There are a variety of doula certifications available for women venturing into the thrilling and rewarding work of supporting families at the time of birth. There are so many available that it can be hard to choose when you are new to the birth scene. We love this list of things to consider when choosing a doula certification. Written by our very own Birth Boot Camp DOULA trainer, Amanda Devereux, she simply knows what she is talking about. Not only is Amanda an experienced and successful doula, she, along with Maria Pokluda, helped form the stellar Birth Boot Camp DOULA program. Enjoy her words and if you have any questions, feel free to contact us. We would love to help!
1. Will I learn how to support a woman during labor and birth?
Of course, a doula training should actually train you to do the work of a doula. One of the doula’s main jobs at the birth is hands-on, physical support and knowledge during the labor and birth of the baby. Online or distance courses simply can’t provide this in the same way an in-person training can.
2. Will I learn how to support a woman’s partner during labor and birth?
Birth support is more than just supporting the laboring woman. The doula should not be the center piece, the partner is her hero and champion; the doula is the partner’s life line!
3. What type of business support and training will I receive?
Having the skills of a doula is just part of this. Learning to be an entrepreneur is equally important. Will you learn interview skills? Will you be provided contracts? Will you gain networking tips? Will you be prepared to leave training and launch a successful business? The skills to support at birth will find little foothold if you lack the ability to implement them and let people know about the incredible service you offer.
4. How will this certifying body market me?
You pay a good chunk of money for training and certification. What do you get from this? Is your certifying body promoting you? Providing marketing materials? Anything else?
5.What type of lactation training is provided?
A doula typically helps with baby’s first latch and then with some breastfeeding support at a postpartum and often times in between. You should know what training is provided for this. You should be comfortable not only with providing support during this time but with knowing when to refer. Truly being able to help in the precious first days of breastfeeding will often require more than just personal breastfeeding experience or attendance at a La Leche League meeting.
6. Is the philosophy of the program congruent with my own ideas of birth work?
A certification agency should offer you something - a community- and this is most beneficial to you when the philosophy of the program is one that promotes your work and passion. Ideas relating to birth abound! Find an organization that you can truly get behind.
Do you find it limiting? Does it help you build your professional practice? Does it result in greater professionalism? Doulas are present for one of life’s great events. A doula who doesn’t understand how to practice in an ethical way or within her scope can cause heartache for the entire community.
8. What do I gain from re-certification?
Re-certification, in professional fields, is important to show that an individual is current in their area of expertise, is safe to practice and is maintaining their knowledge and standards as a professional. You should gain more than the maintenance of letters at the end of your name. Doula re-certification should offer you personal growth as well as continued business, education and/or marketing support.
I am proud to say Birth Boot Camp DOULA offers all of this and more. Learn to doula beyond “The Birth Partner.” Whether you are an aspiring doula or an experienced doula, we offer you MORE. Join us in 2015.
You are 38 weeks pregnant. It is 10pm at night and your labor starts. YAY! Contractions are 7 minutes apart, steady and lasting about 45 seconds. They don’t feel like Braxton-Hicks contractions, so this must be the real thing! Steady, real, feeling like labor.
This goes on until 2am when suddenly, everything stops.
The next night the same thing happens. And the next, and the next.
Though not often talked about and poorly understood, prodromal labor is an important subject. Likely the cause of many early trips to the hospital, emotional and physical exhaustion on the part of the mother, and dashed hopes of natural birth, prodromal labor is something that needs to be talked about more and understood better.
What is prodromal labor?
Prodromal labor is usually defined as a labor that starts and stops, sometimes for days on end. Prodromal labor feels like real labor, it acts like real labor and in many ways it is real labor. Sadly, it eventually stops and doesn’t result in a baby like active labor does.
“My second pregnancy I had 3 days of prodromal labor. I started having contractions on Sunday. They would last for several hours and would get closer together but never closer than 5 minutes apart. After a few hours they would fizzle out and then a few hours later start back up again.”
