Conference Sneak Peek: Advanced Peanut Ball Techniques


Photo courtesy of Premier Birth Tools

Cheri Grant is known as The Peanut Ball Lady, and her mission is to teach the world about the effectiveness of peanut balls (peanut-shaped exercise balls) in labor. She trains other professionals to become authorized peanut ball trainers, and two of these trainers – Amy Bookwalter and Amy Emerson – will be presenting the DONA International preconference workshop “Advanced Peanut Ball Techniques: Lowering Cesarean Births with Positions.” We asked Cheri to give us a little bit of background about her interest in peanut balls and their value in labor support.

How did you discover the peanut ball and become interested in it as a tool for doulas? 

I was looking for something new to teach doulas in my doula training, and I came upon a study by a nurse at Banner Health in Phoenix, AZ (the first to use peanut balls in labor). The nurse, Tussy, had received reports that peanut balls helped women avoid cesareans. She was curious, and she tested and reported on this new idea, which is the report that I came across. (Here’s more info about the report: Tussey, Botsios, Gerkin, Kelly, Gamez, Mensik, “Reducing Length of Labor and Cesarean Surgery Rate Using a Peanut Ball for Women Laboring with an EpiduralThe Journal of Perinatal Education, 24(1), 16–24,

I was intrigued, and I called a nurse on the night shift at Banner Health who said that the peanut balls were working really well for their patients. She also told me that they originally started using the peanut ball because the pillows they used in between patient’s legs kept falling and sliding. They replaced the pillows with the peanut ball and had great success!

After speaking with the nurse, I tried the peanut ball on a few clients, and I was amazed. I learned as much as I could and then started teaching doulas and nurses how to use it. I was also able to quickly get peanut balls available at 13 area hospitals within six weeks by giving in-services, and it took off from there!

After its quick success, I learned more about positioning, how to use it effectively and which size worked well with which client in different positions. I have now sized hundreds of clients and taught more than 500 in-services to nurses and doulas on the proper use of the peanut ball.

We’re really excited about the evidence based research on peanut balls that has happened over the last two years, and especially in the last few months. This research, as well as clinical trials, will be discussed in the workshop.

What will doulas who use the traditional round birth balls learn about peanut shaped balls that might surprise them? 

I want everyone to know that the following information:

  • One size does not fit all clients
  • Different positions require different sizes of peanut balls
  • Peanut balls can be used for comfort and positioning a client to facilitate the birth

Why is positioning so important to help support a client in having a vaginal birth?  

If a baby is stuck in a certain position, or a client’s labor is stalled, you have to move the woman to move the baby. It’s just like having a ring stuck on your finger. You don’t pull it straight off; you twist and turn to get the ring off the finger. In labor, you have to move the woman to get the baby out.

What are some resources on the importance of positioning to reduce the risk of cesarean birth?  

We have lots of information about peanut balls and positioning on our website: We also have a packet, created just for doulas, with lots of helpful information. We’ll go more in depth at the workshop, but this information is a great for anyone wanting to learn more. For those at the workshop, we’ll go through seven traditional peanut ball positions and more than five new positions, including the BEST position to use.

Is there anything a doula should do in preparation for this session?

This is a fun and interactive workshop, so I’d recommend dressing in comfortable clothes. Be ready to practice, and be prepared to have fun!

I love talking about peanut balls, so please don’t hesitate to reach out to me at! Enjoy the workshop at conference!

Certification Still Matters: Certified Doulas Earn Higher Fees and Attract More Clients

Editor’s note:  Last July, Kim James provided an article with information from on which doulas received the most referrals and charged the highest fees. Her article, Certification Matters: CDs and PCDs Get Higher Fees and More Clients, was based on six months of data (January – June 2015).  In this update, Kim draws from a year of data from with the same conclusions. Our thanks to Kim for sharing this update with expanded data. Evidence-based information is important for your doula business too! — AG

Certification Still Matters:  Certified Doulas Earn Higher Fees and Attract More Clients


From the doula availability database,, we have solid evidence that DONA International certified doulas consistently earn a higher fee and receive more referrals than non-certified doulas and doulas certified through other organizations.

From July 1, 2015 through June 30, 2016, 5,258 active doulas in the database received at least two or more referrals.  See chart below:


DONA International certified doulas commanded a 25% higher fee than non-certified doulas and a 7% higher fee than doulas certified through other organizations.  DONA International certified doulas also received twice as many monthly referrals.

What’s more interesting is to look at how DONA International certified doulas compare to other doulas with the same amount of experience.  See chart below:image004

At all levels of experience, certified doulas, and DONA International certified doulas in particular, earn higher fees and attract more clients.

