International Doula Institute | Doula Blog

International Doula Institute Expands Doula Training Program to Address Growing Demand for Doula Support Under Medicaid

March 3, 2023

FOR IMMEDIATE RELEASE

International Doula Institute Expands Doula Training Program to Address Growing Demand for Doula Support Under Medicaid

Philadelphia, PA – International Doula Institute (IDI) announced today that it will expand its doula training and certification program to meet the growing demand for doula providers under Medicaid. The demand for doulas comes as more states have started to cover doula services under Medicaid, as a means of addressing high infant and maternal mortality rates, particularly in Black and Indigenous people.

Presently, around 780,000 birthing people are covered by Medicaid for doula services, however, these services are underutilized due to the lack of available doulas. To address this issue, there is an urgent need to increase the doula workforce significantly, as at least 15,000 new doulas are required to meet the growing demand and ensure adequate doula care for those who need it.

As the demand for doula support continues to grow, IDI is committed to ensuring that there are enough doulas to provide support to every birthing person in the United States. This is a crucial step in addressing the equity problem that has resulted in high mortality rates in certain communities.

“We are excited to expand our doula training program to meet the growing demand for doula support under Medicaid,” said Aliza Juliette Bancoff, Founder of International Doula Institute. “Our goal is to ensure that every birthing person has access to the doula support they need during childbirth. This means growing the doula workforce significantly.”

Our unique doula training gets doulas ready for everything they need to provide the highest level of doula care to their clients. IDI covers a range of topics related to pregnancy, childbirth, and postpartum care, including the role and responsibilities of the doula, comfort measures and pain management techniques, communication and advocacy skills, diversity, equity and inclusion, business management and so much more.

“By expanding our training program, we are empowering more doulas to provide compassionate and effective support to birthing people who need it most,” said Aliza Juliette Bancoff. “We believe that by providing doula training as a means to address the racial disparities in birth outcomes, we can contribute to the reduction of infant and maternal mortality rates in the United States.” To learn more about the International Doula Institute and its training and certification program, visit www.internationaldoulainstitute.com.

Contact:

Aliza Juliette Bancoff

International Doula Institute

484-278-1648

aliza@internationaldoulainstitute.com

Accessibility in Birth – Giving Birth While Disabled

January 23, 2023

If you are able bodied, it can be hard to realize how difficult everyday situations can be for someone with a disability. As doulas, we all believe everyone deserves to give birth with dignity. Accessibility in birth is an important part of ensuring that.

We have seen people from all demographics give birth both with and without care they should deserve. Some facilities and providers do not ensure everyone gives birth with dignity. This is something which can impact anyone.

However, people with disabilities are disproportionately impacted by poor support and lack of accommodations. At IDI, we want to ensure our doulas are prepared to support all people. That is why we offer our Diversity, Equity, and Inclusion for Birth Workers course.

Accessibility in Birth – Why It Matters

Maternal infant morbidity and mortality measure the overall wellness of a community, country, group, etc. When we see disparities in those numbers among certain groups, we know we are not doing something well.

Parents with disabilities often report issues with practical accessibility which directly impacts care. One study found:

“Only 17.2%, however, received any information or training on the provision of healthcare to women with disabilities. Eighty-one percent agreed somewhat or strongly that women with disabilities are less likely to receive comprehensive reproductive healthcare.”

With the data the study determined:

“Women with disabilities require reproductive healthcare no less than women without disabilities; however, the evidence consistently identifies disparities.”

When creating of DEI course, we spoke with several individuals who had experience being pregnant and parenting with a disability. One wheelchair user stated her OB/GYN provider was never able to weigh her properly. She was left wondering if weight had any impact on her gestational diabetes diagnosis.

When it comes to birth, we know that mobility can be helpful both for labor progress and comfort. Yet patients with mobility aids are not necessarily guaranteed a room with space to use their aids. This can lead to having limited options during birth.

If less than 18% of providers have any training in supporting women with disabilities while providing OB/GYN care, they may not even realize the lack of accessibility in birth their patients are facing.

Listen to People With Disabilities

Providing accessible birth care is a vital part of public health. In fact, it is a global concern. The World Health Organization recently published an article, A quest for dignified health care for women with disabilities, highlighting the birth experience of a woman with disabilities.