“I had 3 weeks of prodromal labor with my third baby with contractions every 15 minutes on the dot. I knew the time by my contractions. Occasionally they would get closer...every 5 min for several hours or every 2 1/2 min for hours in the evenings. It really messed with my emotions.”
Different than Braxton-Hicks (which causes no cervical change and which can feel spotty and is generally painless) prodromal labor contractions feel like regular labor and even an experienced mother may be confused and unsure of what is going on. Cori, a birth teacher in Salinas and Carmel, CA said this about her prodromal labor with her third pregnancy, "I went to the doctor thinking I was in labor one of the nights. I had labored twice before, it felt real." Her contractions would last for roughly 6 hours, coming every 5-10 minutes.
Prodromal labor is also different than early labor: prodromal labor doesn’t produce a baby in the next 12 or even 24 hours. It starts and seems serious, and then fizzles out, often at around the same time each day.
You can’t talk about prodromal labor without discussing the emotional impact it can have. Hailie an birth instructor in Abilene, TX said that, “I was REALLY tempted to just go to the hospital - I knew they'd give me Pitocin when labor stalled and I'd end up with a baby. It took a lot of energy and willpower to stay at home. It was the most emotionally exhausting thing I've ever been through. Prodromal labor almost derailed my attempt at a natural birth.”
What can you do about prodromal labor?
As you have probably guessed, prodromal labor isn’t something that anybody wishes for or really enjoys. Is there anything you can do about it?
Many birth professionals feel that prodromal labor is the result of poor positioning on the part of the baby. Sometimes a baby that is positioned “sunny side-up” or posterior will want to move into a more optimal or anterior position.
To remedy this, labor is triggered and the body, the uterus and the baby try to make that baby turn into an anterior position. But, after a few hours the body will take a break, only to try again a bit later.
If positioning issues are the cause of your prodromal labor, then there are a few things that may help:
Chiropractic- Every Birth Boot Camp 10 week childbirth class will have a focus (class 3) on chiropractic and the huge help it can be in labor. Chiropractic adjustments specifically those done by an ICPA certified chiropractor, can help align the spine and pelvis and allow the baby to move into a more optimal position.
Position changes- Another thing your class will talk a lot about is position changes for the mother. There is actually a LOT you can do to help encourage an anterior fetal position and your birth class will cover this over and over again. From hands and knees position to birth balls to lunges, there are many tools at your disposal. Spinningbabies.com can also be a great resource for this. Your class will guide you AND your partner through specific things that may help.
Fixable or fate?
It is possible that this is just how some women labor, and maybe you are one of these women. While it doesn’t sound fun, it is possible to have a positive and even natural birth experience with prodromal labor. The bad news is that it can be exhausting both physically and emotionally. The good news is that you and your partner will have lots of practice sessions where you can put into use all the relaxation techniques and positions you learned in your birth class. The other good news: often when a woman who has prodromal labor finally goes into the “real thing”- it goes quickly. Your body has been working, warming up, and getting ready for your birth.
Prodromal labor isn’t a sign that you don’t work, but the opposite. Your body is trying to get ready for a great birth! Patience can be hard, especially with the added stress of expectations from yourself and others and the weight and discomfort common at the end of pregnancy. Rest when you can, enlist outside help in the form of your chiropractor, doula, midwife and partner, and give yourself permission to cry when you need to. You CAN still have an amazing birth.
We are honored to share a guest post today from one of our newest board members, Katie Dudley. Katie first became interested in natural birth as she prepared for the birth of her own child and attended our founder, Donna Ryan’s, birth class. Our newest student manuals include her contributions in both exercise and nutrition. They are nothing short of incredible and we are so proud and excited to have her on our team. Today she shares three exercises (there are many, many more in the complete Birth Boot Camp class series!) to get you started in preparing for a great pregnancy and birth.