For new doulas, achieving a meaningful certification means you are more attractive to potential clients, especially when you’re just starting out. When you don’t have a lot of births under your belt, having a recognized certification demonstrates to potential clients that you are an effective doula. You’ve achieved a major professional milestone that gives you an edge over doulas with the same amount of experience who are not certified or are certified through lesser-known organizations.

For established doulas, experience is the great equalizer and decreases the fee and referral gaps.  However, achieving and maintaining certification demonstrates your professional commitments and validates your higher fee, even when your practice is established and thriving.

Families who use a database to reach out to doulas are probably looking for mid-priced doulas with moderate experience. When faced with a lot of choices, whether or not a doula is certified seems to matter. For doulas with moderate experience of two to seven years, 60% of all referrals went to certified doulas. Of those certified doulas, 50% were DONA certified.image006

Whether you’re just starting out or firmly established, achieving and maintaining certification is solid business decision that benefits not just families and our profession, but you as a doula business owner.

James, KimAbout the Author

Kim James has run a successful birth doula business for 16 years in Seattle, Washington. Kim’s roles in the birth community include: DONA-approved birth doula trainer at the Simkin Center for Allied Birth Vocations, childbirth and parent educator at Parent Trust for Washington Children, DONA International Washington State Representative and Lamaze International membership committee member. Kim is also the owner and operator of

Conference Sneak Peak: Saturday Night Performance by Melissa Bangs

Melissa BangsPhoto courtesy of Nichole Peterson/NP Images

Hearing someone’s story is one of the best ways to deepen our understanding of their experience.  Storytelling can play a powerful role in healing for the teller and provide perspective to the audience. One brave woman will be telling her story of returning to wholeness through a postpartum mood and anxiety disorder diagnosis at the 2016 DONA International conference.

Melissa Bangs is a storyteller and performer embarking on a one year tour to tell her story of motherhood from the birth of daughter Adelaide to her nearly month long stay in a psychiatric hospital and, finally, her return to health. In Playing Monopoly with God and Other True Stories, she uses honesty and humor to get to the heart of the matter promoting awareness, healing, and hope. Melissa shared a few thoughts with us about her upcoming performance and the role she sees doulas in promoting awareness, compassion and support for women experiencing postpartum mood and anxiety disorders. Tickets are available for Melissa’s 7pm Saturday night conference performance and DONA International will benefit from the proceeds.

— Adrianne Gordon, CD(DONA, MBA


Why are you excited to perform at the 2016 DONA International conference?

Doulas, as well as midwives are, for me, real life superheroes. Each and every one of you should wear a cape.  Truly.

Women are not meant to bear or raise children alone.  Families are not meant to raise children in an isolated way.  And yet we do.  In our modern culture, so many of us are far from support systems and the close-knit, multi-generational models of the past.

Doulas are a beautiful and profound way to close the gaps that modern living has created. Doulas have the power to powerfully prepare, accompany, support, advocate for, hold and honor mamas and papas in these beautifully potent yet often incredibly vulnerable and even bewildering chapters of their lives.  Often a doula will be a mother’s closest ally among all of the healthcare providers within her birth journey.  The potential to support mamas in difficult postpartum chapters is profound.  Of course you all know this!  You do it every day and have done it for eons!

Why is it important for doulas to hear your story?  

My hope is that you will hear and see and feel yourselves in my story, your clients in my story, moms and motherhood.  This is one mother’s story told without shame, with brutal honesty and a great deal of self love.  It is a story that could have remained, like so many shrouded in shame and stigma, and yet, I felt called to share it from a mountain top so that so many others might feel the room, the call, the permission to name what is, to feel less alone, to get help and to forgive.

What’s one thing we should take away from your performance?

If my story does nothing else, may it unleash yours!

And a second thing- postpartum mood and anxiety disorders are the number one birth complication,  and yet, far too often, we are not talking about them.

Whether you are a birth doula or postpartum doula, my hope and call is that the entire birth field, doulas included, will garner extensive and appropriate training on postpartum mood and anxiety disorders and each play our role in peeling back the layers of shame and silence and proactively tackling an issue/an experience that is vastly shared and yet rarely talked about.

How can doulas apply what we learn and experience from your performance?

If you aren’t doing so already, have these conversations with your clients – during pregnancy, just after birth and in the weeks and many months that follow. Ask the tough questions.  Provide the full spectrum of possibilities. If you haven’t already, fully educate yourself on postpartum mood and anxiety disorders and the referral resources in your community.

You are, as you know better than I, the front line.  Postpartum doulas are often the only professional worker seeing mama.  Or it may look like the doula, perhaps the midwife for a handful of visits, and then the pediatrician.  Each has their role in providing a safety net for moms, a role in education, prevention, screening and accessing services when needed.

Doulas already know, so intimately and deeply, how important this topic is.  Many know it much more so than I do.

How can doulas best support women dealing with postpartum mood disorders?

