Blog - International Doula Institute

International Doula Institute Celebrates Black Maternal Health Week

April 13, 2023

A week dedicated to raising awareness, promoting equity, and improving outcomes for black mothers

This week, the International Doula Institute (IDI) joins the global community in celebrating Black Maternal Health Week (BMHW). This annual event, observed from April 11-17, aims to raise awareness about the disparities in maternal health outcomes for black mothers and advocate for policies and practices that improve these outcomes. International Doula Institute is committed to promoting equity in maternal health care and empowering black mothers through education, advocacy, and support.

Black Maternal Health Week was established in 2018 by the Black Mamas Matter Alliance (BMMA), a black women-led organization focused on maternal health, rights, and justice. The week serves as a platform to amplify the voices of black mothers and advocates, raise awareness about the significant disparities in maternal health outcomes, and promote solutions to address these inequities.

Black mothers in the United States are three to four times more likely to die from pregnancy-related complications than white mothers, with similar disparities observed in other countries. These disparities are rooted in systemic racism, bias, and unequal access to quality health care. Black Maternal Health Week is an essential opportunity to draw attention to these issues and work collectively toward solutions.

International Doula Institute’s Initiatives

As a leading educational institution in the field of doula training and support, the International Doula Institute is taking several steps to promote equity and improve maternal health outcomes for black mothers:

Education and Training
IDI is actively working to incorporate anti-racism and cultural competence training into its doula certification programs. This training aims to educate future doulas on the unique challenges faced by black mothers and equip them with the skills needed to provide culturally sensitive and equitable support.
Scholarship Programs
IDI has established scholarship programs to increase access to doula education for black women, promoting diversity within the doula profession and ensuring that more black mothers have access to culturally competent care.
Community Outreach
IDI is collaborating with local and national organizations to provide prenatal education and doula support services to black mothers in underserved communities, with the goal of improving maternal health outcomes and reducing disparities.
Advocacy
The International Doula Institute is using its platform to amplify the voices of black mothers, joining the call for policy changes that will address the root causes of maternal health disparities and improve access to quality health care for all mothers.

The International Doula Institute is proud to be part of the global effort to improve maternal health outcomes for black mothers during Black Maternal Health Week and beyond. By promoting awareness, providing education, and advocating for change, IDI aims to make a lasting impact on the lives of black mothers and their families. Together, we can work towards a more equitable and just future for all mothers.

Doula Support – 6 Quick Tips For Birth Support

April 10, 2023

As a doula, you are a highly trained professional. You trained to learn all about doula support. This article might seem basic, but we can all use quick reminders for how to best support our clients.

As you know. there are several ways you can support families during childbirth. When offering doula support, you also keep in mind the birthing person, their partner, family members, friends, etc. You are part of the birth team, you hold space, and you defer to healthcare providers to navigate the clinical aspects of birth.

Here are a six quick tips for doula support during birth:

#1: Hold Space and Provide Emotional Support

People in labor may feel overwhelmed, anxious, or scared, so providing emotional support can be helpful. Encourage them, reassure them, and be there to listen to their concerns.

By holding space, you are providing that emotional support in a fully non-judgmental way. You recognize and respect that this is a unique journey and fully theirs. You can provide guidance, evidenced-based information, and reassurance, while giving them the space to make choices which feel right for them.

Much of birth can be mind over matter. It is an experience that one knows will not last forever, but there is also no a schedule. In the throws of transition, extra emotional support is often needed. During labor stalls, changes in birth plan, etc., reassurance is key.

It is also important to provide emotional support to their partner. When the partner also feels secure, they can better support the birthing person.

#2: Practical Help – An Important Part of Doula Support

Labor and birth are rarely a quick process. Throughout labor, a birthing person or their partner may benefit from basic practical support. Perhaps a quick snack run or getting fresh water and ice is needed. A forgotten hair tie can seem small, until hair is sticking to a sweaty brow.

Assisting with position changes, supporting breathing, preparing a birthing ball, etc., are all important.

