How Doulas Undermine Our Own Value (it’s not free births)

Jul 9, 2014 by

Anytime I read a “doula” writing online that she knows everything she needs to know already, I want to burst. You know what? You don’t. When you say that, you devalue the entire process of skill development in labor support. What you imply is you already know everything you need to and that anyone can do labor support effectively with only a few days of training (or a few months in a correspondence course). I have never interviewed an expert doula or one who had been to several hundred births who said there wasn’t anymore to learn. Typical comments that I read on Facebook:

“I don’t understand why I need to recertify.”

“I like this organization because certification is for life.”

“I don’t need any more education. I learned everything I needed in my doula training.” OR “I don’t even need a doula training.”

The truth is that you know enough to be of more value than someone who knows nothing. Your heart is in the right place and hopefully that will keep you in a space of observance and support rather than judgment and superiority. But you don’t possess many skills. You haven’t applied most of the knowledge that’s in your head. As a novice or advanced beginner doula, you don’t know what you don’t know. It’s fine to be a beginner but have some respect and humility for the profession.

I have talked to thousands of doulas, yes thousands, in the last 30 years. I have spent years of my life dissecting the minute actions of birth doulas at various phases of skill development (novice, advanced beginner, seasoned, proficient, and expert). I wrote the research on those five phases of skill acquisition! There are fewer doulas at each one of these advanced stages because not everyone can meet the challenges of each phase. [While I am currently revising it, the current version is available here.]

Birth doula work is not about double hip squeezes. It isn’t about birth plans. Birth doulaing at its heart is a spiritual path that will rip away your narcissism and your selfishness. It will restructure your values and strengthen your compassion and empathy for all people through pain and humility. It is about learning how to BE in the presence of conflict and the human experience of living at its most raw and gut wrenching. Birth doula work is not for sissies.

And you know what? A three day workshop, even mine, is not enough to teach you how to do that. You need to learn how to show up for somebody without that person having to compromise because of what you value or think is important. Birth will teach you, but you need support and information too. Learning to communicate effectively with people in power, how to deal with difficult people, and how to listen. These are not things that come easily or that are mastered except with years of practice.

As a professional doula, you know there are many areas where you can improve yourself and your practice. Only someone who is ignorant thinks they know everything there is to know – until they’ve put in the decades to achieve expert status.

Certification has never been primarily about impressing clients. It is about achieving credibility that speaks to the other career professionals you work with.

So when you’re whining about educational requirements or recertification dues, think about what those remarks imply.  They say to me that you don’t value developing the skills needed to improve as a doula because you already know it all.  And there really isn’t much to this doula thing – anybody with a smidgen of education and a few births under their belt can do it well.  These attitudes perpetuate the myth that “Any Woman Can Be A Doula”.   Now think about the damage these comments do to all doulas everywhere – and to gaining the respect we need for our profession.




  1. I am a nurse and a doula. When I got my RN license, I realized that what that license gave me was the go ahead to learn how to really be a nurse. I think the same thing goes for doulas. It is not mandated, but certification gives you the skills to continue your education. I whole heartedly believe that we are always learning and should always see each birth as a learning experience.

  2. Let me respond to this very thoughtful and important post by reflecting on my work as a yoga teacher. Like being a doula, yoga teaching, “at its heart is a spiritual path that will rip away your narcissism and your selfishness.” Like doula work, yoga teaching (for me) involves a life long commitment to self-study and service. Yet, my 200 hour basic yoga certification is something I never have to repeat. I don’t have to “re-certify.” I am a yoga teacher for life — unless I violate the ethical codes of the organization that certified me. I choose to belong to their membership organization and continue with professional development. I choose to read about yoga, engage with other yoga teachers, participate and lead workshops for yoga teachers etc. But, I am certified for life as a yoga teacher. I bring this up because your post reads as a direct criticism of valid and important doula organizations who certify for life. Many of the doulas I most admire have completed extensive mentorship/ training under a model that certifies for life. Furthermore, I believe that those of us who have questioned models that require recertification are not lazy or undermining the value of doula work. We are simply looking at various models of certification — like yoga teaching training — and asking important questions. I choose to be certified as a doula and yet, it’s important that we examine the many models of certification with an open mind that draws wisdom from the examples of best practices around us.Perhaps the solution will be for hospitals and birth centers to require a minimum number of contact/training hours — as yoga centers do with the 200-hour minimum yoga teaching certificate. This way the basic training is nearly guaranteed to be extensive and thorough. I can’t imagine having yoga teachers claim to be certified to teach classes after only a weekend of training, book reading, and a few practice teaches. That would be folly. There’s so much to know as a yoga teacher and there’s so much to know as a doula — it’s never ending honestly — yet, a basic and substantial base requirement makes sense to me. Doula Trainings International has a nine month mentorship program after which one is certified for life. This is very responsible and having mentored quite a few DONA doulas who felt unprepared after a weekend of rapid note-taking, I can attest that a comprehensive and thorough model of basic training is needed in our field. While I am a DONA trained doula, honestly my training as a prenatal yoga teacher and a hospital chaplain has served me most in my work with birthing women. I’m committed to helping DONA move in positive directions in this regard and it makes sense to examine alternative, and perhaps better, models of certification

    • Amy Gilliland

      Hi Amy, Thank you for your thoughtful post. I want to take advantage of this opportunity to point out that certification is not and should not be mentoring. Certification is a process of validating that a person is following the standards of behavior and practice set forth by the certifying organization. That is all. It is not about training or helping people to meet those standards. Since the earliest organizations have offered both, they have been conflated with one another, so the confusion is understandable.