Have the open and frank conversations about all of it, from the bliss to the abyss.  Make  known before baby is here the array of PMAD (postpartum mood and anxiety disorder) possibilities.  Normalize it, because it is very common.  Make yourself an ally and nonjudgmental resource that moms (and dads!) can reach out to with questions with strange and disturbing thoughts or experiences and with the vulnerable and bewildered parts of themselves that they have never met before.  Be the safe place, the informed place, the place of resources.

In the realm of maternal mental health at this time in the U.S., therapy and pharmaceutical medication are the two most common responses, and each have their own power and efficacy.  Therapy alone has proven to cut the rates of postpartum depression in half.  This is monumental.  Talk to mama! Get to her talking to other mamas!  Let her know about postpartum support groups or form one.

Medication can also prove effective and even life-saving for some mamas.  Find a psychiatrist or psychiatric nurse practitioner with perinatal mood and anxiety disorder training and expertise to refer your clients to.  Beware that many do not have this training and can be a real disservice to mamas.  If you don’t have a lot of local resources, connect moms to Postpartum Support International and Postpartum Progress so they have access to a hotline, closed discussion groups on Facebook, and highly trained professionals for support.

Also, educate yourself about alternatives available to psychotropic drugs as these options do not work for many moms. I, for one, could feel nothing on my medication. Nothing.  I had to find another way, and I did. I found a naturopathic physician who tested and balanced my hormones and neurotransmitters, and brought me back to stasis and off medication incredibly quickly.  She gave me my life back.

What else would you like doulas to know?

Doulas sit in a powerful place with the possibility of educating leagues of mamas and papas about the possibilities for their postpartum experience and the options for help and treatment, if needed.

You are the wonder women; you engage in the miraculous nature of new life every day, and you bear witness! I see you at the forefront of closing the enormous gap in services for mamas and families postpartum in this country.

Thank you for all you do and have done!

What’s next for you?

In September, we kick off a nine city west coast tour with the show.

We have just moved into a 19 foot Shasta Airflyte trailer and will for the next year make our way from Bellingham to Baja.  By we, I mean my 6’4” hubby Eric, our 130 lb Bernese Mountain dog, Etta James, and my nearly four year old daughter,  Adelaide, the only member in the entourage who has graciously agreed to remain small for the journey, and me.

We kick off the tour in Bellingham at Mount Baker Theatre September 13th and 14th.  Our second stop in late October is Seattle’s town hall, a unique and powerful performance space.  Then we wind our way down the coast from there.

Beyond the tour and in tandem- conferences, university performances and leading the preliminary phases of statewide strategic planning on maternal mental health in Montana (my other hat… strategic planner). Oh yes, and a book!

Find out more about Melissa, her story and performances at

Is Homebirth Safe?

The safety of homebirth has been much discussed in the birth community over the last few months following the publication of a study in the New England Journal of Medicine at the end of 2015. At the upcoming DONA International Annual Conference, Dr. Michael Klein, a Family Physician, pediatrician, and neonatologist who has delivered more than 2000 babies during his 30 year career will speak on this very important topic. Dr. Klein has not only expertise and experience to bring to the conversation on the safety of homebirth, but also a unique perspective to share. He has worked alongside midwives for over three decades, is both an American and a Canadian, served as a member of the British Columbia Midwifery Implementation Committee that oversaw the integration of midwifery into regulated practice and is one of the researchers that studied five years of outcomes of all home births in British Columbia. Here he shares some of this thoughts on the NEJM study and the safety of homebirth in general. His session at the 2016 Annual Conference is one not to be missed! – Adrianne Gordon, CD(DONA), MBA, Blog Manager

Our five-year British Columbia study has conclusively demonstrated the safety of home birth, such that the College of Physicians and Surgeons of British Columbia have rescinded their long-time ban on physicians working with midwives in home birth.  Similar studies from Ontario, including the most recent study just published in the Canadian Medical Association Journal, continue to show home birth to be safe. (2,3)  In all Canadian studies and several US studies, women experiencing out-of-hospital birth received dramatically fewer interventions, including caesarean sections, than their counterparts giving birth in hospital — leading to fewer complications in the present and future pregnancies.

Why the controversy?The controversial New England Journal of Medicine study is limited in what it can tell us. It is a high level look at outcomes by planned birth site. Such an analysis cannot and does not claim to allow us to know what was actually going on. We can only say that something was going on between the births in the two main outcome categories. Looking at the case reviews from 2012, and assuming a similar result for 2013, I find that a total of eight cases of perinatal death occurred in the planned out of hospital (OOH) category. It was on the basis of this very small number of cases that the statement was made thatthe number of perinatal deaths occurred in the OOH group compared to hospital (similar to 2012-13).