‘“No, no, no! We don’t want to take care of her!” These were the words that Coumba Ndiaye, from Dakar, Senegal, heard repeatedly when she sought care to deliver her baby. She approached four health centres, but all refused her, saying her disability (related to polio as a child) would make the delivery “too complicated.”’

She was eventually referred to a hospital, where she was met with immediate insistence that she have a c-section birth. One respectful health worker stepped in to assist her in having a vaginal birth. However, just an hour after birth, no one aided her in moving, and when she fell, she hemorrhaged. She would not wake up for two days and was directed to not have more children.

While she was eventually able to find some care, she was turned away several times first. She went on to have complications that may have been preventable with a bit of support and accommodations.

Be sure to read her entire story, on the WHO site.

To understand how to best support our clients with disabilities, we need to listen to their experiences.

How Can We Support Accessibility in Birth?

As doulas, we can listen to our clients. We can also guide them to ask their provider questions about the birthing facilities.

There is a great likelihood that your client is used to having to advocate for themselves. However, in this instance you can bring your birth experience to help them know what to ask about. You can also remind and encourage them they have the right to a dignified birth experience.

You can also be an ally and support disability and accessibility advocates within your community.

Looking for more tools to support clients? Be sure to register for our Diversity, Equity, and Inclusion for Birth Workers course.

Postpartum Traditions – Support Around The World

January 22, 2023

As birth workers, we know how important the postpartum period is. For those of us in the United States, we often experience a lack of postpartum traditions and support. Of course, some of us are fortunate to have a circle, culture, etc., within the US which values postpartum support. However, postpartum support in the US tends to be lacking.

For doulas, learning about postpartum traditions and support around the world can help improve the support we offer our clients. While we may not change US culture immediately, we can be part of normalizing postpartum support for our clients.

In the US, it is common for parents to feel obligated to do everything on their own. It’s also common for people around them to expect them to be independent.

Sure, plenty of us survive welcoming a baby with little support. However, as doulas, we know support can mean thriving and getting to enjoy the early weeks and months with a new baby.

Postpartum Traditions – “Sitting The Month” and Other Resting Traditions

In the US, we consider the first six weeks to be ‘postpartum’ and it’s suggested we rest. However, while medically we are told to rest, many do not. It is not uncommon to hit a store on the way home from the hospital. Some parents throw ‘meet the baby’ parties and more within the first couple weeks postpartum.

There is nothing inherently wrong with not resting a lot. However, many new parents do look back and wish they had rested more. Many parents feel obligated to play host, just back into life, and even get back to work.

In fact, one survey found 25% of US birthing parents were back to work or school within two weeks of giving birth.

This is a huge contrast to the Chinese tradition of sitting the month. Korean culture often encourages a similar tradition of one week to four months, with twenty-one days being common. Omugwo is the traditional postpartum care amongst the Igbo people of South-Eastern Nigeria and lasts forty days.

During these days and weeks of rest, warm and nutrient dense foods are eaten. There is a focus on rest, restoring nutrition, and healing.

While often thought of as policies and not tradition, some western European countries offer postpartum support through regular postpartum nurse visits. One example is the kraamverzorgster visits in the Netherlands. Parents are provided with several hours of postpartum support per day for 8-10 days after giving birth.

As doulas, especially postpartum doulas, we can offer support and encourage rest through education and practical support.

A Focus on Nutrition

The standard American diet is not always ideal for overall health and wellness. We are fortunate that many foods are fortified so even less than ideal diets are protective against clinical level malnutrition.

However, pregnancy and lactation can deplete some nutrition stores in parents. This is especially true of women with prolonged or severe morning sickness, dietary restrictions, and certain chronic conditions.

Birth and postpartum bleeding can also impact iron levels.

In many cultures, including the African diaspora in the US, we see traditional postpartum foods which are rich in iron, protein, and other vital nutrients.

At the International Doula Institute, we recognize the importance of nutrition and the wisdom of many different cultures. Part of our training includes not just understanding general nutrition but also understanding dietary traditions in a variety of cultures.

