An Interview with Melissa Harley of DONA International

December 6, 2016

Melissa Harley is the International Marketing and Public Relations Director of DONA International. She’s also a certified doula trainer, certified doula and childbirth educator. She spoke to CareGuide about DONA, the history and direction of the organization and what a doula does.

An Interview with DONA International’s Melissa Harley

DONA International's Melissa Harley

by Clarke Illmatical

What is your background?

“My background personally started with DONA international in 2002. I became a certified doula in 2003 or 4. Working with expecting families, then I became a childbirth educator, certified Lamaze childbirth educator, teaching childbirth education to over a thousand couples. In 2007, I began to work to start to train doulas, which I officially, started training doulas in 2009.

Dona International is a non-profit so it’s run volunteer board of directors, during that time I also started as a state rep for Florida for Dona, and then in February 2015, I joined the board of directors… In January of this year, I joined the board of directors as the public relations and marketing director.”

You’ve worked extensively with doulas. You started training them in 2007. Since you started what has been the overall reaction? Are people receptive to Doula training? What types of people are most interested in your training program?

“We see a wide variety. Actually I think it’s really interesting because the doula work is, I would say, most often sought out by the millennial age group, but with that said, there’s a large portion of people who come into the work who are just starting out in their careers, I’ve trained people that were still teenagers. There are some who come into the work that are retired and looking for another career kind of option path, there looking for an opportunity to work with expecting families.”

Let’s pretend I don’t know what a doula is. What does a doula do and isn’t it the same thing as a nanny?

“Great question. It’s not the same thing as a nanny. A nanny is responsible for the care of small children and the running of the household, or the things that the family asks them to do. Kind of outside of the working of the family. We have two different kinds of doulas that we train in our organization. We train birth doulas and we train postpartum doulas. Birth doulas are focusing on the end of pregnancy and helping to guide a family through the end of pregnancy … communicate with their care providers and may be they have different things going on with their body that they’re not really sure about and so, a doula can kind of guide them to resources and information.

Give them some encouragement and comfort during pregnancy and then a birth doula is on call for families, so that when labor happens, which can be at any time, the birth doula is usually available between one and two hours of the phone call. They don’t have to be with the couple between one to two hours but they’re available if needed. When the family says ‘Hey I’m ready for you to come and offer some more support’ The doula actually goes to their homes and provides labor support and that can be direct support for the mother, comfort techniques, massages, different positions or it can even be support to the partner in helping the partner work with the mother.

Doulas typically, in birth will stay with the couple, whether they’re having a home or hospital birth and if they’re having a hospital birth and they’re going to be moving from the home to the hospital then the doula will accompany them and stay through the entire experience to provide that physical comfort but also the emotional comfort. Sometimes just to say, ‘Everything is okay you’re doing great!’

Just some words of encouragement can be really helpful to families and then after the birth of the baby, the birth doula usually stays for another hour to two hours just to make sure that everyone is settled and had that first feeding and then will follow up with the family once the leave the hospital to make sure they’re starting to adjust okay.

Around that time is when the postpartum doula can kind of come in. Postpartum doulas actually come in after the birth and their role is to help the family adjust to life with a new baby. And their goal as they’re working with families is to teach the family, so whenever they reach about three to four months they’re ready to be on their own.

Our postpartum doulas will come and sometimes on the first day home from the hospital to help the families get acquainted with being home with a new baby and then they’ll come in weekly. The difference between a nanny and postpartum doulas is they’re not doing baby care in the sense of , they’re not watching the baby while the parents are doing other things. That doesn’t mean that they can’t watch the baby an hour or two while the mother goes and takes a nap or does something that is important to her. It’s not childcare.

Postpartum doulas are highly skilled in breastfeeding and infant care, so they’re teaching families. Maybe the family has been nervous about giving the baby a bath, so the postpartum doula would be someone by their side while they’re giving the bath, to give pointers and tips. and helpful support.

At the same time, the postpartum doula can do light housework… They’re not cooks and they don’t clean but if they happen to see something that needs to happen while they’re in the home if they see a load of dishes that needs to be washed they can do that. So it eases the burden on the family.”

