Navigating Doula Certification: Conflicting Beliefs and Practice

I just received an email from an organization asking the mailing list, “Why are trained doulas not obtaining certification or completing recertification after their every few years requirement?” Here is a summary of my thoughts from my last four years in this field.

Some of this is very general, and some is anecdotal evidence of myself and what I've read.

I personally no longer support many of ProDoula’s ideologies. I was more “liberal,” I suppose you could say, before the 2020 pandemic. My trainer is an absolute gem. I love her as a person. She did an excellent job teaching my class. However, the organization has beliefs conflicting with my faith that I’ve slowly moved towards. Through reflection, I need to move on. Yet, here is the conflicting catch. I paid for a life membership. Do I let that go away? Do I still disregard everything else going on to receive certification and recognition?

If I placed a bumper sticker on my car that said, “X, Y, Zed,” I’m giving an organization a free advertisement. Why would I give someone free advertisement if I don’t believe in the cause or the president? Side note: why would a non-autistic CEO run Autism Speaks? (#AutismAwarenessMonth) It goes the same way if I place my face on a site and get a “free” advertisement. That means I also stand with them.

DONA is a beautiful organization. If you open up the packet, it has a nod to Catholicism. I'm not sure if they realize this. It has Christian fundamentals. I'm still trying to fulfill my Birth Doula Certification obligations. I recognize that insurance needs to pay me. However, I am concerned about my BIPOC sisters’s unfair and racist treatment that has harmed them due to its racist internal system. I haven't received a follow-up since probably March 2023. Therefore, I'm not currently aware of the status of any changes. I need to be updated. I hope improvements within the organization are being made as it aligns with ~some~ of my beliefs. But if it doesn’t, should I chuck all my work? Yes, I will. For now, I’m betting they will resolve things sooner rather than later and still stand against internalized/internal organization racism.

No organization will ever fit someone 100 percent. That’s okay. We have to choose our battles.

Now, the “little” training organizations, not recognized by insurance programs, aren’t given enough credit. They do a great job. I have yet to hear about racism within them or other complaints. Yet they aren’t as large, and their programs aren’t approved *yet* by Carrot Insurance or Tricare. I don’t know if they want approval sought. It’s a bummer they aren’t yet approved if they are in the process of doing so because these programs produce quality doulas. I believe that because they firmly focus on their mission statement, they don’t get caught up in insurance controlling their certification programs or their ability to practice - focus on the mission statement is only my speculation. I’m not a part of either organization.

The issue is certification is not inherently wrong. What is “bad” is when how one is “trained” can be a way for governing bodies to control how people practice because it doesn’t align with an insurance’s “insurance code.”

Examples include insurance companies limiting the number of times someone goes to therapy a year, making someone go through unnecessary tests for another doctor’s visit, or restricting an OB’s ability to care for a woman over 40 weeks. Yet, it is a healthy pregnancy - therefore making up non-evidence-based risks for women pre-labor. I could go on.

There are many doulas out there that aren’t complying with receiving certification for various reasons, be it religious, internal organization dysfunction, racism, or simply not wanting to entirely give more power to poor quality healthcare systems that are absurd and nonsequential. Do we join “the man” to fight it internally? Do we join “the man” to help the little people anyway? Do we stand against “the man” and not let this control chokehold us?

I’m not sure. That’s for you to decide. I am stuck between a rock and a hard place, trying to make the best decision for my clients and myself.

Experience and continuing practice are essential to crafting and molding craft to a high standard. High self-governance will naturally draw people to a practitioner. Insurance or not, someone is probably willing to go to them. I know my dentist and chiropractor have opted out of the insurance field. Should doulas try to go with the flow? As the old saying goes, “If you can’t beat them, join them?” Or, as I said above, do not comply and ask clients to pay out of pocket still as they have.

It’s a big topic, and sometimes, it’s difficult to form an opinion—especially when my heart wants to help as many as possible.