You will learn more in your postpartum doula training, but here are just two links to learn more about postpartum nutrition in different cultures:

Korean Seaweed Soup (Miyeok Guk) – My Korean Kitchen

Postpartum recipes from the African diaspora — Mothers-for-Mothers (m2mpostpartum.org)

Postpartum Traditions – Parental Leave

As doulas, we cannot challenge our clients’ employers for more parental leave. However, we do have the opportunity to encourage parents to take what is available to them. We can also reassure them that taking the leave was the right choice.

Finally, we can also work in advocacy and awareness for policy change. Compared to other developed and even developing countries, the US has abysmal parental leave policies. Some clients will be fortunate enough to work for companies offering appropriate leave, or they are choosing to be an at-home parent.

Supporting Birth Partners as a Doula

January 22, 2023

As doulas, supporting birth partners is a vital part of our role. While we provide a lot of support and focus on the birthing person, support for partners is quite important. Doulas provide emotional, practical, and even coach like to support for the partner.

Doulas often correct the myth that they are only for the birthing person. Another myth they often correct is that if one has a supportive partner, they will not necessarily benefit from doula support.

A doula is not just for birthing people, a doula is for families.

How to Include Birth Partners In Birth Preparation

As a doula, it is important to include birth partners as much as the birthing person. During your consult and prenatal visits, you should be speaking to the partner nearly as much as the birthing person.

I often instruct both the pregnant person and their partner to write out what they find relaxing as well as helpful when they aren’t feeling well. I then recommend they think about which of those things can translate to a birth experience.

Often, partners are confused why they would need relaxation techniques. However, we discuss how they cannot support someone if they are overly stressed.

If a birthing person enjoys the beach to relax, perhaps guided visualization can be helpful. They might like audio distraction via ocean sounds, hydrotherapy, and fresh scents during labor.

If a birth partner enjoys music, stress fidgets, outdoors, etc., they can make sure to have a playlist and ear buds, fidget items, etc.

It is also important to prepare birth partners for meeting their needs to they can meet their partner’s needs. This can look like packing some non-perishable snacks (and things they can sneak to eat in hall or bathroom if she’s NPO for birth). It may look like cash for vending machines.

Be sure to prepare partners for their role, what they may see, and how things can unfold during birth. Remind them they’re not solely responsible for comfort techniques and you will be there to coach them.

Supporting Birth Partners During Birth

During the actual birth, you will be providing practical and emotional support for birth partners. This can look like:

Suggesting comfort techniques such as massage or counter pressure so they can be hands on with their partner.
Reminding them to eat and drink.
Providing emotional reassurance about what is happening.
Being with the birthing person so the birth partner can get some fresh air or a breather if needed.
Running to grab a forgotten item.

Remember to think of the birthing person and their partner as a team you are supporting. Yes, your focus is on the birthing person. However, it is a big day for the support person as well. They are also welcoming a child and witnessing their partner go through a very intense experience.

You can help guide the partner in supporting the birthing person. You can act as a coach and support to help them bond through the challenging and intense moments.

You are holding space for the couple. In doing so, you are also bringing the stress level down by ensuring the partner does not feel solely responsible for meeting her needs.

Supporting Birth Partners After Birth

The immediate postpartum period is a time where prenatal education goes a very long way. Educating partners about the physical and emotional changes the mother goes through helps them be prepared to offer real support.

Many are caught off guard by how intense the postpartum period can be. By preparing both parents, you provide invaluable benefits for their relationship. Realistic expectations in the postpartum period for both parents can greatly reduce stress.

While we cannot completely prepare someone for a new experience, we can provide them with education and tools. Helping birth partners know how they can support the mother and engage with baby can improve their relationship with baby as well.

Supporting your clients as a couple and family is an important part of being a truly helpful doula.

Can You Work As a Doula Online?

January 17, 2023

We have seen online birth workers for years, however, Covid-19 really impacted how many we saw. Can you work as a doula online? After 2020, many doulas would say, “Absolutely!”

At the International Doula Institute, we provided you with information about providing virtual support. Many of us found ourselves with in-person clients we could not actually provide in-person support for. Covid-19 impacted every area of work, including birth work.

As a training organization, we find it important to help you learn about all your options. In short, you can absolutely work as a doula online. However, there is also more to it than you might see on social media.

We chatted with Kelly Kolb, Childbirth Educator, Doula, CLC, to learn about her experience working online. She is an experienced doula who broke into the online scene at the peak of Covid-19. However, her extensive birth work experience before Covid-19 means she has a lot of valuable experience to share.