It may not seem huge to grab water, a hair tie, or move a leg, but it can be a very important part of doula support. This is especially true during longer labors. During you prenatal visits, it can also be helpful to discuss what practical support they might need or desire.

#3: Encourage Self-Advocacy

As doulas, our role is to help empower our clients to have a positive birthing experience. Doula support is not typically advocating for our clients but helping them find their voice.

Sometimes this looks like, “I heard the doctor mention Pitocin, your birth plan says you prefer X, do you have any questions about Pitocin?” This creates a reminder they have a voice and can provide informed consent or informed denial. However, you are not speaking for the client.

Preparing clients for self-advocacy during your prenatal visits is an important part of doula support. Helping clients understand what questions, interventions, etc., may come up during labor is important.

#4: Encourage a Calm Environment

A calm and peaceful environment can help someone in labor relax and feel more comfortable. You can help create this environment by dimming the lights, playing soothing music, or using aromatherapy (only sources which can be removed such as on a cotton ball).

As you know, oxytocin is vital for labor. People release oxytocin when they feel safe, cared about, and loved. A chaotic environment, loud noises, bright lights, etc., can interfere with the body’s natural release of oxytocin during labor.

#5: Get To Know Your Client

Whether you have several prenatal visits or you are the backup doula walking in on short notice, take a bit of time to get to know your client. Some clients like lots of hands-on support. Other clients will prefer simply holding space and practical support.

If you are unsure what they like, take time to ask them between contractions when they are feeling okay. Chat with their partner or other support people to find out what they might find most helpful. Never assume a client will like something simply because a previous client liked a specific type of support. Communication and patience are important parts of doula support.

#6: Always Provide Respect and Dignity

As doulas, we can easily get stuck in thinking there are “right” ways to give birth. There are things we may never personally choose, and we may not understand why another person would choose a certain intervention.

However, our role as doulas is not to encourage a specific type of birth. Our role is to provide support, hold space, and provide respect and dignity so they can have a positive birth experience.

Remember, every birthing person is different, and what works for one may not work for another. The most important thing is to be there for them, listen to their needs, and hold space.

A Historic Victory for Doulas and Birthing People in New York State: Medicaid to Cover Doula Support

March 16, 2023

Birthing person with doula

Today marks an unprecedented triumph for doulas and birthing people across New York State. A new bill has been passed, ensuring that Medicaid patients receive free doula support. This groundbreaking legislation will cover doulas at the highest reimbursement rate in the United States, a staggering $1930 per client. Doulas have worked tirelessly to achieve fair wages. This monumental achievement emphasizes the importance of doula services and the positive impact they have on birthing experiences.

The Importance of Doulas in the Birthing Process

Doulas are trained professionals who provide physical, emotional, and informational support to birthing people and their families throughout the prenatal period, labor, and postpartum recovery. They work collaboratively with healthcare providers, offering a wide range of services that can help reduce stress, anxiety, and complications during childbirth. Research has shown that doula support can lead to shorter labor times, decreased cesarean rates, and improved overall maternal and infant outcomes.

The Fight for Doula Support

The journey to secure Medicaid coverage for doula services has been a long and arduous one. Advocates for this cause have emphasized the importance of doulas in improving health outcomes and reducing healthcare disparities, especially for low-income families and communities of color. This bill reflects the hard work of countless individuals who have been fighting for birthing peoples ability to access doula services for years.

The Impact of the New Bill

The passage of this bill is a significant step forward in making doula support accessible to all birthing people in New York State, regardless of their financial situation. By covering doula services at the highest rate in the country, New York is setting a powerful example for other states to follow suit. This legislation will not only benefit the birthing people but also the doulas themselves, as they will receive fair compensation for their essential work.

In addition to improving the financial accessibility of doula support, this bill also aims to address existing disparities in maternal and infant health outcomes. It acknowledges the crucial role doulas play in reducing the risk of complications and providing much-needed support to marginalized communities.

The Future of Doula Support

As New York State leads the way in prioritizing doula support for Medicaid patients, it is crucial to continue advocating for the expansion of such policies nationwide. The passage of this bill serves as a testament to the importance of doulas in the birthing process and the incredible impact they have on the lives of families.

