Care staff
Lisa Kane Low has been a nurse-midwife since 1986 working in a variety of roles including clinical practice, administration, and education. She received her BSN from the University of Michigan, an MS in midwifery from the University of Illinois, and a PhD in nursing focused on women’s health from the School of Nursing, along with a graduate certificate in women’s studies from the University of Michigan School of Nursing. Lisa served as a program development specialist and grant writer for the Center’s Doulas Care Program since December 2001 and as of January 2008, she became the Executive Director of Doulas Care in a volunteer capacity. Lisa also works at the University of Michigan as an Assistant Professor in the School of Nursing and the Women’s Studies Department. She teaches women’s health courses and conducts research related to care practices during labor and birth. In addition, she is in clinical practice with the University of Michigan Nurse-Midwifery service. Her research interests and publications focus on support and care practices during labor, and adolescent pregnancy and childbearing.
Marylee Scherdt serves as the Program Director for the Doulas Care. Marylee is the caring voice on the phone assisting women who call to find a doula. She also serves as a mentor for the volunteers helping them to access resources and problem-solve any challenges they may be experiencing. Marylee has a Bachelor of Science degree from Eastern Michigan University. She has had the privilege of working with new families since 1999. During that time she has worked as a certified postpartum doula, served as a Doulas Care volunteer, volunteered as a facilitator for a Postpartum Depression support group, and is a former member of the Board of Directors at the Center. As the mother of three children, Marylee has been actively parenting for over 24 years.
Jamie Wazenkewitz is the Client Services Coordinator for Doulas Care. She is a dual masters student at the University of Michigan studying Social Work and Public Health, and has a Bachelor of Arts in Psychology from Whitman College. She has experience in early childhood parent education and was an autism verbal/social skills therapist for several years. She has a son, Dylan, and loves supporting families in their childbearing and parenting years.
Joliba Honzaki serves as the Latina Outreach Coordinator for the Doulas Care Program and has also worked as a volunteer doula with the program.
Nelda Murphy, MSW, serves as a Social Work Consultant to the program in addition to being a volunteer doula herself. She provides consultation to the Volunteer Coordinator to help support new families dealing with postpartum issues and other challenges. Nelda has a Bachelor’s Degree in Human Services and Education from the University of Wisconsin and a Master’s Degree in Social Work from the University of Michigan. She has 16 years of experience working in the community, providing therapy, doing research, and finding resources to help families in need of supportive services. Nelda is also a mom of 9 years and a School Social Worker who is passionate about helping families during the childbearing year.
Charlie’s Angels: The Aroma of a Doula
By Charlie Long Graham
The doulas’ role in my life after giving birth has become like treasured memories. With a willing spirit, the doulas’ embrace was warm and their compassionate acts of gentle and genuine service helped to maintain a safe and uplifting atmosphere while my body healed. Their personal and sincere touch, wrapped with sensitivity and a nurturing spirit, made the definition of doula come alive in my presence.
Today, I pay tribute to doulas across the globe, especially the doulas in Ann Arbor and Plymouth, Michigan. These doulas were chosen and trained for action and help set the tone for my healthy postpartum recovery — mentally, emotionally, and physically. The mission statement that represents agencies can often become words with little success, lacking little impact. I am a witness to the statement the doulas made. The doulas bring their mission statement to life, by their works. The Center for the Childbearing Year is reaching women like me within the community and decreasing high levels of stress that often characterize post-birth experiences. Women are overall the caregivers for the families. When you help a woman maintain her mental and physical health, you help a nation.
I represent one of the women within Washtenaw County who was in great need of support after delivery. It is evident that the doulas are being chosen and hand picked to provide this service. Women are able to overcome any obstacles when surrounded with a positive empowering team. The Doulas Care community-based program was in the position to send my family help in the form of professional, non-judgmental, caring doulas. I was encouraged and motivated, while the doulas provided assistance. Without the doulas caring for my newborn and supporting me with my three- and four-year-old sons while I learned to walk again, my road to recovery would have been consumed with discouragement and stress. The doulas added to my hope and lifted my confidence tremendously.