The review also shows that some of the women planning OOH births clearly rejected conventional screening or had conditions incompatible with appropriate home birth criteria. With such a small number of cases, it is impossible to know if the outcomes of interest are due to care, system issues, certification or licensure of attendants or a combination of these factors. Regardless of licensure or certification, midwives like doctors, will have variable skills and judgement. I do not see how it is possible to make a judgement on the quality of care provided by various types of midwives, based on such small numbers.

What should a woman planning home birth know? Doulas in the U.S., Canada and elsewhere need to know the basic information about the conditions for a potentially safe home birth. In the U.S., I would say that when thinking about a home birth or OOH birth a woman needs to ask the chosen provider:

1. How much training and experience does she have and in what settings and under whose mentorship did she acquire that experience?

2. What are her relationships with her backup system and receiving physicians? (Will her backup supports receive her consultation or transfer easily and without judgement)

3. How often does she require transfer for her clients? (It ought to be 15-20% for various reasons)

4. How quickly can she effect transfer should transfer be needed?

The answers to these questions will help women decide if OOH birth is a reasonable and potentially safe decision. Doulas, while not responsible for the birth, nevertheless need to be up to date with the home birth data and appreciate local conditions that may or may not be appropriate for a safe home birth.

And home birth saves money too. All studies that have looked at the costs of home birth vs hospital conclude that home birth is substantially less expensive for the system. (5)

It is critical that those choosing to deliver outside of the hospital or birth center are attended by qualified providers, who must have minimum educational requirements, performance standards, and professional accountability.

Michael KleinAbout the Author

Michael C. Klein MD, CCFP, FAAP (Neonatal/Perinatal), FCPS, ABFP
Professor Emeritus, Departments of Family Practice and Pediatrics
Senior Scientist Emeritus BC Child and Family Research Institute
Centre Developmental Neurosciences & Child Health
Children’s and Women’s Health Centre of British Columbia


  1. Janssen PA, Saxell L, Page LA, Klein MC, Liston RM, Lee SK, et al. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ Canadian Medical Association Journal 2009;181(6-7):377-83  
  2. Hutton EK; Reitsma AH; Kaufman K. Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth. 36(3):180-9, 2009 Sep.
  3. Hutton EK, Capaletti A, Reitsma A, et al Outcomes associated with planned place of birth among women with low-risk pregnancies  CMAJDecember 22, 2015 First published December 22, 2015, doi:10.1503/cmaj.150564
  4. Snowden JM  Ph.D. Tilden E, Snyder J et al. Planned Out-of-Hospital Birth and Birth Outcomes. New England Journal of Medicine. 2015;373:2642-53. DOI: 10.1056/NEJMsa1501738
  5. Janssen PA, Mitton C, Aghajanian J (2015) Costs of Planned Home vs. Hospital Birth in British Columbia Attended by Registered Midwives and Physicians. PLoS ONE 10(7): e0133524. doi:10.1371/journal.pone.0133524

10 Reasons You Should be at the 2016 Conference!

#DONA16 Countdown Images (1)

In just a few weeks, the DONA International Annual Conference: ENGAGE will take place near Seattle, WA. Here are 10 reasons you should be at #DONA16!

  1. Learn new skills and evidence based information.  Continuing to grow your skillset and stay up-to-date on the latest research in the maternity care field is critical for growth as birth and postpartum professionals. This year’s conference provides 7 general sessions and 24 concurrent sessions with leaders in the field plus 3 pre-conference sessions. It’s an all-star line-up you won’t want to miss!
  2. Build your practice. The 2016 conference includes sessions on how you can better engage in building your doula practice including practice models, systems and tools to streamline the business aspects of your practice and marketing to reach your ideal clients. However you want to approach building your practice, we’ll have sessions that support your goals.
  3. Meet re-certification requirements. Maintaining certification demonstrates commitment and furthers the idea of doula support as a legitimate profession to be respected by families and care providers. While there are a number of ways to earn this continuing education contact hours none are as are engaging and fun as the annual conference!
  4. Expand your network.  Connect with doulas from around the world to learn from and support each other. The work we do is challenging! While each area is unique, many of the challenges of creating a sustainable practice, attracting ideal clients, meeting changing client needs, educating the community about doula support and building relationships with care providers are universal. Learn from those who have been in the field for years as well as those who have newer and have fresh ideas and perspective.
  5. Meet your DONA International founders and Board members in-person.  The annual conference provides a unique opportunity for members across the globe to meet and talk with those who founded not only DONA International, but the profession. Breaks and meals are a great time to get to know your Board of Directors personally.
  6. Learn about the future of DONA International. The annual member meeting at the conference will be very special this year as we celebrate the future of our organization to better meet your needs and uphold the standards DONA International has set for the profession. Find about the member survey results and be the first to hear some exciting announcements. Come find out what’s next for the world’s largest and longest-standing, premier doula organization!
  7. Be inspired! Between the great sessions, networking with speakers, founders, Board members and attendees the conference is a wealth of inspiration. How will you grow as a doula? How will you better meet the needs of your clients and community? What ideas, resources, tools and skills will you take back to your doula work so that you can have more impact and meet your professional goals? The sky is the limit on what you can achieve and who you can touch! Be prepared to leave energized and ready to take expand your work in birth and postpartum support.
  8. Return to our Seattle area roots.  Let’s face it, conference aren’t just all work, there’s lot of play too! Celebrating the future of DONA International where the organization started has a lot of members really excited. The area has a lot to offer from the Bellevue Arts Museum to Pike Place, the Space Needle and beautiful scenery.
  9. Stock your library and toolkit. The annual conference always includes an exhibitor area to discover books, tools and other resources hand selected specifically for doulas. This year we’re also adding a silent auction you won’t want to miss!
  10. Invest in yourself. As doulas we givers, the annual conference is an important opportunity to invest in yourself as a birth and/or postpartum support professional for renewal, skill building, networking and time to focus on your practice. When you purchase your conference ticket, you are investing in your own growth as a professional.  2016 is the first in-person conference created just for DONA International members in four years. You don’t want to miss this chance to devote this time and energy to yourself.