Acknowledging the Champions of Doula Support

It is essential to express our gratitude to the tireless professionals and organizations that have worked relentlessly to make this historic win possible. In particular, we would like to extend our heartfelt thanks to the New York Coalition for Doula Access, the core team, Maris Gelman, Patrizia Bernard, Jennifer Gonzalez, Mary-Powel Thomas, Michelle Zambrano, Alison Whitney and Veronica Zeno, which has been at the forefront of this movement. Their advocacy, dedication, and commitment have played an instrumental role in the passage of this bill, ensuring that more birthing people have access to the invaluable support doulas provide. Additionally, we would like to recognize the legislators who have championed this cause. The unwavering determination and collaborative efforts of these individuals and organizations have paved the way for a brighter and more equitable future for doulas and the families they serve.

This is a Big Deal

The passage of this bill in New York State marks a significant victory for doulas and birthing people, especially those covered by Medicaid. By providing free doula support to medicaid clients and fair compensation for doulas, this legislation sets a new standard for how our society values the critical role of these professionals in the childbirth experience. As we celebrate this historic win, let us continue pushing for more inclusive policies and equitable access to doula services across the United States.

Expanding Doula Training to Meet the Growing Demand

In light of todays legislation, the International Doula Institute (IDI) is announcing plans to expand its doula training programs for the Spring and Summer 2023. Recognizing the need to prepare and support an increased number of doulas to accommodate the approximately 96,000 annual new Medicaid-covered clients, IDI is committed to offering comprehensive and accessible training opportunities. This initiative will build the doula workforce so that there is a sufficient number of skilled doulas to provide essential support to the growing number of birthing people now eligible for doula services. By investing in the education and development of new doulas, the International Doula Institute is playing a critical role in promoting the well-being of families and fostering a more inclusive and equitable healthcare landscape for all. To enroll in our Spring or Summer Doula training sessions, please apply online or call 484-278-1648 to speak with one of our helpful admissions counselors.

The bill can be found here: https://www.nysenate.gov/legislation/resolutions/2023/r555.

New study on community based approaches to breastfeeding and safe sleep.

March 8, 2023

A wonderful study was just published in BMC Health today. This is incredibly important for doulas and breastfeeding counselors.

Menon, M., Huber, R., West, D.D. et al. Community-based approaches to infant safe sleep and breastfeeding promotion: a qualitative study. BMC Public Health 23, 437 (2023). https://doi.org/10.1186/s12889-023-15227-4

The article “Community-based approaches to infant safe sleep and breastfeeding promotion: a qualitative study” is a really interesting study that explores how communities can help new parents keep their babies safe while they sleep and encourage them to breastfeed.

The authors talked to 22 people from different backgrounds who are involved in promoting infant safe sleep and breastfeeding in the United States. They found that community-based approaches were really effective in promoting safe sleep and breastfeeding.

Community Based Approach

Community-based approaches mean that people in the community come together to help each other out. For example, they might have meetings or workshops where they talk about how to keep babies safe when they sleep or how to breastfeed.

The authors found that building trust and relationships with families is really important, because then parents are more likely to listen to what they have to say. If they feel like they’re being judged or criticized, they might be less likely to participate in community programs.

They also found that it’s important to tailor interventions to meet the needs of different communities. Different groups of people might have different beliefs or practices around baby care, so it’s important to take this into account when designing programs.

Engaging Stakeholders

Engaging a diverse range of stakeholders, like healthcare providers, community leaders, and parents themselves, is also really important. Everyone has a role to play in promoting safe sleep and breastfeeding, and by working together, we can make a real difference.

The authors identified several key themes that emerged from their interviews, including the importance of addressing cultural beliefs and practices, leveraging existing resources and partnerships, and using innovative approaches to reach new parents.

Overall

Overall, the study shows that community-based approaches are a great way to promote infant safe sleep and breastfeeding. By working together and providing support, we can help new parents keep their babies safe and healthy, and build stronger, more connected communities in the process.

Doulas on Social Media – Is It a Must?