  3. I love this so much! I love learning more and more at every birth. I hope that never goes away! I’ve only been to a dozen births. Every one was different, as all births are. I look forward to continuing education! Yes, being a doula will become a profession however, it is a calling for me. It is tough and beautiful work. I feel honored to be part of someone’s life changing experience! I hope to continue to be fully present at every birth 10 years from now and just as excited. Before I took the class, I had been to 9 births and wanted to keep going. When I was done with the class, I realized just how much I had to learn, and still do. Kim Palmatary, your words are inspiring! Thank you!
    Amy thank you for your passion and enlightenment. I’ll look forward to hearing more :)

  4. I agree we never know enough and we always must continue learning but I dont think re/certification is key to learning. I have gone beyond the courses and trainings needed for recertification, but dont need that paper that sais I did. I will never stop learning because I have a passion and hunger for it and realize the more I learn the more there is to know.

    • Amy Gilliland

      Thank you for your post, Zeresh. You are definitely not the doula I am referring to in this post. I have found that a lot of people just stop listening to what I have to say once they read the word “recertification”. Certification is about a clear scope of practice, a legitimacy ticket into the hospital system and offering consumer protection. It has been imbued with all kinds of other meanings but that is really all it is for. And very few organizations actually offer any certification system that can ensure those things.

  5. Pam

    I have been a doula since 1997. I have been certified since 2005, but I don’t think I will recertify this time around. Why? Because I would rather spend my hard-earned money to further my education and skills than on ‘fees’. I will NEVER stop learning…I still learn something every time I attend a birth, or an interview. I learn through research, through reading, and through taking courses related to pregnancy, birth, postpartum, breastfeeding, mental health issues. I really don’t think I need yet another piece of paper to indicate my ‘worth’ or ‘value’. I know what I bring to the table, and I also know I’ve barely scraped the tip of the iceberg in knowledge, but will pursue it because it is a calling and a ministry for me.

    • Amy Gilliland

      HI Pam – thank you for your comments. Since you make the statements about continuous learning, you are obviously not the doula I am referring to in this post! I find that people agree with most everything I wrote here and choose to comment on certification issues. Certification is about consumer protection, a clear scope of practice and a door opener into the hospital system where most doulas practice. Recertification only states that a person continues to meet minimum requirements, there have been no legitimate complaints about services, and continues a path of professionalism. It makes no statement about someone’s worth or value. I have multiple certifications in different fields and that’s what they stand for.

  6. Jane Peterson

    The same is true of midwives (even us old ones!), we are always, always learning and so should always remain capable of new understanding. It is my opinion that the health care providers who pretend to ‘know it all’ are the ones to avoid. When I was a young midwife an elder doctor who took me under his wing told me, “they call it practicing for a reason, we are all trying to get better all the time.” Wise, I thought.

  7. What a lovely topic. As a Doula who has attended nearly 400 births; and written a book What Does a Doula Do?
    I conduct my ‘Business’ as a Professional, and wish all Doulas would take what we do very seriously. I used to be embarrassed – when asked, “How long is your training”? – 3 days. I have learned, that EACH birth is a training session in the world of becoming a better Doula. I am always fascinated by the Doulas with less training or experience; some seem so cavalier. I have mentored and advised new Doulas, and wished I had had the same mentoring. Doing this and more for new Doulas – even though I myself have yet to learn ‘it all’.

    I found my passion and would love others to follow, but it is a difficult road, and sometimes the pay and hours are not nice. If we all persevere, we will make this a profession that commands a liveable wage, and the title of Doula will be well know. Every woman and man that has engaged my services, praises what I did for them and they happily spread the word, about what Doulas do; help women journey through Labor and Birth. Whether we help both (partner and/or just the Mum) we have a personal obligation to take the tenderest of care with this Magical, Life Changing Journey in their personal experience of life.

    I believe that every woman – no matter how may births she will have; that they will all be different. Then add to the mix – every other woman on this planet having a unique birth experience; no 2 births are alike, so that makes our job so exciting!!! We get a different experience every day and that brings new growth and learning every day. In 13 years I have never been bored with my job, and don’t imagine I every will.

  8. Heidi

    YES! Thank you.

  9. Susan Lindner

    Amy, thank you for the beautiful statement. I was a labor and delivery nurse for 25 years, but not a doula. I attended the doula training and will forever be learning! Sue


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