See the full agenda with sessions and speaker bios at Early bird registration ends soon! Get your ticket before the price increases!

Sailing Through Certification: Packet Reviewer Tips Part 2

Sailing image only.jpg

This is the second installment in our Sailing through Certification: Tips from a Packet Reviewer series.  Birth doula certification packet reviewer, Julia Schetky, posts tips on DONA International’s Facebook groups each week with tips for those preparing that precious packet. The first post here at The DONA Doula Chronicles, covered some key tips on legibility, completeness and organization that apply to both birth and postpartum packets purchased anytime. Be sure to start there!  This second part of the series covers the all important essays  and the resource list. We’ve also included special tips for the resource and reading lists for packets purchased before October 2015.

Don’t forget to post our social media channels when you get that certification call so we can congratulate  you!

Essay: Value of Birth or Postpartum Support

This element of the certification process helps the doula integrate all she has learned and demonstrate that learning. It also shows understanding of the role of a doula and our scope of practice.

  • Review the description of this essay in your packet. It lists all of the things that should be discussed in your essay. All of these items need to be addressed or you will have to revise your essay and re-submit it to the reviewer.
  • The position paper, Scope of Practice and Code of Ethics are key resources for writing this essay. Reread them when you get ready to write it and keep them handy as a reference.
  • Code of Ethics/Standards of Practice elements need to address whether doulas are clinical or non-clinical care, the role of advocacy and continuity of care.
  • List how doulas make a quantifiable and measurable impact on families. Hints: there are at least five and the research publishes in the Cochrane Library in 2011 is your go-to resource.
  • How do doulas impact partners and families? Be sure to demonstrate your knowledge of how doula support is valuable to them as well as the birthing individual.

Essay: Birth or Postpartum Support

In many professions, those who are in training are observed when they first work begin providing their services as a resident, apprentice or junior associate. The essays, along with the Labor Progression Sheet for birth doulas, fills this role by giving DONA International insight into how you supported this client, what skills you used and how you navigated your role as the experience unfolded. Birth doulas, keep that Labor Progression Sheet handy so you can be sure the two documents work together to tell the whole story and so you know what details you don’t need to cover in your brief essay.

  • Respect the word limit! We know it’s hard to summarize the hours you’ve spent with a client and all that happened during their labor or postpartum experience into such a brief essay. This is CliffNotes version of the experience. Be succinct. Remove any extra words and focus on the specific things that are asked for.
  • Using headings before paragraphs that summarize each piece (for example from the birth doula packet purchased prior to October 2015: Description of the Birth, Role as the Doula, Mother’s Reaction to the Process, What You Learned).
  • Edit, edit and edit some more!

Resource List

Some doulas see the creation of a resource list as busy work, but nothing could be further from the truth!  Doulas are an important bridge for families to other services and resources in the community. Having strong knowledge of where you can refer clients when needs arise is a key function of being a doula. The resource list is really a tool for you to provide the support and information your clients need.

  • Remember the total list is at least 45 items.
  • Resources are needed in 30 categories to ensure you have appropriate referrals and information sources for a range of client needs.
  • Include at least two ways that clients can get in touch with each resource (phone, email, website or physical address).

Additional Tips for Packets Purchased Before October 2015

For those working on completing a certification packet purchased before October 2015, here are some tips that will support a quick review of your certification packet.

