From March 4^th to March 6^th, I attended a Doula of North America Organization (DONA) certified birth doula training in Brooklyn, New York. The first day was a required childbirth education class. It served as a refresher to the required reading for the training, The Birth Partner by Penny Simkin. Using diagrams, models, and interactive games, our trainer taught us doulas about everything from the anatomy of female reproduction and the different physiological stages of labor to the health of the newborn and breastfeeding practices. My trainer’s comprehensive approach helped me learn the ins and outs of childbirth in a way that I could not have learned from reading a book. As she joked, we covered “three years of material” during the day.

The next two days were much more doula-specific. We began to discuss labor support, which is the fundamental role of a doula. A birth doula provides emotional, physical, and informational support to a pregnant woman during her pregnancy and especially during all stages of labor. We role-played the types of emotional support that a doula gives to a pregnant mother, learning to use different empathy and interpersonal communication tactics. We discussed instances in which it is better that a mother asks her care provider for specific information, and when a doula can step in to guide her. We also practiced different types of physical support that a doula can give a pregnant woman during labor, such as massage, stretching, and guided movement.

A portion of the training was also focused on doula work as a business. To be a birth doula usually means to be an entrepreneur, to create your own business (if you are not part of a collective), marketing your skill set to potential clients. I found this information valuable as I consider how to find clients and attend as many births as possible this summer. The skills I learned in the training, such as how to develop a network and action steps to take when planning a business, are certainly transferable to any entrepreneurship endeavor, especially for small businesses with one person offering one service.

At certain moments in the training, it was uncomfortable for me to hear pregnant women called clients and to discuss how a doula decides her going rate for paid work, since I believe that all women should be able to have a doula if they want one, regardless of their ability to pay. I personally want to volunteer as a birth doula instead of starting my own business, as I am aware that only certain demographics can afford doula care, know to ask for a doula, or have learned about the benefits of doula support. However, my trainer did discuss these socioeconomic disparities and ways in which doulas can be part of the movement for Medicaid coverage of their services. I see now that it is important to learn about the business aspects of this work if being a doula is a full-time career and source of income. I can also see how a business model can help sustain a volunteer model-by charging a fee for pregnant women who can and want to pay, some of that income could be used to help other women receive services at a lower charge or for free. I see now that being a birth doula is not only about being an entrepreneur, but a social entrepreneur: you can find ways to support women and change the healthcare model in our country for births whether or not you charge for your services. This training felt very much in line with the work of the Patricelli Center, as starting a socially aware doula business can positively impact health equity in our country.