All items can be either mail ordered or purchased on site at the Center. Shipping is billed at cost.

A 40% wholesale discount is available on Patty Brennan’s books and DVD. To obtain the wholesale discount, you must place a minimum order of 6 copies of any one item. Wholesalers pay shipping and handling costs.

Forthcoming publication Summer 2010!

Email Patty to be notified of special pre-publication offers (when available).

• Creating a Successful Service Business
• Establishing and Funding a Doula Program
• Getting Paid for Work You Love
• And More!

The Doula Business Guide is designed to be THE comprehensive, go-to manual for individuals and groups wanting to establish and grow a thriving doula service. This work-in-progress includes the following chapters:

• Choosing a Framework for Your Business
• Business Basics
• Marketing on a Budget
• Non-Profit Set Up and Management
• Establishing a Doula Program
• How to Write a Winning Grant Proposal
• Managing Risk for Doula Businesses
• Strategies to Prevent Burnout

Price to be determined.

Email patty@center4cby.com to be notified of pre-publication offers and discounts!

The Center for the Childbearing Year offers a comprehensive selection of classes and resources designed to help you have the best possible birth experience and ease you through the early weeks and months of caring for your newborn baby. We provide an environment that encourages a sense of community with other expectant couples and new parents. Support groups, lending library, and ongoing opportunities for you to enhance your family’s health through education are available. Learn more about the values that inform our programs.

Our Classes

• Childbirth Preparation — Everything You Need to Know
• Childbirth Preparation — Focus on Labor & Birth — Condensed Series
• Negotiating the Medical Setting — What Parents Need to Know about Epidurals, Cesareans, Birth Plans, and Informed Consent
• Private Childbirth Classes / Consultations
• Breastfeeding Basics — Tools for Success
• Newborn Care 101
• Belly Mapping & the Art of Palpation

Postpartum MotherBaby Support Groups

• Mothering Arts (MotherBaby and Toddler Groups)
• The Breastfeeding Cafe
• La Leche League Monthly Meetings

Lending Library & Resources

• Lending library of books, videos, DVDs
• Community resources, brochures, and business cards of folks providing services to childbearing families; bulletin board for events postings
• Online Directory and Links to service providers and resources
• Online resources that promote informed decision making, including hiring doulas and midwives
• Updated homepage links to timely news items and the latest in relevant research

Products for Sale

• Pregnancy Tea organic herbs
• Postpartum Herbal Baths
• Vaccines & Informed Choice, by Patty Brennan (binder of materials, 2009)
• Whole Family Recipes: For the Childbearing Year & Beyond, by Patty Brennan (cookbook, 2007)
• Guide to Homeopathic Remedies for the Birth Bag, by Patty Brennan (4th Edition, 2005)
• Nursing bras, Medela breast pumps and products, and more are available through the adjacent Breastfeeding Center of Ann Arbor

Services Available on Site

• Barbara Robertson: International Board Certified Lactation Consultant, comprehensive support services
• Kate Stroud: Massage Therapy, Birth Doula Services
• New Moon Midwifery: Homebirth Midwifery Services

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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 may be available upon request, but must be approved in advance. Email Patty to inquire about this possibility. Once we receive payment, we will mail you a letter of confirmation providing directions and other information. Last-minute registrations may be accepted, space permitting.

At what point in your pregnancy should you register for classes?

Plan ahead! You are encouraged to take Childbirth Preparation classes beginning anytime after your fourth to fifth month of pregnancy. Since the full series is seven weeks in length, you don’t want to back it up too close to your due date or you will run the risk of missing the last class or two if your baby comes early. As class sizes are limited, parents are encouraged not to wait until the last minute to register, though we will accommodate you if we possibly can.

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, plus 3% on the total for credit card payments, will be provided upon request up until one week before a class begins. After that time, refunds will not be issued, though students may transfer their registration to another class or support group. Once we are within 24 hours of a class beginning, no refunds or credit transfers will be permitted.

Register Online Now

You can use our secure online payment system to register and pay in full for classes with a credit or debit card.

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 as well as online. Call 734-663-1523.

Questions?

Call (734) 663-1523 or Email Patty.