March 6, 2023

Social media has been popular for well over a decade now. With more platforms, engagement, and users than ever before, are doulas on social media a must?

To be a successful doula, do you need to be on social media? The answer will definitely vary depending on who you ask, where you ask, and what your business goals are.

As an online doula training organization, we clearly use the internet quite a bit. However, that does not always translate to a lot of social media use. In fact, the International Doula Institute’s online training program was quite successful before social media became extremely popular.

Here’s what new doulas need to know about doulas on social media.

#1: Understand Your Client Base

Whether or not you need a large social media presence sometimes comes down to your target demographic. Not all new parents use social media. In fact, plenty of people steer clear of social media.

However, many new parents still use a variety of social media platforms. If you hope to gain online presence, find out which social media platforms are trending. It is also important to know which age groups are using which platforms.

Some doulas find using Instagram can help establish not just a client base but also networking with other birth professionals.

#2: Doulas on Social Media – Follow the Evidence

If you choose to have a social media presence, it is vital that you stick with sharing evidenced-based information. If you are hoping to attract clients and network with other birth professionals, it is important you share appropriate information.

In an age of misinformation, it is important to stick with evidence. Certainly, how different professionals interpret the same data can vary. However, it is important to be able to cite reputable sources if you are sharing information.

You can absolutely share your opinions, anecdotal experience, etc. It is just important that you are clear about it being that versus peer reviewed evidence.

It is also vital you never give direct medical advice. For liability reasons, it is important you clarify that in posts, videos, etc.

#3: Have Fun!

Yes, as doulas we are sharing important and evidenced-based information. However, social media is also about having fun. When you are trying to engage clients and peers, it’s best to have a bit of fun. Be yourself. Let your personality shine in your content.

If you do not find social media fun to do, it may not be your best route for clients or networking. Doulas existed long before social media. It is completely possible to have a successful doula business without using social media.

If you find social media stressful but you want to reach people, consider:

Blogging
Attending birth worker meetups
Attend trainings and exchange contact information with fellow birth workers.
Learn more about birth workers in your area, as well as other professionals working with growing families such as chiropractors, physical therapists, lactation professionals, yoga and Pilates instructors, etc.

#4: Invest in Your Social Media Account – But Diversify

One of the biggest mistakes new doulas make is assuming you can network only online and fully expand your business. It takes more than a fun social media account to grow a business. If you invest time into your social media account, you can absolutely reach other professionals and potential clients.

However, if you only network online, these connections may not actually translate to work. It is important to meet people in-person, connect with professionals, and let people get to know you. Building trust within your community, both in-person and online, is important.

Another thing to know about social media is that their algorithms are ever changing. It is important to diversify your advertising and networking because a popular page can suddenly see minimal traffic with algorithm changes.

Ultimately, whether doulas on social media is a must or not comes down to personal preferences and goals. If you are unsure about whether social media advertising is for you, take time to follow and observe other accounts. Do NOT copy other accounts, however, you can get an idea of what it can entail to run a business social media account.

Safe Sleep – What Doulas Need to Know

March 5, 2023

As doulas, it is vital we help educate our clients about many infant care topics. This includes ensuring they understand the evidenced based information for safe sleep for babies. While different professionals and families have varying opinions, we must provide evidence to clients, not simply our opinions.

As doulas, we will often be the professional a client looks toward. As a professional, we have a responsibility to provide our clients with honest, evidenced-based answers to common questions.

However, as birth workers, we also understand that sleep and babies can be quite nuanced. The American Academy of Pediatrics says X and UNICEF UK says Y, while Dr. James Mckenna and anthropologists might say A. How do we know how to educate clients about safe sleep when there are clear guidelines at each organization, but variations between organizations?

Safe Sleep – Always Provide Clients With Current Recommendations For Their Location

If you are a doula in the United States, it is important you provide clients with current recommendations provided by the American Academy of Pediatrics, your local health departments, etc. If you are in the UK, be sure to provide information from NIH.