There were many people wondering how I could make it without becoming completely depressed. Those people underestimated my level of faith and the mission statement behind the doulas. I was fortunate to have a caring agency that provided me with assistance. The “aroma of doulas,” their dedication and commitment to this much needed volunteer and support service was like a scent of inspiration. They created an environment where I could heal with confidence and hope. It’s an honor to send words of thanks and appreciation to all the employees and volunteers for developing and maintaining an agency that helps mothers overcome the challenges of childbirth. I salute you for your commitment to women.
A Doula to the Rescue of a Breastfeeding Mom
by Charlie Long Graham
Kiki Farrow is a doula from the inside out, with tender-loving care
spreading her gift of compassion and kindness to women everywhere.
Kiki received a call about a mother in need;
I was hospitalized and unable to walk after giving birth.
I’m the mother who was determined to continue to breastfeed.
I had a breastfeeding dilemma and the only way I could
continue to nurse my three-month-old son with pride,
was to have 24-hour help by my side.
Kiki entered my hospital room with an aroma so sweet;
I will never forget the day she set my spirit at rest.
Kiki was a gift to our family and stands out as one of the best.
My breastfeeding dilemma was about to come to an end;
The day I received my doula, Kiki, I received a mentor, a nurturer, and a friend.
Kiki’s smile was like a rainbow full of promise and cheers;
she embraced you with her presence, while eliminating all your doubts and fears.
A stranger no more after five minutes of her special touch,
her doula expertise and inner beauty rose to an A+.
I was wheelchair bound with three children, four and under;
I had a high need for committed assistance.
Kiki’s dedication prepared me for my independence.
Kiki remained committed after my month-long hospital stay;
she was so devoted to my family, with rich and kind words to say,
I said to myself, “this doula deserves pay.”
My doula helped organize my home, putting things at arms reach,
in order for me to care for my children and breastfeed with peace.
This is what I call doulas in action delivering a service to your satisfaction.
“Compassion in action” – my doula made those words come alive.
Through her service, I breastfed my son for 18 months with pride.
Transportation to therapy, housework, child-care, you name it!
My doula was determined before she left me alone,
that I could handle things on my own.
I honor Kiki Farrow for being my doula sent with grace,
always on time with a spirit of excellence,
embracing me with her sincere and loyal presence.
I will always cherish and honor the Center for the Childbearing Year.
I am thankful for your labor of love and for choosing women like Kiki Farrow:
Pleasant, Patient, Positive, and Powerful.
Continuing Education Credits (CEs)
“As someone who had taken lactation education training classes before, I thought I wouldn’t learn much new information — I was wrong! Thanks so much!” — Class participant
Continuing Education credits or CEs have been awarded for all eligible programs. For readers unfamiliar with CEs, also referred to as CEUs, they are a requirement for certified doulas and many other licensed professionals to keep their credentials active. The DONA-certified doula is required to complete 15 hours of continuing education in every three-year re-certification period. CEs have been approved for nurses, social workers, and doulas for some programs. Any program approved for nursing CEs will also satisfy DONA CE requirements.
Please note, however, that because a program has been approved for nursing or social work CEs, it does not follow that one must be a nurse or social worker in order to take the training. A medical or professional background is not required in order to become a doula!
The following providers have approved CEs for select programs offered through the Center for the Childbearing Year:
- The University of Michigan Health System Educational Services for Nursing, accredited as a provider of Continuing Nursing Education by the American Nurses Credentialing Center’s Commision on Accreditation (these CEs fulfill requirements for nurses, doulas, and some childbirth educators);
- Michigan Social Work Continuing Education Collaborative (these CEs fulfill requirements for social workers); and
- DONA International (these CEs fulfill requirements for doulas)
If you are unsure whether or not a program will fulfill your unique licensing requirements, please check directly with the folks who licensed you. While many massage therapists, for example, are drawn to doula work, it is my understanding that nursing CEs do not fulfill massage therapist continuing education requirements.