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Use this page to register online only if you are prepared to pay in full for classes with a credit or debit card. For those interested in paying with a check or cash, or to reserve your spot with a partial payment, click here for more information. If you prefer to use a credit card over the phone, please call Patty Brennan at 734-663-1523.

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Refund Policy

A full refund, minus a $25 processing fee, plus 3% on the total for credit card payments, will be provided upon request up until one week before a class begins. After that time, refunds will not be issued, though students may transfer their registration to another class or support group. Once we are within 24 hours of a class beginning, no refunds or credit transfers will be permitted.

The American College of Obstetricians and Gynecologists (ACOG) recently revised its 2003 guidelines for induction of labor. The ACOG Practice Bulletin, Number 107, published in the August 2009 issue of Obstetrics & Gynecology serves as a resource to help medical practitioners make decisions about appropriate methods of cervical ripening and induction of labor and their effectiveness. At least two of the ACOG recommendations, inducing labor for “psychosocial” (non-medical) reasons and cervical ripening with the synthetic prostaglandin misoprostol (trade name Cytotec), differ from labor induction practice guidelines issued by the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the National Institute for Clinical Excellence (NICE), which drafts clinical guidelines in the U.K.

Induced labor puts women and babies at risk. Compared to women who go into labor on their own, women who have an elective induction are at increased risk for intrapartum fever, instrumental birth, cesarean section, and are more likely to use analgesia including epidurals. Babies are at risk for irregular heart rate patterns, shoulder dystocia, neonatal phototherapy to treat jaundice, neonatal resuscitation and admission to a neonatal intensive care unit. These risks are documented in CIMS’ “Evidence Basis for the Ten Steps of Mother-Friendly Care” (see Step 6, pages 42-43). According to the white paper “Idealized Design of Perinatal Care” published by the Institute for Healthcare Improvement, “Based on a review of U.S. medical malpractice claims, [the labor-inducing drug] oxytocin is involved in more than 50 percent of the situations leading to birth trauma.”

These complications of labor also impact mother-infant attachment and the initiation and continuation of breastfeeding. See “Breastfeeding is Priceless” (PDF).

Although ACOG approves of “psychosocial” induction, NICE clinical guidance (PDF) warns that induction of labor has a significant impact on the health of women and their babies; it should be clinically justified and should not routinely be offered on maternal request except under extraordinary circumstances. SOGC advises that there is no benefit to elective induction (PDF). Because it is associated with potential complications, elective induction should be discouraged and only provided after women have been fully informed of the risks and of the inaccuracy of establishing gestational age. ACOG approves of inducing labor at 39 weeks while SOGC states gestational age should be at least 41 completed weeks, and NICE guidelines state induction for non-medical reason can be considered at or after 40 weeks.

Misoprostol, an inexpensive synthetic prostaglandin, was developed and is marketed to prevent and treat gastric and duodenal ulcers. The use of misoprostol for cervical ripening and induction of labor (off-label use) is approved by ACOG, but not recommended by either SOGC or NICE. Misoprostol, also known as PG1, is not approved by the manufacturer for use in pregnancy (PDF). Misoprostol is associated with excessive uterine contractions, fetal heart abnormality, hemorrhage, hysterectomy, and sometimes fetal death. Both SOGC and NICE recommend its use be restricted to clinical trials. For a more detailed discussion of the use of misoprostol for induction of labor, see Science & Sensibility.com.

Nearly one in four births in the U.S. is induced (PDF) and according to the Agency for Healthcare Research and Quality (AHRQ), although it is not entirely clear what proportion of these inductions are elective (i.e. without a medical indication), the overall rate of induction of labor is rising faster than the rate of pregnancy complications that would lead to a medically-indicated induction. According to Childbirth Connection’s report, “Evidence-Based Care: What it Is and What It Can Achieve,” the most common gestational age at birth among single babies in the U.S. is now 39 weeks rather than 40 weeks.

Consumer information on induction of labor is available from:

• The American Academy of Family Physicians’ FamilyDoctor.org
• March of Dimes. See “Inducing Labor” and “Induction By Request“
• Lamaze International’s “Care Practice #1: Labor Begins on Its Own” (PDF)

Are you an expectant parent wanting to learn more about doulas or seeking the services of a doula?