Currently, the American Academy of Pediatrics recommends:

Back to sleep for every sleep.
- This includes infants with reflux as there is no evidence to support side or inclined sleep is safe.
- All babies should be placed on their back to sleep until one year of age. If a child rolls to their side or stomach on their own, that is fine. However, caregivers should not place them on their side or stomach.
There should be no blankets, pillows, stuffed animals, etc., in the sleep surface with the baby.
Use a firm, flat sleep surface.
- Inclined sleepers and wedges, baby loungers, swings, car seats not on their base, etc., are not safe sleep surfaces.
It is recommended that babies sleep in the same room with their parents, but a different sleep surface, for ideally the first 6 months of life.
- “The AAP understands and respects that many parents choose to routinely bed share for a variety of reasons, including facilitation of breastfeeding, cultural preferences, and a belief that it is better and safer for their infant. However, on the basis of the evidence, the AAP is unable to recommend bed sharing under any circumstances.”

You can read these guidelines in depth in the AAP’s policy statement.

UNICEF UK has similar guidelines as the AAP. They often provide more in-depth information about how to discuss these with parents.

Is Bedsharing Inherently Dangerous?

As a doula, you are likely to navigate these questions. It is important to recognize that statistics show about 50-80% of parents at least occasionally bedshare, varying by region, culture, etc.

A healthy, term infant contact sleeping with their biological, lactating, parent is not inherently dangerous. It is likely a biological norm.

However, modern blankets, modern furniture, pillows, overheated homes, prescription medications, soft mattresses, pacifiers, bottle feeding, etc., are not necessarily natural. None of these things are inherently wrong for parenthood.

However, when we combine contact sleep with comfy mattresses, fluffy pillows, big blankets, prescription medications, bottle feeding, etc., we do create a situation with real risks.

There are typically two different approaches professional organizations make when providing public education regarding bedsharing. One approach, which is what the AAP uses, is to blanketly discourage any bedsharing with infants, especially newborns.

The other approach is to discourage bedsharing while recognizing that statistics show some parents will do so anyway. For that reason, providing some guidelines to reduce risk is also included. This is the approach UNICEF UK seems to take. Per the UNICEF link shared above:

“The authors found that many breastfeeding mothers and caregivers do sleep with their infants whether intentionally or unintentionally. They argue that the data supports policies to counsel parents and caregivers on safe sleep practices, including bed-sharing in non-hazardous circumstances, particularly in the absence of parental smoking, recent parental alcohol consumption, or sleeping next to an adult on a sofa. Further research with appropriate methodology is needed to drill down on actual rates of infant deaths, paying close attention to the definitions of deaths, the circumstances of the deaths, and confounding factors, in order to ensure we have the best information with which to derive public health policy.”

What Should Doulas Tell Clients About Co-Sleeping and Bedsharing?

It is important that you provide current recommendations for your region and only evidenced-based sources. One should never tell a client that it is safe to bedshare and they should do so.

However, if a client is interested in bedsharing, your language is important. One might say something along the lines of, “Well, currently the AAP advises against bedsharing. However, some researchers, such as Dr. James Mckenna, believe bedsharing is safe in some circumstances if both the parent and child meet the criteria. You might find it helpful to look at the AAP website and Dr. James Mckenna’s website to learn more and make the informed decision which works for you.”

Navigating Safe Sleep During Doula Shifts

As a doula, it is important you follow all current sleep guidelines. If parents request you do something which is not in-line with current guidelines you can say something such as, “I’m professionally bound to following current AAP guidelines. It is a liability for me to do anything else. During my shifts, I can only put baby to sleep in a flat bassinet, crib, or pack-n-play. This is not a judgement on any sleeping arrangements you choose during your time caring for baby. I’m simply required to follow current guidelines.”

This means you can only put baby to sleep on approved sleep surfaces without blankets, pillows, etc. If parents continue to ask questions, you can use the opportunity to educate them regarding safe sleep recommendations.

Some doulas have made informed decisions to bedshare with their own children. That is a personal choice which some are comfortable making. However, it is important you do not use that anecdotal experience in place of evidenced-based information. If clients would like information about bed-sharing, be sure to point them to sources such as Dr. James Mckenna.