One reason we chose Katie as the developer for our pregnancy fitness program is her trust in the female body and its inherent power. We too believe that women are capable of birth and that they are strong! There are many in the fitness industry who believe that pregnancy and birth are very harmful and damaging to women's bodies and they need to be "put back together" afterwards. With proper exercises before, during and after pregnancy, in addition to phenomenal pregnancy nutrition, we don't believe this to typically be true.
As with any fitness program, seek approval from your physician before beginning, especially during pregnancy. These exercises are widely accepted as safe for pregnant women in general, but (as with everything relating to birth) there are exceptions. Be aware of your body and listen to it. Consult with your care provider if you have any questions.
I always thought it was humorous when people would come up to me during the last couple of months of my pregnancy and say “Aren’t you ready for that baby to come out?” It was my first child! Of course I’m ready. They would then they would follow it up with “I’m sure you are so ready, you must be miserable!”
Being in the health and wellness industry, I find this sentiment is pervasive. In fact, my husband recently had a conversation with a pregnant couple urging us to get pregnant too so “we could be miserable together.”
As a personal trainer and fitness junkie, I don’t just love exercise and nutrition; I also believe that just as our bodies are strong and capable of fitness, women’s bodies are also strong and capable of an enjoyable pregnancy and birth.
Are there “uncomfortable” aspects to pregnancy at times? Yes. The possible months of nausea are not great, the swelling is pretty interesting, we all know about the weight gain aspects, the going to the bathroom throughout the night, being physically out of sorts and many other common pregnancy “symptoms”. Pregnancy is a multifaceted experience both wonderful and filled with unique challenges for each of us. A woman’s body goes through a lot of changes, but does it really have to be as physically uncomfortable as many women experience, let alone miserable? I say for many women, “No”.
I believe we can be proactive in combating many of these discomforts through proper exercise. That was my personal experience, but also, and perhaps more importantly, the experience of countless pregnant women I have worked with over the years. While I did experience months of nausea (not fun), other than that I felt great. I didn’t experience the aches and pains that other women talk about in their backs, hips and joints that I had anticipated before becoming pregnant. Pregnancy can be a joy! I felt good and I felt strong. I had a physical confidence with the extra 45 pounds I was carrying on my body and I really attribute that to being physically active before and during my pregnancy and eating nutrient dense foods.
I was on my feet 8-10 hours a day with clients and I focused most of my exercise on my postural health. Making sure my spine and my hips were supported by a strong core can be life changing.Many women complain of lower back pain during pregnancy. There are things we can do about this!
Most of that pain is caused by lordosis (rotated pelvis). Many other women also have SI Joint dysfunction, leg cramps, numbness and aching in the hips and legs. The majority of these ailments can be alleviated with appropriate physical activity, massage/myofascial release, chiropractic and stretching. By doing so, individuals create strength and balance in their alignment relieving a lot of unnecessary pressure on their frame. I’ve seen this myself through my own pregnancy and the many women I’ve had the opportunity to work with over the years as well as others my colleagues have trained.
It’s a new physical world that we live in. Many of us spend our days sitting behind a desk or at a computer. Others are in the car for work or with their families. These positions can weaken and put strain on our bodies. We just do not have the physical demands as those generations that came before us. Our days are generally not spent foraging food, washing clothes by hand, and carrying water on our shoulders. Most of us have to make a point to get physical activity to strengthen our bodies. And that’s ok! We can do it!
Don’t know where to begin? Here’s a great place to start. These are a few of my favorite specific strengthening exercises for preparing the body for a comfortable pregnancy and a great birth.
One of my favorite core exercises for everyone is bridging. Bridging is utilized to strengthen the glutes, hips, pelvic floor, and core. It is especially beneficial for individuals who spend a significant amount of time sitting. This particular exercise helps to lengthen those muscles that are contracted during sitting and help strengthen the muscles that are relaxed in that position. Women and men that sit often have weak glute muscles and have a difficult time activating them which can affect the knees and lower back.