References List

  • When you are notified your packet has been received for review, notify your references so they are expecting to hear from someone with DONA International. Find out what the best times are to reach them and let your reviewer know.
  • Birth professionals:  Be sure these references know you well know to answer questions about how you work with others in the birth and postpartum community. Also consider how reachable these references are. It’s notoriously difficult for packet reviewers to reach doctors via their main office phone number or to connect with nurses who work night shift.
  • Clients: Consider how reachable this person is and if they can speak to your strengths as a doula as well as areas where you need to grow.
  • Have a back-up reference or two in case your primary references are hard to reach. This is often a factor in packet reviews that take longer than average.

Reading List

  • For the first section, you must have read all three items listed.
  • In the subsequent sections, you are to read at least one from each category.

We are grateful to Julia Schetky, CD(DONA) for her support of DONA International doulas working toward certification. For additional support, feel free to contact Certification Director Johanna D’Aleo at

Sailing through Certification: Tips from a Packet Reviewer Part 1

Obtaining those CD(DONA) or PCD(DONA) credentials comes from a combination of training, experience, independent learning and reflection. Certification demonstrates proficiency, professionalism and dedication to the field. The documentation of all of the certification steps are collected in the certification packet. The packet contains documents and forms the doula submits once all steps for certification have been completed and is something like a doula thesis project. Certification packets are reviewed by a team of trained DONA International doula volunteers. They have been through the process themselves, so they know firsthand how important that manila envelope is! One of the birth doula packet reviewers, Julia Schetky, has been posting on the DONA International Facebook group with tips to help ensure your packet is complete and organized so that it can be reviewed and approved quickly. The turnaround time for certification packets has been greatly improved in recent months with new internal processes at DONA International. Receiving complete, organized and legible packets helps keep those packets moving through the review process in a timely manner for everyone.

We’ve summarized some of Julia’s top tips to help your packet sail through the review process. Look for Part 2 in this series in a few days on the essays, resource and reference lists. We’ll continue to build this series. Julia posts new tips each week to our Facebook group.

Don’t forget! Once you get the call that you’re certified, but sure to post on our social media channels, as we love celebrating our newly certified DONA International doulas!

— Adrianne Gordon, CD(DONA), MBA


Reviewers can’t evaluate what they can’t read! For birth doulas, it’s nearly impossible to complete the Labor Progression Sheet while supporting a client. Simply take notes while you are supporting the client (it can be helpful to keep a blank form in your doula bag so you can remember what to document) then later, after the birth (and a nap!) sit down and complete the form using your notes.

  • Submit only final versions of all documents. No drafts please.
  • Type or print your answers on all forms.
  • Birth doulas, if using a packet purchased after October 15, 2015 write carefully in order to stay within the boxes on the labor documentation form. If absolutely necessary print a second form and make a note that there is a second form. Be sure to label that form with the client’s name and date as well as your name.

Organization & Labeling

Take a moment before you seal that envelope and look at every item in the packet. Can the reviewer tell whose packet each piece belongs to? Is is clear which client each client-related sheet/document is for? Reviewers sometimes spend a lot of time matching client sheets to essays or other parts of the packet as they attempt to put together the full story of the birth or postpartum experience. At times they even need to call the doula and ask which client the information is for.

  • Label ALL items with your full name including essays, resource list and professional references list.
  • Client name and dates on all client related documents (including Labor Progression Sheets and evaluations) and at the top of the essay.


Triple check that you have completed every field and checked every box on each form. If it doesn’t apply, simply add N/A. For example, the details on the Labor Progression Sheet help fill in what you can’t cover in your brief birth essay and are important to help the reviewer better understand what happened at the birth so she can see how you supported the client.

  • Application form: Don’t forget those boxes at the bottom. DONA International membership is required for certification prior to submitting your packet. And yes, you REALLY want to keep a copy of all of your materials just in case.
  • Client sheets, evaluations and essays:  Client name and dates, please!
  • Labor Progression Sheet: Use your notes from the birth to fill in all of the fields of the form including the “Reason” section for all “yes” answers.

Huge thanks to Julia Schetky, CD(DONA) for all her work on the DONA International Certification Committee. We are grateful for her time and dedication in reviewing packets, noting trends that slow down the review process and writing weekly tips for everyone working through the certification process. You can find new tips from Julia each week posted in the DONA International Facebook groups. For additional support, feel free to contact Certification Director Johanna D’Aleo at

Best of the International Doula: What Women Want … in a Doula

Do you ever wonder what clients are really looking for in a doula? In this essay titled “What Women Want…In a Doula,” Anna Merrill shares her observations from her busy career. As the owner of a successful birth business in New York City, she’s seen a lot of prospective clients come through the doors, enough to see general patterns in what clients want. It’s an interesting read, and will hopefully help influence the ways you market to clients! — Susan Troy, Managing Editor, International Doula

What Women Want….in a Doula

By Anna Merrill, M.S., M.A., LCCE

For more than six years, I have been co-director of New York City’s largest private company providing services to new and expectant families. We offer classes covering a wide range of pre- and postnatal care, ranging from childbirth education to breastfeeding to newborn care and infant CPR. We also offer doula services in a range of prices. Over the years, I’ve spoken to hundreds of women about their particular needs and what qualities they are looking for in a doula.