I’ve talked to a few doulas. Your doulas with Dona, you guys have broken this up. There are two paths, there’s a birth doula and a postpartum doula, whereas other doulas do both functions. Is there a reason you guys decided to separate these two functions? Do you have doula with DONA that does both?

“We have plenty of doulas who that actually pursue both and do both Because they do marry nicely together. But we do believe that the need of an expectant family is different than a postpartum family, our training program is separate so that the doulas can totally focus on up to the time of birth and just after.

Those needs are very very different than once they’ve settled from giving birth and no they’re not dealing with that but now we’re dealing with ‘Oh my goodness, we have a newborn we have to bring home. What are we going to do and how are we going to do it?’ We encourage doulas to do both. We do feel that they’re complementary services but they are unique.”

In terms of parenting and the development of the family over the last hundred years or so or north America. It seems like the modern family has changed drastically. Over 500 years ago, the functions of a doula would have been included in the family and the family unit. Can you explain how the family unit is changing and why doulas are so essential right now for the modern family? Mothers are career oriented or the dynamics of the family has changed, you may have two mothers. How have doulas answered the call of the modern family?

“That’s another great question. We see a variety of families. Our mission and vision is to provide services for all kind of families and training for all kinds of doulas with various backgrounds. You’re absolutely right.

Sometimes we’ll see the traditional family and sometimes we’ll see a family that is completely different and I think it’s important to meet that family wherever they are. We do a really good job of assessing needs of families individually.

For instance, I might have a mother whose partner is deployed and she has that traditional family but she’s going through the process on her own or might have a single mother or two mothers and each one is going to bring different things to the table. So what we do is to work very hard to make sure that we’re looking at that individual family makeup and see what their needs are how we can best fill in the gaps.

Something I think doulas are really good at is filling the gaps. What’s going on here and how can I fit in to make it a better experience for everyone?”

Your organization, how did DONA come about? How did this professional organization come about when most people don’t know what doulas are?

“DONA in 2017, is going to be celebrating our 25th year. It was founded in 1992 by medical care providers. Doctors organically found that when women were supported in labor by other women, there were better health outcomes. That the mother had experienced healthier and faster labors and they had been more satisfied with the births and that kind of married around the same time with one of our founders who was doing the same work on how women remember their birth experiences for all of their lives and how important it is to protect and preserve that birth memory because she’s going to have it forever.

Every time a birthday comes up or every time her partner wears the same shirt they wore at birth or there’s a smell. There’s all kind of things that make women remember their birth experiences.

The other founders were doing their research on the medical side of it. They were actually pediatricians and they decided to come together and formally come together to form an organization for educating and certifying doulas. Because they saw a tremendous benefit.

Since that time, at that time that they started, one of the founders told us recently, her name is Penny Simpkin, she told us recently that when they originally started DONA, that they dreamt of 100 doulas. They thought ‘If we can just certify 100 doulas, what a difference we’d be making’ and DONA this year certified our 12,000th.

We’ve trained even more that have for one reason or another not been able to complete their certification in full. It’s definitely taken on a license of its own as a profession for young professionals that have heart and desire to work with families in this really precious time but families more and more are starting to see the benefits of doulas.

I’ll tell you anecdotally when I started teaching childbirth education classes I would say to my classes, does everyone know what a doula is pretty much nobody did. So I would have to use that opportunity to explain what a doula does. Now when I ask that same question, pretty much everybody does. It seems like people don’t know what a doula does when in that time of their life, they’re learning about it…”

Professionally, if somebody wants to be a doula, what kind of mindset do they need? To be successful, what kind of temperament, what kind of personality and what kind of individual will be successful?

“I don’t think that’s there’s any one kind of person that can be successful. Because we have lots of different kinds of families and mothers. So the more diverse our doula pool is the more families will receive support from those doulas. They’re also looking for someone who is like them.

With that said… If we’re there for support in that manner. Unconditional labor support than families really benefit. Then the hands on things that we’re trained to do in our training, that also is a benefit to the family.

