What’s in store for 2015: Interview with DONA International President

Recently, Sunday Tortelli, President of the DONA International Board of Directors talked with The DONA Doula Chronicles about the organization’s plans for this year.
TDDC: The DONA Doula Chronicles,  ST: Sunday Tortelli

Sunday headshotTDDC: Thank you, Sunday, for making time to talk with me and provide a look into what’s coming for DONA International in 2015.

ST: I appreciate the invitation and enjoy the opportunity to connect with our membership!

TDDC: Let’s start with a quick summary of your role in DONA International. For our readers who aren’t familiar with either how non-profit boards of directors work or DONA’s own structure, could you give us a quick summary of your role as President of the Board of Directors?

ST: As the President of our board, I guess you could say that role is one of a “generalist” rather than a “specialist.” What I mean is that I have the privilege of working with everyone on pretty much everything. Each director on our board is a specialist overseeing the work of their committee.Our executive director and home office staff are also specialists focusing on very specific functions as they assist us with the management of such a large and active organization. It’s important that I have an overall working knowledge of the goals and challenges of our management and each committee, as we strive to uphold the mission and vision of DONA International in all that we do. For that reason, I am grateful to have spent many years as a “specialist” in my first role on the DONA International Board of Directors as Director of Publications. In that role, I was responsible for producing the International Doula and eDoula, and I also had the advantage of assisting in the production of all the documents, packets, brochures and published information from all the committees. That experience gave me a very deep understanding of all aspects of our organization and I draw from it every day in my current role.

TDDC: And you also serve as Interim Editor of the eDoula newsletters in your spare time!

ST: Yes, I am happy to fill in on a temporary basis, but that position is available if any of our readers are interested!

TDDC: I’ll be sure to include information so our readers can learn more if they are interested. With the start of a new year, I thought we might be able to talk about what’s in store for DONA International in 2015. If there were a theme for this year for DONA, what would it be?

ST: Hmmm…..I think it would have to be “connection” or “connecting” something along those lines. We are really looking to strengthen our connection to our members and their connection with the organization, better connect doulas to high quality, accessible, affordable and evidence-based continuing education and increase DONA’s connection to the larger community including families.

TDDC: DONA International has always been known for its commitment to education so let’s start there. What is happening in 2015 to connect DONA members to information and training to improve their knowledge and skill?

ST: Actually, we mean all doulas, not just DONA International members. We think that by offering quality educational offerings for doulas who are not yet members we will improve the knowledge and skills of all doulas. This also lets us highlight our strong commitment to continuing education, scope of practice and evidence-based resources to the larger birth community. We are now offering on-demand webinars so doulas can access DONA approved trainings anytime and from anywhere. Just like at our annual conference, we will address topics related to the doula’s role, research, business areas like marketing and where possible – doula practice skills. We are giving members one free webinar per calendar year.

TDDC: Since DONA is offering the webinars will they count toward recertification contact hours?

ST: Yes. Just like sessions attended via our virtual conference coming up in August, the webinars will count toward the continuing education requirement for recertification.

TDDC: Tell us about strengthening the connection between DONA International and its members.

ST: One of the things we recently reviewed is recertification. From time to time, it’s important for every organization to evaluate its processes to see how those processes can be improved to better serve our members. We know the recertification process can be stressful and confusing for members and it also takes considerable resources by DONA as well to answer questions, review packets, etc. We believe very strongly in recertification to maintain knowledge and skills, and also demonstrate legitimacy and credibility to care providers and the families doulas serve. Most professions have recertification requirements for the same reasons – accountants, lawyers, nurses, doctors, therapists, and childbirth educators to name a few. So, we’ve simplified the recertification process. Now there is only one designation and one fee. Rather than the previous “inactive” or “active” statuses, which were confusing to many members, a doula will simply become “recertified” upon earning and documenting the minimum number of contact hours, maintaining DONA International membership and paying the recertification application fee. There is no need to submit documentation of doula experiences. The recertified doula may then choose to be listed on the DONA website or not. This updated recertification information for birth and postpartum doulas is already available on the website. We are also making some minor modifications to the certification process, and the birth and postpartum certification packets are currently in revision.

TDDC: What other ways is DONA International looking to foster a stronger connection with members?