• What is a doula?
• Hiring a doula
• Birth and Postpartum Doula Directories

For Aspiring Doulas

Are you thinking about becoming a birth doula or a postpartum doula? To learn more about what doulas do, fees for doula services, and more, see links to articles for expectant parents above.

Become a Birth Doula

• 2010 Schedule & Fees
• Pre-requisite option

Become a Postpartum Doula

• 2010 Schedule & Fees
• Pre-requisite option

Becoming a Doula — First Steps

Doula Certification

For Practicing Doulas

Earn Continuing Education Contact Hours

• Professional Education in Breastfeeding & Lactation
• Small Business Development

Build your Business

• Advertise your services. You can purchase an annual Directory Listing or Community Spotlight Ad on our website or simply Exchange Links for free.
• Learn about Small Business Development.

Attend our Monthly Support Group

• Doula Collective

Still Working on your Certification?

The following support is available for those who need to complete certification requirements:

• Lending Library containing all of the books required for DONA International birth and postpartum doula certification
• Work/Study Exchange to observe a childbirth preparation series, breastfeeding class, and/or newborn care class that meet DONA requirements
• check out our Directory and Links to complete your list of Community Resources

For Doula Program Development

Support for Existing Programs

• Grant Writing Services & Training
• Program Planning
• Strategic Planning Facilitation

Support to Launch a New Program

• Establishing a 501(c)(3) non-profit
• Establishing a Community-Based Doula Program
• Establishing a Hospital-Based Doula Program (Birth and/or Postpartum)
  
• Grant Writing Services & Training

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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 may be 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.

2010 Schedule At-A-Glance

Register online if you are prepared to pay in full for the training(s) with a credit or debit card. For those interested in paying by check or cash, to reserve your spot with a partial payment, or if you prefer to use a A VISA or MasterCard over the phone, please call Patty Brennan at 734-663-1523.

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PLEASE NOTE: Do not register for Parts I & II if you plan to take the DONA Postpartum Doula Workshop; Part II is incorporated into the postpartum doula training weekend.

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Continuing Education Contact Hours for Nurses & Doulas

A $15 processing fee per class is charged for folks who wish to purchase contact hours.

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Refund Policy

A full refund, minus a $25 processing fee, plus 3% on the total for credit card payments, will be provided upon request up until two weeks before any class begins. After that time, refunds will not be issued, though students may transfer their registration to another class. Once we are within 24 hours of a class beginning, no refunds or credit transfers will be permitted.

Discounts

Professional trainings offer an inducement for early registration. To qualify for the early registration discount, payment must be postmarked or paid IN FULL no later than 5pm on the early-registration date (ERD) listed.

Payment by Check

When sending in payment, please include the following information:

• your name
• address, phone number, and email address
• 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

A doula is a labor support professional who “mothers the mother” during childbirth, as well as during the prenatal and postpartum periods. Birth doulas provide support to pregnant women prenatally, through labor and birth, and in the early days postpartum. Postpartum doulas provide in-home services to families, typically lasting from three weeks to three months, or longer with special circumstances. Some doulas combine the birth and postpartum roles into a complete service package, thereby offering continuity of care throughout the childbearing year.

Doulas are non-medical care providers. Their role is limited to educational, emotional, physical, and logistical support. They do not provide clinical care such as taking blood pressure or checking dilation in labor, nor do they give medical advice. A “doula” who offers vaginal checks at home in early labor, for example, may be offering a service that you find desirable, however her role is more accurately described as “monitrice” (a clinical role which falls somewhere in between the doula and the midwife role). Postpartum doulas are not “baby nurses,” but a nurse may offer in-home care to postpartum families. Likewise, a “doula” who “prescribes” homeopathic or herbal treatments to support healing also may be offering a service that you value, but she is operating outside of the scope of practice of the doula professional.