There is an additional fee of $15, beyond the cost of the training, to process CEs. The added CE fee helps us cover the significant administrative burden and cost involved with getting programs approved for CEs, as well as the required post-training follow-up.
Certification
Patty Brennan is an approved doula trainer through DONA International. All Birth Doula and Postpartum Doula trainings, as well as the Introduction to Childbirth for Doulas and Professional Education in Breastfeeding & Lactation trainings offered at the Center, fulfill certification requirements. Kate Stroud has completed the birth doula trainer process through DONA and her approval as a trainer is pending. To learn more about the certification process, including associated costs beyond training, go to the DONA website. There is a separate process for birth doulas and postpartum doulas.
Certification candidates must accept responsibility for following the steps outlined by DONA regarding the certification process. These steps will be discussed in detail during your doula training. A Certification Packet must be purchased from DONA for those seeking certification. The DONA website outlines some important time restrictions and considerations regarding the purchase of Certification Packets. Please read the instructions carefully.
Is Certification Required?
Students should be aware that the pursuit of doula certification is optional. Certification is not required in any state in order for one to practice as either a Birth Doula or Postpartum Doula. Certification does represent an individual’s effort to professionalize her services and may increase public perception of the validity of the doula’s role. Certification may also enhance the ability of doulas, now and in the future, to qualify for insurance reimbursement for their services.
How CCY helps doulas complete certification requirements
- We offer all of the classes on site to help you complete certification requirement, including a professional breastfeeding class that works for both birth and postpartum doula requirements (Professional Education in Breastfeeding & Lactation), and CPR training.
- As an alternative to the Introduction to Childbirth for Doulas class, there are ongoing opportunities under a Work/Study Exchange, to observe a series of Childbirth Preparation classes offered at the Center for expectant parents. The doula helper attends the seven-week series of classes for free and, in exchange, brings a healthy snack and beverages for the couples each week. The helper is also expected to arrive a half hour early for class to help the teacher set up and stays afterward to help with clean up. If you are interested in this opportunity, please email Jamie to sign up (this email is being protected by spam bots; you need Javascript enabled to view it). You can also simply register for this class at the reduced fee of $175 or sign up with a friend at the couple price of $235.
- We also need helpers for the Breastfeeding Basics and Newborn & Infant Care classes. This is an opportunity to expand your knowledge base, while interacting with expectant parents. Email Jamie to sign up (this email is being protected by spam bots; you need Javascript enabled to view it).
- Need help completing the experiential component of the certification process? Through Doulas Care, women who have completed doula training can get hands-on experience at births or postpartum, by volunteering in this community-based program serving low-income mothers and their families.
How to Register
PRE-REGISTRATION IS REQUIRED FOR ALL CLASSES. Registration is limited and will be accepted on a first-come, first-serve basis. To reserve your spot, send a minimum payment of $100 (or the full fee if tuition is less than $100). Balances are due on the first day of class. A limited number of more flexible payment plans or work/study opportunities are available upon request, but must be approved in advance. Email Patty Brennan. Once we receive your check, we will mail you a letter of confirmation providing directions and other information. Last-minute registrations may be accepted, space permitting.
DISCOUNTS: Most of the professional trainings offer an inducement for early registration. To qualify for the early registration discount, payment must be made IN FULL no later than 5pm on the early-registration date (ERD) listed.
A full REFUND, minus a $25 processing fee, will be provided upon request up until one week before any class begins. After that time, refunds will not be issued, though students may use their credit to enroll in a future class or support group (minus $25). Once we are within 24 hours of a class beginning, no refunds or credits will be issued.
Please make checks out to:
Center for the Childbearing Year
Mail to:
Patty Brennan
Center for the Childbearing Year
722 Brooks St.
Ann Arbor, MI 48103
CREDIT CARDS: We accept VISA and Mastercard over the phone. A $10 fee will be assessed for credit card refunds. This is in addition to the $25 cancellation processing fee detailed above.
Questions?
Call (734) 663-1523 or email Patty Brennan.