ST: We are continuously looking to improve our communication avenues with our members so that we are providing them with timely and pertinent information whether that’s through the eDoula e-newsletters that are specific to each member’s region, the International Doula magazine, the blog or our social media accounts. In order to be more responsive to news items or research and continuously share practice tips and resources, we’re expanding our blog and social media presence this year. Last fall, we sent out our first Annual Update to help provide a summary of DONA’s activities and achievements, and we will look to repeat that and improve it this year. On a more direct level, we’d really like to see more of our SPAR – State/Provincial/Area/Representative – positions filled. These members are important first points of contact to new members in particular. SPARs are a great local resource for members and can help connect members to the right person within DONA – whether that’s someone at the Home Office or a Board Member to address their need. SPARs often host area gatherings or virtual meet-ups of DONA members, which helps to connect members to one another for support and to share resources. This role is a great way for members to support DONA and other doulas.

TDDC: You also mentioned connection with the public and expectant families. What are the plans there?

ST: We revitalized our Advisory Council this year to serve as a resource for the organization. They will provide us with outside advice on our operations, marketing and member services. We announced their appointment in the most recent issue of the International Doula and will be introducing the members of the Advisory Council to DONA International members more fully in the spring issue of the magazine. We will then share more on the Advisory Council and its members with the larger community. It’s important that our members hear of developments like this first. It’s their organization after all and we wouldn’t exist without our members.

TDDC: I appreciate you giving us a peak into what’s coming this year for DONA International and taking the time to talk with me today.

ST: You are quite welcome. Thank you for sharing what’s happening with The DONA Doula Chronicles readers.


Note: For those interested in the role of eDoula editor, please contact Director of Publications Tracy Good at publications@dona.org. If you would like to be a State/Province/Area Representative please contact the Regional Director for your area. The full list of Regional Directors and open SPAR positions is available here.

— Adrianne Gordon, MBA, CD(DONA)

Does Vitamin D Deficiency Increase Labor Pain?

Vitamin D is often called “the sunshine vitamin” since it can be absorbed through the skin from the sun. Deficiencies in vitamin D have long been associated with brittle bones and some research has found connections with cancer, autoimmune diseases, high blood pressure, asthma, and depression. Recently, a connection between low vitamin D levels and increased pain during labor and childbirth has been explored.

A study presented at the ANESTHESIOLOGY ™ 2014 annual meeting found an association between low vitamin D levels and increased requests for pain medication. The study evaluated the vitamin D levels in 93 pregnant women and then the amount of pain medication consumed during labor. The findings showed a correlation, but how or why vitamin D levels may impact labor pain is not known.

The sample size for the study is quite small and only patients who requested and received an epidural were included. This raises some interesting questions. Do expectant mothers who desire a natural childbirth produce or consume more vitamin D? Is this related to their level of information and education about pregnancy and childbirth? We know that childbirth education and the intention of a natural birth are correlated. Could it be that as part of their learning process, this population of mothers-to-be also research nutrition, diet and supplements?

Additional research on the connection between vitamin D levels and the amount of pain medication consumed during labor is definitely needed. In the meantime, it may be useful for doulas to provide information to clients on what is known about vitamin D in terms of general health benefits during pregnancy. The World Health Organization (WHO) notes that vitamin D deficiency is associated with increased chances of pre-eclampsia, gestational diabetes and pre-term birth. WHO provides information on vitamin D supplementation, including their guidelines and evidence on the topic, here.

Vitamin D deficiency: http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/expert-answers/vitamin-d-deficiency/faq-20058397 and http://www.mayoclinic.org/drugs-supplements/vitamin-d/evidence/hrb-20060400

ANESTHESIOLOGY ™ study: http://www.newswise.com/articles/moms-to-be-with-low-vitamin-d-levels-could-have-more-painful-labors and http://www.inquisitr.com/1540849/vitamin-d-could-make-childbirth-easier/

— Adrianne Gordon, MBA, CD(DONA)

In Case You Missed It: Homebirths Encouraged for British Mums

Last month, Britain’s National Institute for Health and Care Excellence released new guidelines encouraging women with uncomplicated pregnancies – roughly 45% of all pregnancies in their estimation – to have their babies at home or in a birth center instead of a hospital. This new advice marks a significant shift in the NIH’s position on birth location, which as recently as 2007, advised caution about home birth. The change came, in part, from the findings from a 2011 Oxford University study that found that low risk mums-to-be birthing in a hospital had a higher risk of cesarean delivery, infection, and episiotomies. The study also noted that hospital-based births are more likely to include epidural anesthesia, which was found to increase the risk of protracted birth and the use of forceps. The overall risk of serious complications and death for infants was found to be the same across hospital, birth center, and home births for multipara mothers. First-time mothers birthing at home have a slightly increased risk for such complications.