All doulas provide information, emotional support, and comfort measures such as massage, hydrotherapy, and enhanced relaxation. Doulas enjoy providing attention to expectant parents and getting to know their clients prenatally. By the time you go into labor, your doula has become a trusted friend and mentor. During labor and birth, doulas feel privileged to be present and helping at such a sacred and joyful event. Postpartum doulas simply love hanging out with new moms and their babies! Your doula is there to support you in your choices and to provide concrete physical and logistical support. Doulas do not take the place of dads, partners, or other family members who want to help you. Their job is to facilitate everyone’s optimal participation at your birth, as well as to provide support to the entire family through the postpartum recovery and adjustment period. If you are a single mother, your doula can serve as your primary support person so that you are never left alone in labor.

A selection of services provided by birth doulas

• Nutritional counseling
• Tips for coping with discomforts of pregnancy
• Preparation for birth
• Assistance in creating a birth plan
• Support at home in early labor
• Comfort measures in labor
• Massage
• Suggestions and support for positioning in labor
• Continuous support throughout labor and birth
• Troubleshooting for difficult births
• Facilitate communication and informed decision making with your health care providers
• Support for dads and partners
• Natural birth coach and advocate
• Support for VBAC (Vaginal Birth After Cesarean)
• Cesarean and post-cesarean support
• Respect for the bond between mom and baby in those tender early hours
• Encouragement and skilled support to breastfeed
• Postpartum home visit(s)
• Community resources and referrals

A selection of services provided by postpartum doulas

• Breastfeeding support
• Newborn care
• Comfort measures and support for the mother’s physical recovery
• Shopping, errands, meal preparation
• Laundry, light cleaning, household organization (not housecleaning)
• Sibling adjustment support (not babysitting or nanny services)
• Depression screening and referrals
• Education on infant topics
• Community resources and referrals

Shifts worked by postpartum doulas vary. Some may do overnights, others may stick to the weekday hours when their children are in school, and so on. Expect a typical shift to be from three to four hours, though some doulas may work an eight-hour day. There are no rules – it is up to you and your doula. Typically, support is more concentrated in the first two weeks and then gradually the family weans off of doula support. However, in special circumstances such as multiples, preemies, babies with special needs, or moms suffering from postpartum depression, postpartum doulas may be involved over a longer period of time.

Before hiring a postpartum doula, consider whether or not you are really seeking a nanny for your other children or house cleaning help. If those are your primary motivations, then you should hire a nanny or house cleaner and will probably come out better financially by doing so. Another option may be to start out with a doula for the first couple of weeks while mom is recovering physically, adjusting emotionally, and may be in need of breastfeeding support, and then transition towards hiring a nanny later (say, in the case of twins or multiples).

What is a certified doula?

A certified doula is one has chosen to complete a certification process through a doula or childbirth association such as DONA International, Association of Labor Assistants and Childbirth Educators (ALACE), and others. While certification processes differ, certification generally means that a person has: (1) completed a proscribed training program, (2) documented a minimum level of hands-on experience with positive client evaluations, (3) completed reading requirements, (4) agreed to work within the Scope of Practice as defined by the certifying organization, and (5) paid her membership and certification processing fees. The process certainly guarantees a minimum level of training and experience for providing doula services. It is an effort to professionalize the traditional role of the female support person at birth and during postpartum.

Is certification important?

It depends upon who you ask. From the consumer perspective, good worth of mouth in the community, or a recommendation from a trusted friend trumps certification any day. Certification is no guarantee that your doula encompasses the personal qualities of patience, humor, compassion, integrity . . .

Some insurance companies may reimburse for doula services. Ask your doula if any of her clients have been successful in getting reimbursement or partial reimbursement for her services. As the doula profession grows, we expect increased success for insurance reimbursement and if/when this happens, it is likely that certification will be required.

What are the benefits of doula support?

There have now been several studies on the benefits of continuous labor support on labor and birth outcomes. Laboring women who are supported by doulas have lower c-section rates, lower instrumental delivery (forceps and vacuum extraction) rates, and are less likely to use epidurals or pain medication than women who do not have doula support. These women also have shorter labors, have more positive childbirth experiences overall, and are more likely to breastfeed. Furthermore, the newborns of these women have higher 1-minute and 5-minute Apgar scores.