From these discussions, I’ve found that the most important characteristic is that the doula supports their emotional as well as physical needs during this life-changing event. Specifically, the single biggest things mothers-to-be have cited they are looking for in a doula are acceptance and respect — someone who won’t arrive at the birth with their own agenda or idea about how the birth should go. They need to feel unconditionally supported throughout the process. They don’t want to feel guilty or judged by their doula if, for example, they end up “needing pain medication” or other interventions.

In terms of the “bonuses” expectant mothers value beyond the obvious services, those incorporating a mind/body element are the most in demand. There really are no other strong preferences — they are just as varied and unique as the women themselves. Some request a doula who is a mother herself (although in my experience, most actually don’t care either way). A few will request a doula who is older and can provide more of a motherly energy, while others specifically want someone younger who is more like a friend. Others would like someone who is very experienced or has worked with their doctor or midwife before. Occasionally, I’ll have someone request a specific personality type: calm and mellow, or more bubbly and assertive. The underlying theme is a desire for a doula who will work with them and strive to understand and support them on their terms.

Whenever a pregnant woman asks me how she should choose a doula, I always tell them it’s like a blind date: You either have chemistry with the person or you don’t.  It’s the same with meeting a potential doula. Does the conversation flow easily? Does she feel like an old friend? Do you think you can spend many hours with her and not get annoyed? You get the picture. Conversation should not be forced or awkward. For the doula, especially new doulas, I always make this same point. It doesn’t matter how hard you try to get a mother or a couple to like you, you can’t force a connection to happen or make a couple love (and ultimately hire) you. You will either fit naturally, or it’s not a good match and should not be forced. You’re not going to book births with every potential client you meet, and that’s OK. Once I realized this, and stopped trying so hard for the “success” of getting hired for births, my booking rate increased dramatically. The smell of desperation I had been exuding, which was discoloring the energy of my interactions with these women and their partners, was replaced by something else. Confidence? Ease? Knowledge that I was going to be at the births I was meant to be at? It’s impossible to say, but whatever it was, this realization made a big difference in how I approached meeting potential clients and led to more positive outcomes for everyone.

The doula marketplace has become much busier in the last few years. On one hand, it’s great that doulas are becoming more popular and more people know about the profession. However, there is also now more competition among doulas to book clients. As the popularity of doulas continues to increase and become more of a staple in maternity care (yes!), I’m excited to see what happens to the profession as we move into the future.

About the Author

Merrill, AnaAnna Merrill has been a birth doula and childbirth educator for more than eight years. She is currently the co-director of Birth Day Presence, a company that provides services for new and expectant families in New York City. She holds masters’ degrees in psychology and health education and is finishing her doctorate in health education at Columbia University. Anna is also on faculty at Mt. Sinai Roosevelt Hospital in Manhattan and teaches at Brooklyn College.  Best of all, she is the mother of two adorable little girls!

Deadline Approaching for Advanced Doula Applications

Advanced Doula graphicAre you working to advance the maternal-child field? Know a doula who is? The deadline to submit for the Advanced Doula designation is fast approaching! Apply by May 31, 2016 for consideration. Your next opportunity to apply won’t come again until May 2017, so don’t miss out!

The Advanced Doula designation was unveiled by DONA International last year as a new credential for veteran doulas who are leading the advancement of our field through additional expertise, commitment to their communities and publication. A higher level designation is granted in many professions to credit those who are leaders in the field. Advanced Doulas receive the lifetime credentials Doula AdvCD(DONA) and/or AdvPCD(DONA). The inaugural class of 2015 included doulas with a broad range of backgrounds and expertise demonstrating the growth of the professional birth and postpartum field.

New to the eligibility criteria this year, applicants who have not published writing on a related topic (criteria #3 below) may be considered if they have presented on a topic related to doulas, birth, breastfeeding, parenting or the postpartum period at a national or international conference. This change was made to reflect the value and contribution of teaching others and acknowledge that recognition as a presenter on the national or international stage demonstrates expertise and advancement of the field. Applicants who have both published writing and been a national or international presenter are encouraged to include all publications and presentations in their submission.

Eligibility Requirements for Advanced Doula Designation 2016:

1) Certification: Achieved and maintained certification in good standing with DONA International for at least two consecutive certification periods (6 years)

While a DONA certified doula in good standing, applicants will have also:
2) Pursued additional training, certification and/or licensure in a related field.

3) Published a book, magazine article or professional blog post (other than on their own personal or business blog) AND/OR presented at a national or international conference on a topic related to doulas, birth, breastfeeding, parenting or the postpartum period.

