Do You Need a Doula Certification to be Considered an Expert? A Chat with Emily Edwards From The Good Birth Co.
Ever wonder if doula certifications are really necessary to attend births or be a birthworker? Or what a doula’s “scope of practice” is?
In Episode 31 of the Birthworker Podcast, I'm joined by Emily Edwards from The Good Birth Co, who is sharing her insight and experience from working as an RN and birth doula who trains both moms and fellow birthworkers in birth trauma prevention.
In this interview with Emily, we chat about:
Why doulas don’t need high levels of education to start supporting women…
Who would truly benefit from the doula industry becoming regulated…
How to handle the “who are you certified through” question when you aren’t a certified birthworker…
… and a whole lot more!
Kyleigh Banks: I'm kind of hypocritical in this space because in some ways I feel backed up against a corner. There are people out there that want to be doulas, feel like they have to have a certification, and then I feel like if I actually want to train doulas, I have to partake in this stupid little game where it's like, if you could check off these boxes, you are a doula certified through our program.
It's a really weird spot for me because 99.99% of my brain says, these doula certifications are so ridiculous because it really means absolutely nothing, and Emily will talk all about that, but there is the 0.01% of me that's, "Hey, by the way, if you finish my program, you can get a certification." So yeah, it's something that I've been up against a little lately. I don't know what's in integrity. I don't know how it'll change in the future, but it's definitely something I'm thinking about. When did you start thinking about almost just the hypocrisy of doula certifications?
Emily Edwards: That's a really big question. I would say, I think it started just really when I started thinking about becoming a doula or a birthworker. I started researching all of the options and I couldn't find any particular one that aligned with who I was and fulfilled all of those needs. Right out of the gates, anytime I heard that doulas don't advocate, it just was a flat-out no for me. I can't be down with this because I don't agree with it. But ultimately I decided to stick with flying solo and not doing it that way because I knew what I was doing was so different. What I think really was a tipping point for me in terms of seeing the kind of training organizations for what they would be is when a mentor in my community told me, flat out, to not engage with my birth plan because I would be risking doula access and birth rights and movement forward if I did that personally.
This person was actually an owner and a curriculum creator in my local geographical area. And someone I really considered to be a mentor. And when I heard that, I knew this is not for me. Anyone who is really opposed to creating change that could invoke waves, that's a red flag for me. It really came to a head, I would say in 2020 when we started to see, particularly in Canada, there were a couple of really big, well-known organizations that things started to come out about them. Things like theft of intellectual property, and not paying their contributors, particularly their BIPOC and LGBTQ+ community educators, what they were truly worth or what they were actually asking for.
It turned my stomach. And that is when it really then pushed me further into, “Who are these people that are making money off of this? What kind of inner workings, interconnections, and gatekeeping is happening?” So that was really the catalyst for me. From that point on, I was… again, no shade to anyone who does choose to certify, anyone who does find value in that. Not anything against that, but I knew, this isn't for me. I have the skill set I need. I have the credentials I need from another arena. I'm good to go.
Kyleigh Banks: I love that. Can you talk about the fact that there's no inherent value in a doula certification like that? We've made that up.
Emily Edwards: Absolutely. At the end of the day, doulas are unregulated care providers. When I say that, it often comes with people assuming that there's negativity to that. But my day job is working with older adults in long-term care, retirement, and home settings in the community. I can really make a strong comparison between birthworkers and personal support workers. In that world we sometimes refer to them as UCPs or unregulated care providers, to actually be the people who do the hands-on work of making this magic happen.
As an RN on that team, I can oversee many, many things, but when it comes to actually those nuts and bolts of care and knowing someone intimately, that's the role of a UCP. And again, like a birthworker. It doesn't mean that your role is any less important, but what it does mean is you do not require higher levels of education to enter that workspace, and you do not have a higher set of ethical codes or practice standards that you are legally obligated to adhere to.
I say that all with a very large caveat that where someone else's professional scope starts is where doulas and birthworkers cannot encroach. That's very specific protected tasks like medication administration or, for nurses, we can put fingers or instruments so far through the dermis or so far into someone's body, but at a certain point then it's someone else's scope of practice. So with that being said, you don't have a scope, except where someone else's starts. And I think that's a really incredibly powerful thing to know. And I'm sure we'll get into the fact that some of these titles and the way that care teams perceive birthworkers is really less than, but in reality, it's just a different part of the team.
