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Choosing to Cross Certify as a Doula With BirthWorks International

As I read “Doulas of Love” by Cathy Daub, I was reminded about why I am seeking dual certification as a doula with BirthWorks. As an experienced birth doula, I was familiar with many of the topics since I am a certified Childbirth Educator with BirthWorks. But there was an aspect of the guidebook that was refreshing, and it was admittedly the uniquely BirthWorks part. I think the best way for me to articulate what I learned through my reading would be to
explain what I found to be the most important.

Human Values through the Five Senses is a wonderful goal for my work not only as a doula but also in my life. And taking in the five human values through the five senses illustrates the importance of completely incorporating human values into our daily lives. And I feel I do that. I strive to speak honestly, to encourage and not tear down. I eat (mostly) healthy foods, and exercise my body regularly and support my clients in doing the same. During their births I am constantly helping them to see the positives and the benefits to the hardships that come their way. Labor is hard, but that’s part of the process. To be present with women and help them to see past the difficulty into the learning and transformation that labor brings, is an honor and essential for their positive memories of the birth. I am humble in their strength, and I am calm in their anxiety. I was encouraged to know I already use human values in my doula work.

The second thing that really spoke to me was the explanation of the Three H’s of “Head, Heart, Hands.” The hands should only carry out what is approved by the heart and considered in the mind. The subconscious actions do not consult the heart and manifest as reactions rather than responses. Again, I was encouraged to know that I follow what my heart feels is right and am privileged to work with many providers who do the same. I also found it interesting to consider how sometimes women in labor act from their subconscious, reacting with outbursts
in labor, instead of calm responses. This makes sense though, since a laboring woman, while also feeling with her heart, is less in her frontal cortex, the thinking brain, and far more in the limbic portion of her brain where the subconscious lies. So when a laboring woman acts in this way it can be considered a positive, for it is a sign that she is deep in her labor.

Doulas who practice serving from their hearts, exemplify the BirthWorks Human Values and character training. I have heard doulas and the work we do described as heart work. This is a very intimate job. Our role is very personal and we are present with our clients during vulnerable and intimate moments. It’s of utmost importance that we are respectful and serve unconditionally, meeting our clients where they are. In order to do this truly we must speak
with our hearts and serve that same way. It is not our birth but our clients’ birth. And as such, it’s also important that we respect their decisions even if they wouldn’t be our decisions.

That took me time to learn, but I wholeheartedly believe it now. There is book knowledge about stages of labor and comfort measures. But the true value we bring to a birth is our hearts. The rest will come but if we are not connecting with our clients through our hearts, then all of the techniques and knowledge will fall flat. Incorporating and practicing Human Values goes both ways—the way I serve my clients, and also the way my clients walk their journey of pregnancy, birth, and parenting. Being reminded of the importance of processing my decisions
through not only my brain but also my heart can do so much to encourage my words and actions will help and not do harm.

I also love how the BirthWorks human values approach to doula certification doesn’t stop there. These values are also important to use in life. And these are the parts of my doula work that I find most challenging. Not for me. But when I see providers and nurses acting in ways that don’t respect human values it’s very difficult and it upsets me. As doulas we are caught in the middle. We cannot undermine or oppose providers, for that does not instill
confidence and safety in our clients. My role is to protect the emotions of my client and help her to feel calm and secure. My job is made more difficult when a provider is not using human values in their approach. Thankfully, I rarely encounter this. But I realize there are doulas who are constantly struggling with the cognitive dissonance felt when the providers’ actions don’t reflect human values.

The next thing I found notable in Doulas of Love was being reminded of the deep affect our relationships with our mothers can have on our pregnancy, birth, and mothering. I have a very good relationship with my mother, however I have worked with clients who are not as fortunate. I see how difficult it can be to incorporate their mothers in their birth in a healthy way, and some choose to disengage them for the sake of preserving their experience. We discuss the importance of being selective about one’s support team, but I also remind them it’s critical to communicate feelings even if difficult. It’s all very complicated, that’s for sure. And while it can be hard information to process, and even feel a bit too overblown to me, I don’t recall there being any mention of the mother/daughter relationship in my other trainings.

In helping a woman in labor to relax, I highlighted the line “It is important to remember that the most comfortable position may not be the most effective one.” I agree with this mostly. I see it happen often when a client lies down and finds the contractions ease a bit. Rest has its place in labor, but I know women often prefer it because it is less painful. This is the case in early labor. For we know in active labor it can be more difficult and uncomfortable to lie
down. However, I have served clients for whom when they feel pain, if it’s localized to one area, like on their left or right hip, it may signify a problem and not so much the progress of labor. It could indicate that the baby is in a less than optimal position and thus would require some intentional maternal positioning to encourage baby to move off the one hip. But I agree almost entirely that the less comfortable a position the more productive the position.

I appreciated the reminder of the importance of holistic nutrition as well. Nutrition is not just what we put in our mouths; it is also what comes through our eyes, ears, out of our mouths, and into our minds and hearts. That is profound and illustrates just how extremely influential the messages are that we take into our bodies, not just the food we eat. The messages are all nourishment to us or poison, depending on what it is saying. The section on birthing language really spoke to me. I had not previously given much thought to the significance and underlying meaning behind the word support, not until I heard Michel Odent, MD explaining why the word robs laboring women of their power. It changed my verbiage and now I consciously avoid that word. I have replaced support with serve and I do it now without thinking. It’s so important that we always remember that the woman is the one
birthing her baby, not the partner, not the doula, and not the nurse, nor the provider. As soon as we forget that she is the one birthing, we disengage her from the process and walk the dangerous line of doing things for her or to her, rather than having an open dialogue about what it is she desires and feels is the best course of action. Counsel and explanation of options from the provider is of course welcome and helpful, but the decision should be made by the
woman.

If we are to truly believe our clients have the knowledge and ability to birth the way they need to, then we need to avoid considering ourselves an expert. I never want to feel I’m the expert at a client’s birth, although sometimes they paint me out to be just that. The knowledge of comfort measures and labor stages and nuances can easily make us come across as one, as well as the sheer numbers of births attended. But I’m constantly checking myself to
make sure I am respecting the mother as the one who knows best and only offering insight and ideas when relevant or requested for I have never attended her in this particular birth. The only one who is an expert in her birth is her. Knowing and truly believing this, I use my heart to determine whether I should say or do things that are to “help”. I weigh it very carefully before proceeding. And I think BirthWorks’ approach articulates what I feel my doula approach has become.