home-479629_640Going forward, pregnant women in the UK expecting their first baby will be encouraged to seek care from a midwife-led delivery unit either based in a hospital or out-of-hospital. Those having their second or subsequent baby and considered low-risk will receive even greater encouragement to delivery at home. The guidelines recommend informing multipara mothers that a home birth would be just as safe for their baby and an even safer option for them than delivering at a hospital. NIH’s announcement about the new guidelines says, “Healthcare professionals should inform women of the options available to them and advise that they have the freedom to choose where they give birth.”

Read the full announcement from NIH here.

Additional coverage of the guidelines can be found at The New York Times and The Guardian.

Make S.M.A.R.T. Plans for 2015

new-year-586148_640A new year is upon us and with it comes planning for the months ahead. While some may resolve to start or expand a doula practice (pun intended!), it’s no secret that the right kind of goals can make all the difference in what you will achieve in 2015.

It is commonly known that writing down goals increases your chances of achieving them. But did you know that how you set those goals also impacts the chances they will be achieved? S.M.A.R.T. is an acronym that is both easy to remember and also provides very helpful tips in creating goals that are more likely to be achieved. It stands for:

Specific, Measurable, Achievable, Relevant and Time-bound

Specific – This means that the goal isn’t overly general such as “Become a doula.” What kind of doula – birth or postpartum? Does this mean attend a training? Complete certification? With what organization?

Measurable – There is a quantifiable aspect of the goal such as “Complete the remaining requirements for my birth doula certification.”

Achievable – This helps prevent the goal from being too large or complicated. For example, “Attend five births as a certified doula” might be too big of a goal for someone who hasn’t yet attended a training or reviewed the requirements to be certified – it simply may be too much to accomplish in the time available.

Relevant – While this generally applies more when someone like a supervisor is setting a goal for you, it is important to make sure that the goal is worthwhile and matches up with other goals and plans. For someone expecting a baby, finding a doula may be more relevant to where she is in life than becoming one! Of course for others, pregnancy may be the perfect time to lay the foundation for a flexible career that she can manage from home; it’s a matter of considering the whole picture.

Time-bound – Setting a specific deadline can make a big difference in whether a goal is achieved or not. This is particularly true when you have several steps which together achieve a larger, overall goal. For someone embarking on a doula career, setting deadlines to choose a training and certifying organization, completing the training, and supporting her first client will go far to help achieve the larger goal of becoming a doula. For someone who wants to finish up her certification and then expand her practice as a certified doula, her S.M.A.R.T. goals might look like this:

  • Find certification packet and review outstanding requirements by January 15th.
  • Complete reading requirements by March 31st.
  • Write essay by April 15th (sometimes shorter time frames can help stave off procrastination!).
  • Create resource list by May 15th.
  • Collect Client Confidentiality Release Forms, birth record sheets and client evaluations from all clients in 2015.
  • Request evaluations from care providers at every birth attended in 2015.
  • Submit completed certification packet by June 30th!

Remember that writing goals down can help make them a reality. Sharing your goals with family or a close friend who can help keep you accountable can also help keep you on track as well. Here’s to S.M.A.R.T. plans for 2015!


— Adrianne Gordon, MBA, CD(DONA)

Flu & Pregnancy – New Research Published

flu in pregnancyTwo studies published this fall provide important information on the flu in pregnancy. First, reviews of Centers for Disease Control data from recent flu outbreaks show that pregnant women who contract the flu are at higher risk for complications and overall have worse outcomes. Their babies can also suffer complications, including preterm birth and low birth weight. The flu is a serious illness for pregnant women but little has been known on exactly why. Theories have included a) that pregnant women have a weakened immune response to illness in general which may help prevent the rejection of the fetus and b) that changes in the body due to pregnancy exacerbate flu symptoms. New research from Stanford University, however, has uncovered new and surprising information about how a pregnant woman’s body responds to the flu.

The Stanford researchers found that pregnant women actually have an unusually strong immune response to the flu virus. Senior author of the study Catherine Blish MD, PhD said, “We now understand that severe influenza in pregnancy is a hyperinflammatory disease rather than a state of immunodeficiency. This means that treatment of flu in pregnancy might have more to do with modulating the immune response than worrying about viral replication.”

