Wednesday, August 19, 2015

Why You Should Write a Birth Plan

Every now and again I come across a blog post or article about why birth plans need not be written. I've read birth can't be planned, making a plan just encourages disappointment, there's no benefit, choices can be made on the fly instead, and that birthing women are unqualified or even selfish to have preferences on how they will give birth. Silly women and their silly preferences!

Those arguments are all very short-sighted, miss the purpose of writing a plan, and don't place the woman at the center of birth. I think they're wrong.  I think you should consider writing a birth plan and that it can be an important part of preparing for birth.

Writing a birth plan isn't about planning your birth, it's about planning for birth.  

Birth Plan vs. Birth Preferences

First, let's get into some semantics.  I prefer to call birth plans birth preferences.  When I'm working with clients we talk about how to write a birth preference list.  The purpose and intentions are the same whether you're writing a plan or a preference list, but language is important.  It's true that you can't map out exactly how your birth will go, but you can always have preferences!

Considering Options

Your birth preference list or birth plan is an important tool for preparing for birth.  It helps you to think through your options, how would I prefer to handle discomfort during labor?  What position(s) might I prefer for birthing my baby?  How do I feel about standard newborn care procedures?  What happens in the event of a cesarean?  You might not have preferences on everything, but it's a good practice to think about what is important to you and then highlight those points on your list.

Preparing for Birth

Thinking through options and electing preferences on points that are important to you allows you to think about what you will experience.  How do I envision my early labor?  What will happen when I arrive at the hospital?  What happens after my baby is born?  Thinking through the process step-by-step allows you to research and ask questions ahead of time so that you're more educated going into the birth.  It also allows you to address any fears or concerns you may have. This allows you to feel more confident going into your birthing time.

Communication Tool

Your birth plan is a tool to help you communicate with your health care providers.  It conveys to them what kind of birth you're hoping to have and what is important to you during your birthing time.

Going over your preferences with your OB or midwife during a prenatal visit allows you to make sure everyone is on the same page.  This discussion provides your care provider an opportunity to voice their opinions on your preferences and gives you a better idea of what to expect during the birth.

If you're hoping for intermittent fetal monitoring and your OB is going to recommend continuous fetal monitoring, this is something you want to consider before you're actually in labor.  If you are envisioning birthing your baby in an upright position and your OB is going to ask you to get in the bed when you begin pushing you want to know this before you're working to birth your baby!

Likewise, if you are birthing in a hospital you can hand over a copy of your birth preferences to your nurse upon arrival.  Your nurse is not likely to be someone you will have met or chosen beforehand, but they're going to be a major player in your birth team!  You want to convey to them what your preferences are, how you envision your birth, and what you and your OB or midwife have discussed together ahead of time so your nurse can help support your wishes.

Labor Tool

If your health care providers understand the kind of birth that you're hoping to have they will take that into consideration with their actions and suggestions during your birthing time.

If your nurse knows that avoiding pain medication is very important to you they may suggest you utilize a tool such as a birth ball instead of offering an epidural.  If your OB knows that it's very important to you to keep your birth as quiet and intimate as possible they may not bring along the medical student who is shadowing them.

Your preference list provides your birth team with something to reference to remind them of your wishes. It's also helpful in the event of a shift change when a new nurse, OB, or midwife will be taking over your care, allowing them to quickly review your wishes.

Tool For A Positive Experience

People who are active participants in their birth, making choices that are right for them, have a more positive experience overall. You're not incapable of making decisions or communicating during your birthing time, but it simplifies things if there are as few surprises and major discussions as possible. Writing a birth plan helps with this.

During birth circumstances may change, preferences may change, you may have to make decisions on the fly; when it comes down to it you can't plan birth, but you can plan for birth.  You can prepare prenatally and go into your birthing time feeling informed, confident, and supported.

A thoughtfully written birth plan, utilized with purpose, can be a fantastic tool to help you prepare for birth so that once the time comes you can focus your energy and attention on what's important: birthing your baby and having a positive experience while doing so.

Friday, August 14, 2015

How to Become a Doula

Where did you go to doula school? 

I've been asked this several times now and the answer is: doula school doesn't exist.

Typically, what people mean when they ask this is how do you become a doula.  (Of course this is often asked after I've already answered the what is a doula? question.)

Because there is no national or state level certification, licensure, or standard for doulas there are many routes to becoming a doula.  I'm going to talk about how to become a professional doula because that's what I know.


First, you need to be trained.  But I already have experience with birth, or maybe even supporting women in birth, you say.  If you're representing yourself as a doula and not just an experienced support person, you need to be properly trained.  There is always more to be learned and it's very important that you understand what exactly the role of a doula is if you're going to call yourself a doula.

There are many training organizations out there, some are complete distance learning, some have in-person components, some offer lifetime certifications, others have ongoing education requirements in order to maintain your credentials.  They're not all created equal.

If you're ready to be trained as a doula the best place to start is by exploring the various organizations that train and certify doulas to see which might be the best fit for you.  Here is a chart comparing several of the larger organizations.

I chose to train and certify with DONA International because they're one of the oldest, largest, and most well respected doula certifying bodies.  I very seriously considered pursing a distance learning program because I'm an enthusiastic self-learner, but luckily there was a DONA approved training offered locally in Columbus so I decided to go for the in-person workshop with DONA and I'm SO glad I did!  I love learning at my own quick pace, but I believe there are many benefits to attending an in-person training.  Workshop lengths vary based on the organization and trainer.  The workshop I attended was 4 full days.

After you attend the workshop you are knowledgeable about the basic technical aspects of how to be a doula as well as what your scope of practice is.  Some doulas stop here and practice as a trained, but not certified, doula.


In order to go on to obtain certification as a birth doula there are typically additional requirements beyond the initial training.  To become a DONA certified birth doula, once you have attend the training workshop there is additional required reading, childbirth and breastfeeding education components, attendance, documentation, and evaluations from care providers and clients at a minimum of 3 qualifying births, several essays, professional references, and several other miscellaneous items.

I never questioned whether I would certify, that was my plan from the start.  I'm a professional and it's important to me to be held to the highest standards and that my credentials reflect my skills and expertise, not only to clients, but also to other birth professionals.  The additional requirements to obtain and maintain certification help me to be a more knowledgeable and well rounded doula and hold me accountable to standards set forth not only by myself, but also my certifying organization.

In order to maintain my certified doula credential I have to meet a minimum continuing education requirement of 15 hours every 3 years to ensure that my skills are always growing and that I am staying current with birth practices.  Because I have to re-certify at regular intervals this challenges me to continuously grow as a professional and remain dedicated to my birthwork.

I completed my doula certification less than a year after I started my doula journey, but many doulas spend around 2 years working on their certification, some up to 4. My certified doula credential isn't just some letters after my name, it's an achievement I worked towards for quite a while, propelled by my desire to offer the highest quality and most professional services I can to the clients that I serve.

When searching for and interviewing doulas for your birth it's helpful to ask about their training, experience, and certification.  Ask any doula you may potentially hire why they chose to train with and/or certify with a particular organization.  It can help give you insight into their background as well as the standards that they uphold.

Additional Resources:

Birth Professionals of Central Ohio Classes & Specials

Top Ten Questions for Choosing a Doula Training

What It Means to be a Professional Birth Doula