Before Online Work, There Was Traditional Birth Work

When many of us at IDI first began our birth work, online training was not much of a thing. And online birth work services? A rarity.

However, as the internet became more efficient and accessible, many of us found massive benefit in online training. In fact, it made it possible to not just train but easily access continuing education in birth work.

Once social media really took off, we started seeing doulas and childbirth educators providing general support. Eventually, we even saw doulas providing virtual birth support. Wanting to learn more about this option, we chatted with Kelly Kolb.

She shared about the start of her birth work and how she eventually began work as a doula online:

“I did traditional, in-person birth work for 4 years before beginning to teach online. When COVID hit, like so many birth workers, most of my work went away. In-person classes were cancelled, most of our local birth places stopped allowing doulas to be present, and some clients lost income and/or job security, so had to cut back or cancel services.

“Besides impacting my family’s income, this also left so many families with little option for education or support to prepare for their births and parenting.”

Kelly did not initially set out to work as a doula online. But like many of us, it became necessary not only for our own business but so families could have support.

Work As A Doula Online – Getting Started

Roman philosopher Seneca once shared the wisdom that, “Luck is what happens when preparation meets opportunity.”

Work as a doula online, especially during Covid-19, likely falls under such a quote for many. To provide support to a virtual client, work with a company, etc., you need to be properly prepared. Technically, anyone can call themselves a doula, we are not a regulated field.

However, without proper training, any company, organization, or family is likely to move onto someone with proper experience. And to work online, more than just training, most doulas will have taken the time to also build up their in-person experience.

Kelly shared, “An opportunity came up to build a curriculum for new parents including birth, postpartum, breastfeeding, and newborn care, and work with a team of doulas and childbirth educators to teach families across the US and Canada. It was so meaningful to help families find community, support, and the information they needed.

“We had so many special moments of connecting families across distance when they were feeling isolated. Whenever one would ask a question or share an experience, others would nod, agree, or send virtual hugs to each other.”

Kelly was trained, experienced, and able to jump at the opportunity to assist in curriculum development for new parents. From there, she was able to provide doula work and support to clients all over the world!

The Benefit of Working Online

As doulas, we can all agree there is something special about providing in-person support. In fact, I think we would all agree we provide amazing hands-on support for our clients.

However, while there are obvious benefits to in-person support, there are also benefits to online support. For doulas, this looks like:

Being able to offer support to more families
Less travel time and expenses
More flexibility
Expanding your experience
Working with more demographics and in more locations
Diversifying income and potential client base

And for families, Kelly shared:

“We also found that online teaching provided opportunity to support some families in unique circumstances: online classes permitted a military family with parents stationed in different parts of the world to participate in class together. Ex-pats were able to access English-language classes.

“And we found that partners were particularly engaging with online classes as it gave them a chance to connect with the pregnancy at a time most could not attend prenatal visits or ultrasound appointments.”

Can You Work As A Doula Online Post-Covid?

As covid-19 restrictions eased up a bit, many doulas were able to return to their in-person work. However, many have found a hybrid style of work continues. This hybrid style allows for a bit more flexibility and the ability to reach more families.

Kelly explained here experience and what her clients have done in a post-pandemic world, “Once I began taking in-person postpartum and birth clients again, I still enjoyed providing online classes. They were convenient for many families with tight schedules and a helpful option for families looking to reduce their exposure at times COVID counts were high in their communities.

“I’ve also found that some clients are now choosing virtual postpartum appointments to discuss issues like feeding, sleep, routines, and get those comforting reality checks of what’s “normal” in those early days at home with little one.”

How Do You Start Work As A Doula Online?

First things first, make sure you are a trained doula! If you have not already started, be sure to register for doula training today.

Kelly had some excellent advice for those interested in beginning work online.

“For birth workers interested in offering online services, I’d suggest:

Get familiar with the options that are available both widely across the internet and locally in your community
Determine what makes your offerings/perspective/format/etc. unique
Spend some time ahead learning about engaging online audiences as the techniques for effective engagement are so different from in-person classes
Work carefully to identify your key audience and develop marketing plans of how to reach them. It’s a really challenging space right now. Many of the big names have pivoted or gone out of business in the last year or two. And sort out how these fit with the rest of your business. It’s easy to get overloaded as small business owners.
Know who you can call on to cover a class if you get called to a birth, get sick, or have another emergency. Like everything else in birth work, it really helps having folks who truly have your back when you need.”