I think that if I was looking for a specific skill set, I would be looking for somebody who is willing to support a family regardless of her choices, being very open-minded to pursuing what the families needs are.

Really these are things we train for in our training, we talk a lot about how we can come in and leave or baggage at the door. What we did in our families may not be what is best for that mother. It’s not something I think has to be inherited skill, it’s something we talk about and we explain the importance of preserving that birth memory and the number one way is to make sure that the birth mother is involved in the decision-making process all the way through.

A doula can walk into the birth with the understand ‘What can I do to help the mother feel empowered.’ Not what can I do to empower her, but how can I help her feel empowered because if it comes from within then she’s setting that mom up for a more positive birth experience.”

Let’s talk about the training. What kind of training do you offer for doulas for them to become certified?

“Our current birth doula and postpartum doula are similar but separate tracks.

They both start with basic knowledge, reading, understanding the birth process. But really they begin with our training and in-person workshop. That’s when a doula will come in and meet with another group and will be a part of an intensive two or three day, sometimes four just depending on the trainer and the different things that they offer in their training. They’ll be engrossed in the work. It’s going to start from the history of birth and why this is important and work all the way through exactly how it’s best to work with clients. From the time that we get a phone call that they’re interested in a doula to the time that we say thank you very much and complete our service with them.

During training, they’re going to do exercises that have to do with communication and best help a family comes to their own decisions and they’re going to do exercises, role play on helping support someone who is in labor or whose having a tough time with contractions. They’re going to learn hands-on labor support skills.

We like to say birth doulas are labor support experts, they actually get more training on labor support than many labor delivery nurses, so that’s very important to have that hands-on time where they can learn how to do a technique that might help the family.

We’re also going to cover some business aspects, getting ready to start running a business. We’re going to cover a little of that for those that want to go out and become a doula as a career, so the have some tips and some tools to help along that way… Once our doulas finish the workshops then they’re basically sent on with clear directions on what to do next. We consider our training programs kind of a full comprehensive program. It’s not just that two or three-day workshop. It continues with a pretty extensive required reading list and text…”

When does this training take place?

“They take place all over the country. I was just on the website, we have 83 workshops scheduled for the next two months, around the world. We are an international organization.”

Can you tell us the types of certifications that you have?

“We have a certified doula, certified birth doula, certified postpartum doula. Those are the two main ones”

You mentioned before that some doulas have taken both certification tracks…

“Yes. Some can do separate but certified birth and certified postpartum, we also have two other credentials.

One is approved doula trainer and that can be an approved birth trainer or postpartum trainer. The third kind of credential within an organization, a newer kind of credential just started within the last couple of years, it’s the advanced doula credential.

That credential is preserved for the doulas who have not only become certified doulas and work with families and have extensive experience with families but also have done something above and beyond to contribute to maternal healthcare in a positive way. Who also are either conference speakers or published authors. They’ve gone above and beyond the typical doula. Right now we only have 30 advanced doulas. It’s a prestigious award.”

What about conferences?

We just finished our annual conference it in July… It was in Seattle, Washington.

Normally, your conference are how long? How many days?

“Depending on if we do a press conference or post-conference work, the typical conference is a four-day experience and sometimes we do a couple of days after for people for people who want to take specialized training.”

Where do you see DONA going? What kind of things will you have in the future?

“This year DONA international did an extended member research project. We looked at all of our members because we’re a non-profit and a member driven organization and we asked them what things were really important to them… one of those is advocacy. Our doulas would like to see use becoming more involved in advocating for doulas in health care. Advocating for reimbursement for doulas or advocating for maternal healthcare in general. We’re actually developing an advocacy committee to pursue, looking at the best ways are we can serve our membership and the world of doulas through advocating for the role of the doula, even in legislation.

The next thing that we’re going to be working on is helping our newer doulas find more connection and mentorship within the doula community once they’re trained… and also those that have requested more business training for those who want to pursue doula work as a career path. As a small business owner that they will have more tools.”

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