On Ethics - Part 2 ~ Our Business Practices & Values

Today we would like to discuss some of our business practices and why we've chosen to conduct things the way we do.  It is important to us that we remain open with you, our clients and community members, and that you feel you can trust us.

1. All of our doulas are trained.  Michelle is certified. Sherel and Kaitlin are actively pursuing certification.  This means they are not yet certified, but are working toward that goal through continuous study and practical experience.
• Each of us has attended training workshops and/or received education through a recognized certifying body.  
• Michelle received her initial training through DONA International in 2008 at a workshop held by a certified doula and doula trainer.  Michelle continued her education through Childbirth International and has certified as a birth doula through the organization. (2012)
• Michelle has also attended a variety of professional workshops and participated in conferences for birth professionals.  Documentation is available for reference.
• Sherel has completed her first year of midwifery education through Midwives College of Utah.  This qualifies her to serve as a midwife's assistant.  She is also a birth doula student through Birth Arts International and will also be certified this year. 
• Sherel has also attended professional workshops in addition to academics.  Documentation is available.
• Kaitlin attended a DONA International training workshop in Spring 2011 and is actively pursuing certification through DONA and Birth Arts International.  
2. Certification takes time.
• We are all mothers.  Our families must come first.  Caring for our children takes up much of our time and we are proud of that fact.  We also maintain households and need to nurture family relationships.  
• No one training program is exactly the same.
• Training may consist of: a 3-day workshop, followed by required reading, a minimum number of births to attend, compilation of a resource list, audit of childbirth classes, and essay writing. (See DONA or CAPPA)
• Training may consist of: intensive academic coursework consisting of psychology, communication skills, anatomy and physiology, business practices, ethics, etc. as well as all of the above.   This may or may not include a 3-day workshop. (See Childbirth International  or Birth Arts International.)
3. We charge for our services.
• During our training as doulas, we were taught to charge for our services even before we were certified for a variety of reasons.
• We incur expenses such as childcare, transportation, food, supplies, etc.
• We spend a lot of time with our clients, meeting once a month during pregnancy and at least 2-4 times during the postpartum period.  
• We are providing a valuable service.
• We provide service as volunteers, but we also are a registered business.
4. We are a registered business in the Province of Alberta, as well as in Medicine Hat and surrounding area.  We maintain a business license for Medicine Hat as well as one for businesses with offices or practice areas outside of Medicine Hat.  This documentation is available for reference.
5. We refer to other doulas in our area and related professionals and maintain a listing of qualified professionals without prejudice.
6. We believe every family has the right to choose a support person who is right for their family and we respect their decisions.  Education, qualifications, personality, comfort level, and values are all very important aspects of that decision.  We strive to be forthright in all of our interactions with potential clients.
7. Education is important to us.  We surround ourselves with the resources necessary to stay up-to-date on evidence-based practices in birth care. 
8. We are not medical professionals and do not portray ourselves as such nor shall we ever act in that capacity as birth doulas.
9. Our practice believes every family deserves the support of a doula that they are comfortable with and are able to cultivate a relationship of trust with.  If we are not a good fit, we gladly refer to our fellow doulas in the community.  
10. We strive to maintain open, professional relationships with our colleagues.  It is our wish and our hope that families in our community feel well supported, informed and cared for by all members of the birthing team.

On Ethics and Beliefs

Hello, Readers!  I realize it has been some time since we've posted to the blog.  We hope you all had a wonderful holiday season and are now enjoying spending joyful winter days with your family.  The following post is based upon recent concerns I have had in practice as well as in the birth profession overall.  Enjoy!

On Ethics

In September 2011, we authored a post pertaining to the distribution of product samples and coupons to our clients.  Mothers-to-be are often given samples of baby lotions, diapers, coupons for private ultrasound companies, etc. from a variety of sources including doctors offices, formula companies, and maternity stores.  We, too, have provided certain sample products to mothers in our client packages which we hand out at our initial consultations.  Our primary sources had been from companies such as Lansinoh, Medela and Seventh Generation.  We are revamping our policy on samples for the following reasons:

1. Medela is no longer compliant with the WHO/UNICEF Code of Marketing of Breast Milk Substitutes; therefore, we cannot in good conscience distribute their product(s).
2. While we support companies that are WHO Code Compliant, we will no longer distribute samples of their products unless requested by our clients.
3. We feel that we have a responsibility to families to provide them with excellent care, support, and evidence-based information that is not coloured by commercial sources.

On Beliefs

Please note: The following are my personal beliefs and are not necessarily the opinions of my colleagues.

As I grow and continue to learn in my role as a doula, and through my personal life experiences, my beliefs regarding pregnancy, birth, breastfeeding and parenting continue to evolve and become more clarified.  Therefore, I wanted to share with you what is in my heart.

1. I believe that woman were created to birth without unnecessary interventions.
2. I believe that women are strong.
3. I believe that pain is subjective, yet also that fear and tension exacerbate pain.  See The Fear Tension Pain Cycle - based on the research of Dr. Grantly Dick-Read.
4. I believe that families deserve complete evidence-based information on all potential interventions in pregnancy, birth and breastfeeding in order to make truly informed decisions.  I believe I would be remiss if I did not assist them with finding this accurate information.
5. I believe that birth is safer and healthier for mothers and babies when medications are not used.
6. I believe that babies are active participants in their own births.
7. I believe that babies are born wired to be breastfed.
8. I believe in the WHO Hierarchy of Infant Feeding Choices.
9. I believe breastfeeding is possible for the majority of mothers and infants with knowledgeable and compassionate support.
10. I believe birth belongs to mothers and babies, not to any caregiver or system.
11. I believe mothers will birth in their own time.
12. I believe babies will be born when they are ready.
13. I respect technology and medical interventions, as they have their place in emergency situations.
14. I believe birth is a natural process, not a medical event.
15. I believe that I do not empower women, rather they empower themselves with strength, trust in their bodies and the process of birth, and knowledge of the benefits and risks of all of their options.
16. I trust women!

I believe this list is not finished and that I will be continuously learning and evolving.  I am so thankful to all of the families I work with as it is they who truly teach me.

Limits, Standards and Ethics

As a birth doula, I am not considered a medical professional; therefore, I can provide medical information, but never medical advice.  I respect the professionals I work with including midwives, doctors, nurses, childbirth educators, lactation consultants and other doulas.  I abide by the Standards of Practice and Code of Ethics of my training organization.  If you have any questions regarding the standards I practice by, please email me.

Ethical Holiday Gift Giving

During the Holiday Season, we often get mixed up in the hustle and bustle and crowds at the mall.  Our children's Christmas lists are longer than a roll of paper towels and we, too, may have our eyes on the latest techno gadgets.  However, throughout the year, families are in need all over the world.  As a birth doula, children and expectant mothers are, of course, especially on my mind this time of year.  So, I thought I would share a few gift giving ideas with you that are selfless and bring a world of help to families in need.  If you'd like to help women and children affected by HIV/AIDS and poverty and give the gift of life this Holiday Season, please visit the following links:

World Vision Online - HIV/AIDS related gifts

World Vision - Maternal Health in Afganistan

World Vision - New Mother & Baby Kit

PlanCanada Home Birthing Kit