Postpartum doulas can have a strong impact on early parenting success. The evidence shows that women who use a postpartum doula have increased rates of breastfeeding, decreased rates of postpartum depression, decreased incidence of maternal re-hospitalization for complications postpartum, a stronger bond with their newborns, greater self-confidence in their parenting abilities, and increased understanding of newborn care.

Is it appropriate to have a doula if my partner will be at the birth?

Yes! The doula’s role includes supporting the laboring woman and supporting her partner. Your doula should be able to work alongside your partner and/or other family members and show him/her/them how to best support you. If you and your partner have taken childbirth classes, the doula can remind you of techniques you learned in class and provide guidance through the physical and emotional challenges of labor support. Your doula can provide your partner with breaks, facilitate communication with your care providers, and, in short, be an excellent addition to your birth team.

Is a doula appropriate if I have an epidural?

Yes! Many women are unsure of whether they will want an epidural (or know they will want one) prior to going into labor. While you should ask your doula if she is comfortable working with women who choose a medicated birth, the role of the doula is not to critique your birth choices but rather to support you and ensure that your wishes are respected. A doula can improve your chances of having an unmedicated birth if that is what you prefer, but she should also be able to provide you with non-judgmental emotional and physical support in the context of a medicated birth. Women who choose to use an epidural during labor can especially benefit from a doula during the pushing stage, as this stage can take longer for medicated births due to the decreased physical sensations intrinsic to the use of epidurals. In addition, because the medications used often make mothers and babies drowsy, it is extremely helpful to have a doula during the immediate postpartum period so that she can support early breastfeeding efforts. Epidurals provide pain relief, not emotional support!

Is a doula appropriate if I am having a planned cesarean birth?

Yes! Although women having planned cesareans do not experience labor in the same way as women planning natural births, a doula can still be helpful to prepare you for the experience. Your doula can help you learn about the choices that you have in the context of a cesarean birth and can also provide emotional support before, during, and after the surgery. Because recovery from a cesarean often takes longer and is more complex than recovery from a vaginal birth, a doula can be an asset to parents during the postpartum period. A postpartum doula can help with newborn care, provide breastfeeding support, prepare meals, and help take care of your home while you recover from surgery.

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Patty Brennan, Director of Center for the Childbearing Year LLC, has been an advocate for childbearing families for over 28 years. She is a consultant, professional grant writer, program development specialist, and approved birth and postpartum doula trainer through DONA International. Patty holds a Bachelor of Arts degree from Boston College and has served on the faculties of both Washtenaw Community College and Schoolcraft College. She is the author of Whole Family Recipes—for the Childbearing Year & Beyond and Guide to Homeopathic Remedies for the Birth Bag.

In Summer, 2010, Patty’s new book, The Doula Business Guide—Making Your Dreams a Reality, will be available. This unique resource is a “must have” for every doula and doula program implementer. It focuses on:

• Creating a successful service business
• Establishing and funding a doula program
• Managing risk for doula businesses
• Getting paid for work you love
• And more!

(Pre-order your copy here.)

Patty’s expertise in the field of maternal/infant health includes:

• Grant Writer (11 years)
• Doula Program Development (13 years)
• Non-Profit Start-Up and Management (8 years)
• Adult Education / Curriculum Development / Public Speaking (28 years)
• Doula Trainer (13 years)
• Childbirth Education (28 years)
• Small Business Start-Up and Development (32 years)
• Volunteer Management (8 years)

Risk Management for Doulas & Doula Programs

See Patty at the 2010 DONA International Conference in Albuquerque, New Mexico on August 6. She will be teaching specific strategies that doulas and program administrators can implement to reduce risk and address liability concerns. Purchase of insurance can be a piece of the puzzle, but the focus will be on preventive strategies.

Contact Patty Brennan

Email patty@center4cby.com or call 734-663-1523. She can help you sidestep hard lessons learned and launch your program or write a grant for funding. She can save you time, stress, and money!

Learn More

• Grant Writing & Grant Writing Training

• Establishing a 501(c)(3) Non-Profit

• Establishing a Community-Based Doula Program

• Establishing a Hospital-Based Doula Program

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