All About Midwives
In the State of Michigan, consumers have great freedom of choice regarding midwifery care. If you are just beginning on a path of looking into your choices regarding birth attendants and place/setting for the birth of your baby, then these choices may be a little confusing. We will attempt to clarify here.
Certified Nurse Midwives (CNMs)
CNMs are credentialed through the American College of Nurse Midwives (ACNM). They are RNs with additional Masters-level training in midwifery. Nurse midwives can attend births in hospitals, free-standing birth centers, and homes, though they are primarily found working in hospitals. You may find nurse midwives in solo practice, small group practices of two or three midwives, or large practices of ten or more who rotate being “on call.” Large practices may assign one midwife who you see for prenatal care, but it is potluck at your birth. Most insurance companies will reimburse for their services. They work with doctor back-up and abide by medical protocols that may mandate consultation with, or transferral of care to, the back-up doctor in some circumstances. CNMs, for example, cannot be the primary care provider for women expecting breech or twin deliveries. Ask your prospective nurse midwifery service about their protocols regarding transferral of care and insurance coverage.
Direct-Entry Midwives
Direct-entry midwives — also known as “lay,” homebirth, or traditional midwives — are an eclectic group in Michigan. There is no government oversight regarding licensure or certification of direct-entry midwives in this state. The practice is considered “a-legal” in that it is neither prohibited by law nor sanctioned by the state. Compared to some states in the country where direct-entry midwifery is against the law, or other states where it is licensed and regulated, the status of Michigan direct-entry midwives allows for maximum consumer choice regarding birth attendants.
Direct-entry midwives may attend homebirths or out-of-hospital birth center births. Typically they work with low-risk, healthy women who desire a normal, non-medicated birth. A complete homebirth or birth center service package should include prenatal care, attendance at your labor and birth, and postpartum care, with phone consultations as needed.
Direct-entry midwives may participate in a national certification process through the North American Registry of Midwives (NARM). A midwife who has completed experiential skills training and passed the NARM exam earns the Certified Professional Midwife (CPM) credential. This credential is used as the requirement for licensure in 22 of the 24 US states which license direct-entry midwifery. Some direct-entry midwives may have a nursing background and RN credential, but practicing midwifery is outside the scope of nursing licensure. Direct-entry midwives who lack credentials may nevertheless be highly experienced and qualified, and have sound reasons why they have chosen not to pursue the CPM credential. Most direct-entry midwives are apprenticeship trained and self taught. Some have attended midwifery schools or undertaken a home study course. “Lay” midwife technically means a person with no experience or training who attends births.
Theoretically, there are no complications that a birth center midwife can handle without medical backup that could not also be handled at home. While a birth center may convey a greater sense of safety, this, in and of itself, is an illusion. However, if the birth center attendant is more skilled, that is not an illusion. When emergencies happen at a homebirth or in an out-of-hospital birth center, 911 is called and the woman and/or baby is transported to the nearest hospital. In Michigan, physicans do not back up direct-entry midwives in the same sense that they back up nurse midwives. However, ERs cannot refuse care and many direct-entry midwives have friendly doctor “back up” to the extent that a physician may order necessary tests for the midwife or be willing to consult with her if needed.
Insurance & Fees
As a rule, insurance companies do not cover out-of-hospital birth attended by direct-entry midwives, but there are some exceptions. Women on Medicaid or covered under HMOs will not be able to get reimbursement for direct-entry midwifery services. Check with your insurance provider regarding the feasibility of homebirth coverage. Midwives should also be able to tell you the providers with whom their clients have had success in gaining reimbursement or partial reimbursement. You should expect to pay the midwife’s fee up front, out of pocket, and then gain her help in generating a proper receipt suitable to submit to your insurance provider for reimbursement. Midwifery fees in Michigan currently range from $1,000 (very low-end for midwives attending rural, religious, or Amish communities) up to $4,00 or more. If you have a high-deductible insurance plan, it is quite possible that the midwife’s fee would equal the amount of your co-pay for a hospital birth. Healthcare Spending Accounts (HSAs) or “Flex” accounts can be used as well.
