Benefits of National Doula Certification
1. Respect from and engagement with physicians, midwives and nurses at every hospital because they have a clear understanding of the accepted standards of practice of nationally certified doulas. They could ask one question and know what to expect: Are you nationally certified?
National standards means a group of doulas in a community could negotiate with a hospital to gain privileges and respect for their knowledge. Possibilities include getting into the OR reliably, being consulted about their client’s progress, sharing knowledge at educational meetings, and discussing conflicts in an arena of professionalism. Both birth and postpartum doulas could be considered part of the team rather than adjunct or isolated from their client’s care. Some doulas already have this situation. But out of the tens of thousands of hospitals and hundreds of thousands of medical staff, I can count those places on my fingers. Wouldn’t it be great if we all had that negotiating power?
2. We get to define the standards for appropriate doula behavior, not each individual hospital.
3. Respect and easy establishment of credentials when moving from one area to another.
4. Consumers (parents) would have clear understanding of national, evidence based standards of practice and materials that explain “What to expect from a nationally certified doula”. They would have an established outline of what to do when those expectations are not met, someone objective to listen to their concerns, and an organized grievance procedure.
5. National behavior centered competencies would outline uniformity in services offered so a unique, standard billing code can be used with Medicaid and other insurers. There is no guarantee of this, but scientific evidence plus strong standards equal a greater likelihood of this occurring. I cannot see it happening without it.
6. The opportunity to participate in public health initiatives based on doula credentials, not on academic or nursing credentials or having someone vouch for you. Doula support is a key part of the solution for many maternity issues. But we are not included (or taken seriously) because there are no strong national standards. Initiatives cannot plan to include doulas because they have no easy way to say who will be eligible to fill the doula’s role unless they do all the training and certifying themselves – which is an initiative all on its own and beyond the scope of the funding they are applying for. So doulas are left out. These are missed opportunities for jobs, influence on the maternity care system, and better care for mothers and families.
7. Doulas are seen as a luxury rather than a necessity for birth and postpartum families. But for maximum health and well being, there is no substitute for the one on one care a doula provides. Done well, national standards allow our profession to grow so that not just wealthier families or women lucky enough to live in areas with community-based programs get this service.
8. Right now, there is no system that recognizes achievement as a doula. One of the possible reasons we have so many training programs is because the role of “trainer” is the only one achievable after “doula” or “certified doula” in a particular group. Recognizing levels of achievement and leadership within the profession would meet this very human need to strive for something and be recognized for it.
9. Separation of training and certification. A national certification organization would set competencies to be met. The applicant’s responsibility would be to meet those competencies – likely from a variety of sources and beyond the initial two or three day training workshop or correspondence course. The term “competencies” is used in many professions especially those that involve education and caring at their core. Competencies state an area of expertise and specific behaviors that demonstrate that ability. In your comments to me many of you have mentioned that you deal with competencies in order to be certified as massage therapists, realtors, respiratory therapists, and certified nursing assistants. For an example of how a competency based system works, go to this home visitor organization web site, and click on the “gold” list.
The next question is, “Who sets the competencies?” and “Who provides the training for these competencies?” The answer is we do. This system allows for a natural progression of training that focuses on obtaining the skills that ensure doula success but cannot be taught in an initial 16 to 24 hour basic course. Interpersonal skills such as listening, relationship closure, debriefing, minimizing trauma, and conflict management come immediately to mind.
10. National certification with competencies and behavioral standards would allow for expansion of the doula role into other fields. Community health education workers and home visitors could easily include doula work into their own job descriptions, or permanently include doulas into their programs. While this is occurring in a few places (Illinois’ the Ounce), it is most often haphazard and dependent on a single person or limited time grant. Even though the evidence is available and there is a program to replicate, other stakeholders outside the program also need to be convinced. Funders may also not be able to give money for initiatives where workers do not have established competencies. Evidence based national certification standards set by doulas makes it more difficult to minimize our effectiveness or brush our contributions aside.
11. National certification available to all shows that we take ourselves seriously, have professional competencies that define our role, and makes that statement to the world. We are not just hippies, hipsters, yuppies, hobbyists, bored at home parents, soccer moms/dads, frustrated midwives, or trying to exert power over someone’s else life experience. The market demand for our services shows that we have a part on the team to play, we are here to stay, and we believe that what we have to offer makes a positive difference in the quality of health care and the emotional lives and memories of the families we serve.
12. Being a part of other health related professions would expand doula employability, wages, and the number of mothers who could receive doula services. It would also enable more people to become doulas and hopefully at a wage that would support their families. Many trained and effective doulas are not cut out to be independent business owners. But this is the only choice for many. Respect for and expansion of the doula’s role would allow for different models of employment, such as working for social programs, agencies, HMO’s, physician and midwife groups, and collectives. We don’t have this now because there are no strong standards for employing doulas on staff or for third party reimbursement for their services (see #5).
In sum, national certification offers us legitimacy and opportunities to move our profession forward. Some of those directions are dependent on interaction with others, however once we start taking our work seriously it will positively influence how we are perceived. Most likely it will open doors that cannot be imagined today.
Note: What’s the difference between accreditation or certification? Certification verifies that a person has attained a level of competence and met requirements to practice in a certain discipline. Accreditation evaluates institutions and programs and ensures they have met standards. Click here for more.
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Posts In This Series:
1. Social movements – The Next Step In The Doula Revolution
4. This post: Benefits of National Certification for Doulas