Whether you work as a doula online, provide in-person support, or a hybrid, it is important to be flexible. Any experienced birth worker will tell you that birth work ebbs and flows with trends. At times, your inbox will be flood with inquiries for lots of in-person, hands-on support. Other times you might find your inbox filled with questions about online classes, virtual support, and more.

Birth itself does not change. However, the support available, trends, provider styles, etc., is ever changing. As doulas, we can help support our clients as we see services and support change around. Doulas offer a consistency in an ever-changing world.

New Year’s Resolutions For Birth Workers

January 14, 2023

January, the time of year where we are motivated to do our best and make changes. Often, people think about physical changes, health, and even take on challenges like dry January. But what about New year’s resolutions for birth workers? Are there any changes we should make?

As doulas and childbirth educators, we want to improve our work while also being aware of our priorities. Self-care, our home life, etc., are all important. Finding balance between improving our birth work skills and business growth, along with balancing our priorities can be hard.

These new year’s resolutions for birth workers can help us find that balance.

Take Time to Recognize Your Strengths – Most Important New Year’s Resolution

Before jumping into think about what we can add to or change in our lives, it is important we recognize our strengths. In the same way we remind our birthing clients of their strengths, it is important we do the same for ourselves.

Do your clients rave about your ability to bring a calming presence? Are you a walking birth encyclopedia? Perhaps you’re a wizard with the rebozo, a genius with the affirmations, or a talented business owner. Whatever your strength is, this year, we are going to recognize it!

That’s right, no jumping to where you can possibly improve without recognizing your amazing strength.

Create Your Business Boundaries Without Guilt

Listen, as fellow birth workers, we get it. We know you want your clients confident you are always available. However, being available 24/7 for everything from signing of a contract until baby is walking will have you burned out quickly.

Yes, we are on-call from about 37-42 weeks. Sure, we will always do our best to support preterm births when we can. And we want to help answer questions and concerns throughout the pregnancy.

However, it is important to create boundaries so you can find a healthy balance between work and personal life. Some doulas only respond to non-emergency, not on-call birth needs during set hours. They inform their clients of their “business hours” and let them know they will respond within X number of hours. And there is no guilt!

Think about it, even their obstetricians or midwives are not available to them 24/7 outside of birth. They have a patient portal or calling for non-emergencies to ask questions. Patients can schedule an appointment for additional concerns outside their typically scheduled visits. They always have access to the 24/7 emergency line, but that is only to be used for truly urgent matters.

Take time to think about what boundaries you need with clients and have them clearly written in your contract. This makes it easier for you to balance and it helps your client to have realistic expectations. Realistic expectations lead to positive experiences when they know exactly what to expect with your services.

New Year’s Resolutions For Birth Workers – Continuing Education

As birth workers, it is vital we continue learning. Given that birth impacts so many areas of life, there is almost no limit to what areas you can expand your knowledge.

Take this year to choose one, or more, areas you can learn more about to better support your clients. Work in a diverse area? Be sure to take our Diversity, Equity, and Inclusion For Birth Workers training and learn how to best support families from all walks of life, different abilities, different family structures and more.

Many birth workers like to expand their knowledge in lactation, pelvic anatomy, emotional intelligence, business and entrepreneurial skills, social media, nutrition, mental healthcare, and more!

There really is no limit to the areas you can learn more about. The big thing to keep in mind is ensuring you learn from evidenced-based sources.

Choose a Networking Goal – Important New Year’s Resolutions

Birth work can sometimes feel isolating. We spend a lot of time working one-on-one with our clients and not much time with colleagues. Make it a resolution to connect with other birth workers in your area to:

Improve your business network
Connect with local resources for yourself and your clients
Improve birth related socializing to help reduce burn out
Find backups or provide backups for others
Expand your knowledge

Make it a point to attend a birth worker event or connect on social media with local birth workers. It can be scary sometimes, but once you find a few likeminded birth workers, you will wonder why you did not reach out sooner.

These are just a few ideas for making birth worker new year’s resolutions. What resolutions do you think can help birth workers?