4) Made a major contribution to advance the mission and purpose of DONA International, the recognition of doulas and/or the maternal-child field locally, regionally and/or internationally beyond that which supports their own personal or business endeavors.

Please note that criteria 2, 3 and 4 must have taken place while certified by DONA International.


Advanced Doula FAQ to help doulas determine if they qualify for the designation and answer questions about the review process.

2016 Eligibility and Application Description offers additional details and a link to the application form.

2015 Advanced Doulas Slideshow is a great source of inspiration sharing brief bios of each member of the inaugural class.

Nine Tips to Get the Most Out of Your Doula Workshop

By Penny Bussell Stansfield BA (Hons), AdvCD(DONA), BDT, LCCE, CLC, BCLMT

Your doula workshop (also called doula training) is an important first step in your journey to become a birth or postpartum support professional. We asked DONA International approved birth doula trainer Penny Stansfield, who has trained over 1,000 doulas, to give us her top tips for getting the most out of a doula workshop. Feel free to share with others you know who are planning the next step in their doula journey. — Adrianne Gordon, Blog Manager

Nine Tips to Get the Most Out of Your Doula Workshop

  1. Read, read, read ….. Start with the DONA International Position Papers (The Postpartum Doula’s Role in Maternity Care and The Birth Doula’s Contribution to Modern Maternity Care), Standards of Practice and Code of Ethics.  Then move on to reading some of the books on the required reading list.  The more you have read before the workshop, the more you will be able to participate in discussions and group activities.
  1. Be focused. Prepare and organize your family life so that you can give your time and attention unequivocally to the workshop. The workshops are packed with educational information, group activities, discussions and lectures. It requires your wholehearted participation. You cannot pop out to pick a kid up from a birthday party or leave early because of a family dinner. This is an ideal rehearsal for those times when you are called out to a birth or an unexpected postpartum assignment. Make sure that your family and friends understand your commitment and are prepared to support you.
  1. Prepare your route and estimate the driving time. I can’t tell you how many students arrive late the first morning either because they get stuck in traffic or they get lost. Out of respect for those who arrive punctually, I always start my workshop on time, which means that latecomers miss out on valuable introductions and housekeeping information at a minimum and sometimes on part of the first session. Think about this – what impression will you give to your birth or postpartum client if you show up for your appointment late because you got lost or underestimated the amount of rush hour traffic? Allow additional time on the first morning – if you get there really early, you will have a great opportunity to start getting to know other students before the workshop begins, or you can offer to help set up. And by the time the workshop begins, you will feel like you have already made friends!
  1. Identify your goals. Write a list of what you want to get out of the workshop. Do you want more education about birth and/or newborns? Does setting up a business seem like your biggest challenge? Do you feel your communication skills need to develop? Are you concerned about how you are going to complete the certification process? Do you want guidance on how best to maximize social media presence? Whatever your learning priorities are, make sure that you are finding answers to the questions on your list over the course of the workshop. If this isn’t happening, talk to the trainer. Trainers are not mind readers, so don’t be afraid to speak up and have your needs met!
  1. Network, network, network! Start connecting with birth and postpartum doulas on social media and in person. Attend some local doula gatherings. Find out if there are doula agencies or businesses in your area that might be hiring doulas.  Set up a lunch meeting, introduce yourself, ask questions, make an impression and be professional. This is your first step in creating a reputation in your community as a doula. It will give you a big step up as you complete your certification after the workshop if you have already done some networking before the workshop.
  1. Start your Resource List. By networking and seeking out other birth related professionals, you can make a good start on your resource list before the workshop. You can continue to add to your resource list during the workshop as you talk to other students from your area. Knowing where you still need resources will help you make the most out of these connections.
  1. Take good care of yourself. Find out about the food situation at the workshop in advance. Will meals be provided? Are there kitchen facilities for you to use if you bring your own meals? Are there restaurants nearby? Becoming hungry or dehydrated during a busy workshop will hinder the learning process, so don’t let that happen. Wear comfortable clothes and multiple layers so that you can avoid becoming too warm or too cold.
  1. Be prepared for personal growth. Doula workshops can provide opportunity for personal reflection and healing. Some intense emotions may arise. Trainers create an atmosphere of mutual respect, support and open communication. You may discover hidden strengths and vulnerabilities. Many students say that attending their workshop was life changing.
  1. ENJOY! Our workshops are fun, educational, interactive, and you will have the time of your life!

About the Author

105_0560 copyPenny Bussell Stansfield BA (Hons), AdvCD(DONA), BDT, LCCE, CLC, BCLMT has been a DONA International birth doula and approved birth doula trainer since 1997. She has trained over 1,000 doulas in over 100 workshops all over the US. She is also a board certified licensed massage therapist and teaches prenatal massage at the graduate level. She lives in Tucson, AZ.