Bridging is also advantageous for those that have an anterior rotated pelvis, by strengthening the hips to stay in a more neutral position.
1. Lie on back or stability ball with knees and feet straight and in line.
2. Tuck pelvis to neutral position, keeping shoulders relaxed and spine straight.
3. Squeeze glutes and pelvis up off floor keeping core tight and knees straight. Pause.
4. Slowly lower down to starting position and repeat.
*Try 2-3 sets of 12-15 repetitions 3 times a week.
Squatting is one of the most functional exercises people can do. Individuals use it almost every day whether bending down to grab something out of a cabinet or to sit on the floor. It not only supports movements in everyday life, but can also help women achieve an easier birth physically and support their bodies throughout the pregnancy. A squat strengthens the glutes, hips, core, feet, back, pelvic floor and the stabilizing muscles around knees. People with previous injuries are often afraid to squat, but when executed and practiced with proper form, squatting can actually help prevent an injury from recurring.
The squat pictured above is a deep birthing squat. Not all women will be able to perform this easily or with proper form the first time. Pay attention to your body and listen to it! Consult with your care provider if you have questions. More specific thoughts are also found in your student "Field Manual" and the videos in your class. The deep squat was once a natural and everyday movement for women, now we often need to "re-learn" it to prepare for birth. But be assured: squatting is an incredibly important position for pushing with the ability to shorten and speed the second stage of labor. You don't want to learn it in the heat of birth.
Squatting isn't a competition! Go to a comfortable depth for you. Keep your spine and pelvis neutral. Don't push beyond what you are able.
1. Stand with feet shoulder width apart, toes following knees.
2. Keep core and glutes tight, sit back straight and lower as if sitting in a chair with a neutral spine
3. Pause at bottom, keeping feet flat on floor.
4. Sitting up tall, keeping glutes contracted, press through heels and return slowly to starting
*Try 2-3 sets of 15-20 repetitions.
A perfect asymmetrical exercise for pregnancy, the quadruped helps to strengthen our core through an unstable position. By executing exercises in this manner, it allows for better control over the body by strengthening the stabilizing muscles. To keep the body in a neutral position when practicing an asymmetrical exercise requires better muscle recruitment. Over time this provides more support for the spine and more control over the body. This is an especially beneficial exercise for those combating sciatica or Diastasis Recti. (If your Diastasis Recti is known and severe this may not be the best position for you. This will often feel wrong for these particular women. We encourage all women to pay attention to their bodies.)
In addition, "all-fours" positions are fabulous for birthing and women left to their intuition often birth in this position. Many care providers notice that hands and knees positions can help in properly positioning a baby when done during pregnancy and even during the birth. They can also make labor more comfortable, particularly back labor. Practicing things like the quadruped or pelvic rocking can help prepare you in many ways. Exercises like this help strengthen your body so that you can function better in pregnancy and during your birth.
1. Start on all fours with hands directly under shoulders and knees directly under hips.
2. Activate core and glutes.
3. Keeping back and hips level, raise arm and opposite leg straight out. Relax shoulder.
5. Take your time, move slowly keeping core tight (draw belly button to spine) and glutes
6. Return to starting position and alternate sides.
*Important to keep spine straight and not twist or shift hips.
Pregnancy and birth are miraculous and under-appreciated times in our life. Opinions are pervasively negative regarding the functioning of our bodies during pregnancy. But knowledge, effort, and some labor can help prepare our bodies, ease the burdens placed on them, and help us enjoy the amazing moments of pregnancy and birth a little bit more.
Katie Dudley is responsible for the new and improved exercise and nutrition program in the Birth Boot Camp 10 week educational series. This article is just a tiny taste of what she has created for our students. Her amazing program appears in our new online classes and our new work book for students (the "Field Guide) and includes myofascial release, stretching, exercises, postural support, nutritional awareness and charting and much more. You can find her at Cornerstone Integrative Fitness and Wellness in the Atlanta, GA area and weekly in your online classes!
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