This could have important effects on how the flu is treated in pregnant women. The current course of treatment is medication to slow the replication of the virus. This, however, does not address the newly discovered hyperinflammatory response of a pregnant woman’s immune system. This is particularly important in maintaining adequate lung function in pregnant women suffering from the flu where inflammation – even when caused by too many immune cells – is of particular concern.

The physician authors of both studies recommend pregnant women receive a flu shot to reduce their risk of contracting influenza. We recognize there is a strong debate about vaccinations and encourage doulas to share evidenced based information with clients so that they can make informed decisions. Our friends over at Lamaze International’s Science & Sensibility blog have a great post from 2011 about the flu vaccination in pregnancy with a number of resource links.

– Adrianne Gordon, MBA, CD(DONA)

CDC Flu Data Review
Study Summary
Interview with CDC Study Author

Stanford Study on Immune Response
Press Release from Stanford Medicine
Study Abstract

Positions Available With DONA International!

DONA International is currently accepting applications for two publications committee contract positions, Blog Manager and eDoula Newsletter Editor. These positions are open to experienced and qualified DONA International members, preferably those currently certified. The application deadline is December 23rd, so don’t delay if you are interested!

The eDoula Newsletter Editor oversees and coordinates publication of our quarterly regional e-mail newsletters, working closely with our director of publications and regional directors to deliver newsletters that keep our members informed and connected. A generous stipend is offered for this one-year appointment, with the option to renew.

The Blog Manager oversees and coordinates publication of this DONA Doula Chronicles blog by authoring or commissioning content that will build and sustain awareness of birth and postpartum issues relevant to our members and the general public. A generous stipend is offered for this one-year appointment, with the option to renew.

We are looking for creative, energetic and enthusiastic professionals with related experience to engage and support our membership! Perhaps you have the necessary qualifications and are the perfect person for one of these positions? Email Publications@DONA.org for the job descriptions and application details.

Winter Weather Tips for Doulas

Originally posted on The DONA Doula Chronicles:

This winter has packed a powerful punch with snow, ice, and frigid temperatures for parts of the U.S. and Canada that hardly ever see this type of weather.  What’s a doula to do? Support and availability to clients during the winter months can present unique challenges. Whether you are a veteran doula used to snow storms or a novice doula from the balmy South, here are some tips to help you stay safe, comfortable, and better able to serve your clients during the winter months:

1. Keep your gas tank full.  This doesn’t mean you need top-off your tank daily, but keeping your car with a good amount of gas is a good first step in staying safe and warm. There’s nothing fun about having to stop for gas on your way to a birth on a freezing winter night.  In the event you get stuck, you’ll have fuel…

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Doulas on TV: Frasier to Bones and Beyond

screen-92134_640The birth community has been abuzz about the latest portrayal of doulas on a primetime television show. Yes, the doula in Bones was outside of our scope of practice and, in general, did not provide the appropriate emotional, informational and physical support she was hired to provide (which is why she was fired). Many blogs and social media accounts related to birth have decried this portrayal of doulas to the millions who watched Bones that week.

Wait…..over five MILLION people saw the episode of Bones that included a doula? And since then there have been dozens if not a hundred conversations in on-line birth communities about what doulas do and don’t do? Is that necessarily a bad thing? Would there have been so many conversations if the show portrayed a doula practicing within her scope and providing excellent support to the mother? Probably not. No one is talking about the OB-GYN in the episode, now are they?

While it is hard to watch (personally, I have been known to yell at the television during birth scenes but I digress), the inclusion of doulas on mainstream television shows is a testament to how far we have come. The episode didn’t include people mispronouncing “doula” or questioning the mother for hiring one, for example. It was assumed that the viewers knew what a doula was and that hiring one was a completely appropriate choice!

This isn’t the first or last time doulas will be mentioned or shown in a sitcom or drama. Doulas were portrayed for the first time on primetime American television in 2004 when the then number one comedy show Frasier introduced millions of people to doulas through a character named “Harvest.” Doulas and the birth community were abuzz then as well. Then DONA International President Ann Grauer said at the annual conference that year, “Thanks GOODNESS there was a doula on Frasier! It’s the number 1 comedy in America and we just made prime time history! Yes, she was far from reality, but so are wine enthusiasts, radio talk show hosts, and psychiatrists as portrayed on Frasier. To be parodied in a mainstream television program means we have arrived and we need to celebrate it and have a sense of humor about it.”