Choosing a Midwife
The practice of midwifery is not the practice of medicine, and medical procedures such as pitocin induction, epidurals, and surgical procedures should take place only in hospitals. Some homebirth midwives may be skilled in working with herbs, homeopathics, and nutrition. Prevention is a hallmark of good midwifery care, and supporting, rather than interfering with normal processes often prevents complications. Midwives can vary in their approaches to midwifery care. For example, some midwives may choose to use dopplers to listen to fetal heart tones, while others may use the low-tech fetoscope. Just because a midwife attends births in a birth center or at home does not guarantee her practice of midwifery is non-interventive.
Clients should interview midwives carefully to find the approach to care that is a good match for their needs. How many births has she attended as the primary midwife? (This should be distinguished from “years in practice” which is essentially meaningless; i.e., someone can claim 25 years’ experience, but have very limited experience as a primary midwife. Hint: Most midwives worth their salt will have a ready and precise answer to this question and it should not be rounded off to the nearest hundred. Do you trust the claim she is making?) Which potential complications can the midwife handle? How is she prepared to handle them? What percentage of her clients give birth with their perineums intact? What are her practice protocols for pre-term or post-term babies? Under what circumstances will she transfer care to medical backup? What percentage of her clients end up with a hospital transport? Is water birth an option? The answer to these questions will vary, depending upon the individual midwife and the practice setting. By asking the right questions, you should be able to find the midwifery practice that is most closely in alignment with your beliefs and preferences.
Careful interviewing of prospective midwives is in order! Ask around. Good word of mouth about a birth center or homebirth practice is important. Midwives who are dishonest, irresponsible, or unskilled get weeded out pretty quickly, but there may be a few out there who are mis-representing their level of training and experience. Create your own list of questions prior to interviewing midwives, a list that reflects your values and priorities, and hire someone who has her act together. Trust your instincts AND check her references/credentials.
How to Register
Pre-registration is required for all classes. Registration is limited and will be accepted on a first-come, first-serve basis. To reserve your spot, send a minimum payment of $100 (or the full fee if tuition is less than $100). Balances are due on the first day of class. A limited number of more flexible payment plans or work/study opportunities are available upon request, but must be approved in advance. Once we receive your check, we will mail you a letter of confirmation providing directions and other information. Last-minute registrations may be accepted, space permitting.
Discount for Multiple Classes
Sign up for more than one of any of the childbirth and parenting classes and support groups and take a 5% discount off the price. In order to qualify for the discount, you must pay the full fee at the time of registration.
Make-Up Policy
We are not able to accommodate the many requests we receive to allow people to make up classes in a series for which they have schedule conflicts. Our classes are usually full and there simply is not the space to do this. If you have to miss a class, it is fine for you or your partner to come alone. If you both have to miss, the teacher can point you in the direction of reading and audio/visual materials that cover similar information. If you anticipate multiple conflicts, you may want to consider private classes which can be designed to meet your unique needs.
Refund Policy
A full refund, minus a $25 processing fee, will be provided upon request up until one week before any class begins. After that time, refunds will not be issued, though students may use their credit (minus $25) to enroll in a future class or support group. Once we are within 24 hours of a class beginning, no refunds or credits will be issued.
Payment by Check
When sending in payment, please include the following information:
- your name and name of one person who will be attending the classes with you
- address, phone number, and email address
- due date
- the class names and dates in which you are enrolling
Please make checks payable to:
Center for the Childbearing Year
Mail to:
Patty Brennan
Center for the Childbearing Year
722 Brooks St.
Ann Arbor, MI 48103
Payment by Credit Card
We accept VISA and Mastercard over the phone. A $10 fee will be assessed for credit card refunds. This is in addition to the $25 cancellation processing fee detailed above.
Questions?
Call (734) 663-1523 or Email Patty.
Lisa Kane Low recognized as a finalist for the Ann Arbor News’ Citizen of the Year Award
Lisa Kane Low, the new volunteer Executive Director of Doulas Care, has been honored by the Ann Arbor News for her extraordinary commitment to community service for her work with the Doulas Care program. Read more