Her wise words apply to Bones and the various appearances of doulas or the concept of a doula on TV in the last 10 years. Since Frasier, doulas have been shown on Mad About You , A Baby Story, Tia & Tamara, The Rachel Zoe Project (featuring DONA International Board Member Ana Paula Markel) and Mulaney among others. And just like the lawyers, accountants, police officers, bartenders, and contractors shown in television shows, these portrayals are dramatizations or caricatures. Even so called “reality shows” use plot lines and editing to create drama and humor to keep audiences interested. And remember, not every mention or portrayal of doulas is negative. Suze Orman’s show Can I Afford It? addressed the value of doulas with this great quote from the financial advisor “You cannot afford to not get a doula. It’s a need, not a want.”

Our job as doulas and doula advocates is to use TV portrayals of the profession to start conversations about what doulas do, what we don’t, and the value we bring to birth and the postpartum period. And yes, to have a sense of humor about it. After all, not every workplace is The Office, either.

– Adrianne Gordon, MBA, CD(DONA

Tis the Season – Tips for Doulas During the Holidays

candle-432813_1280While marketing began weeks ago, the holidays are closing in (really). It is a special time of year, yet one that can bring a good bit of stress, too. Here are a few things to keep in mind as you support clients between now and New Year’s:

This time of year includes extra events, activities and demands on your time and energy. Pause before saying yes to commitments and evaluate your overall schedule and obligations. Be realistic about what you can do. Not overcommitting will help reduce stress and mean less to juggle.

Create back-up plans for events and responsibilities. Having more on your plate means needing a wider safety net than usual, whether that’s extra child care support, backup doula arrangements or even a plan B for getting those cupcakes to your child’s school event. Ask for help where you need it. Everyone needs a hand now and then, and doulas are no exception!

Increase your communication with doula partners or back-up. This can be incredibly helpful in alleviating stress and providing support to one another. Coordinate client check-ins or follow-ups and adjust on-call schedules, if needed.

Make time for self-care. Give yourself what you need to manage your own stress and wellbeing, whether its downtime, connection with others, exercise or quiet. Support your own health and remember that this is the beginning of cold and flu season. Eat well, sleep, stay hydrated and be mindful of sugar and alcohol consumption.

This is a busier and more demanding time of year for our clients, as well. They may be pushing themselves too hard or may be too distracted with activities, shopping, cooking, visitors and travel to pay attention to how they are feeling. Self care declines for clients also during November and December. Be sure to check in and encourage rest, hydration and healthy eating.

Be compassionate with yourself and others. We’re all busier and more distracted this time of year. This is a season of giving and gratitude, so don’t forget to extend that to yourself! We’d love to hear your tips for supporting clients during the busy holiday season. Share in the comments. Enjoy the season!

— Adrianne Gordon, MBA, CD(DONA)

In Case You Missed It: Online Continuing Education for Doulas

Staying up to date on evidence-based information, best care practices and how to continuously improve a doula practice is no easy task. These days many educational options are available on-line for degrees and certifications. While doula support is a very hands-on and personal service, staying up to date via the web can be a great way to stay informed and keep your doula practice inspired and growing around your busy schedule. To support the continuing education of busy doulas and build on our 2013 virtual conference, DONA International has launched Every Doula Everywhere & Anytime Webinars.

These webinars are available via on-demand viewing, so they are available 24/7 and have already been evaluated by DONA International to ensure they are relevant, current, evidence-based and within the organization’s scope of practice for doulas. Most are around an hour in length, and all provide DONA International contact hours (1 hour for 60 minutes of webinar) for recertification. If you are a member of DONA International, you get one FREE webinar per calendar year. Watch your email for your code for your free session. Otherwise, webinars are $20 each with the proceeds going to DONA International to support, train and grow doulas.

There are four webinars available now with two more offerings being added every month. Currently available are: Master the Doula’s Advocacy Role (Kim James), Successful Ways to Manage Your Doula Business (Stefanie Antunes), Decision Fatigue (Penny Simkin) and Cracking the Code of Social Media (McCulloch/Boucher). December will bring Safely Wearing a Newborn (Serena Weingrod) and Beyond Competition: Birthing Your Doula Business (Sarah Juilusson).

Keep up with what’s being offered here at The DONA Doula Chronicles, via DONA International’s Facebook group or right on the virtual training site: https://www.vconferenceonline.com/dona/.