Kyleigh Banks: I love that. I love taking continuing education courses, and last year was the year for me to go back to the basics and just really learn all about birth, all about birth work, all about being a doula. After being in the community for three years or so, that was really cool, going back to the beginning and just starting fresh with a new point of view. Anyway, it was called autonomous hospital birth. Unmedicated autonomous hospital birth, how doulas and birthworkers can help that happen in a hospital setting. And Emily, let me tell you, I didn't know if I should just hang up and shut my computer and just be, "F this." I didn't know if I should stay there and witness this. Just like "I cannot believe that there are doulas out there learning this."
And that was actually when I was in the process of creating my doula training program. So it actually lit the fire of holy cow. Programs like mine are so, so important. The things leaving her mouth, she literally said, doulas and birthworkers have one get-ou-of-jail-free card. You can speak up to the provider once. You can say something that can cause some energy in the birth room, just once. And then after that, you have to shut your mouth. So choose that one time really wisely. And I'm not even exaggerating or adding anything. It was worse than that because it wasn't even a slip. It was a main core focus of the class that she kept coming back to, and in my mind, I'm just like, "whoa." She had this whole layout chart where it was the doctor's on top, then the nurse is under, and then the moms and the doula way down at the bottom.
And I just thought to myself, doulas actually aren't even a part of that system. It's like mom and doula up top, doulas completely detached from anything else. Unregulated care person hired by the person giving birth, and then all the hospital systems underneath the mom. Doulas do not even play a role in that whole hierarchy at all. So yeah, my mind was absolutely blown. I was under the impression that we had moved beyond that point. I was under the impression that that's what they taught doulas 10 years ago. And so it absolutely blew my mind.
Emily Edwards: People at the big organizations that are pumping out doulas in a weekend, they're telling them, rather than actually giving people skills to navigate that system, they're saying just don't engage with it. That's kind of useless when we know the majority of folks are birthing in a hospital, whatever reason that is, that's a whole other topic. But the fact is, the majority of clients will be in that setting. And if you are not equipped with some reasonable skills, you're going to drown. You are going to burn out, you are going to succumb to vicarious trauma, and you're going to really let the people down that are hiring you. Because they have expectations and they often weren't aligned. If you really are subscribing to that, I can't open my mouth or I can only say one thing. But yeah, it's scary what some people are walking away with as their idea of what this is.
Kyleigh Banks: I love that you mentioned the doula programs that are pumping people out in a weekend. That to me is the aha-moment of, oh, doula certifications actually don't mean anything. You could literally watch a 40-minute video online and print out a certification. And that's absolutely not to say that no one should get certified. That's not to say that no one needs any training. Absolutely not. It's really important that anyone going into birthwork, or even honestly, someone who's been a birthworker for years just is honest about the fact what a certification actually means.
Emily Edwards: Yeah, exactly. I really see it as a limiting factor for many people. I really think it's a piece to the push of regulation. Being certified is one thing, it gives a level of professionalism or a veil of professionalism, but what would the goal of actually regulating as a profession be? Other than really a financial structure to profit for some people and limit access for others? I really see that as the ultimate piece, and I always laugh, you can't ban a privately hired companion. You're just a random person that this birthing person chose to pay to come and attend and give them support through the birth. Whereas if you are in a regulated profession, that's when real and true doula bans or birthworker bans can occur as a whole, because you're all going to be part of that same entity. So when that kind of threat is given by some care providers or some institutions, it's, well, literally, there's no such thing. We're just people out here doing this work. Short of an individual being barred from the establishment.
Kyleigh Banks: It was interesting in COVID too, at least in the states, some of the major cities and major hospitals were actually asking for doulas to bring their certification and their paperwork. And that even to me is absolutely crossing the line. I mean, it's clear.
Emily Edwards: Completely. We know that what happened in that time was very, very different from what we are hoping the rest of, pre COVID, post COVID, whatever it is now. But that's saying that the hospitals are placing value on one group of birthworkers over others. And that tends to profit a very small group of people, disenfranchise a lot of other people, and leave a lot of other people out. This also means it is often the people who can't afford perhaps certain supports or don't have access to certain supports, they're the ones being limited, not the folks who can access, again, a certified doula to provide that paperwork. Which also reinforces the fact that the hospitals are buying it, even though it's not a thing.
Kyleigh Banks: I know. I mean, that's not the only thing they buy, let's be honest. But man, you're so right. And of course they're buying it. It's really a believable act or really a convincing act. I have new prospective doulas come to me and say, "If I take your training, is it as legit as *insert big huge organization here*?" And I do the whole, what we just talked about, whereas there is no accreditation board. It is an absolute free for all. And I think that can scare a lot of people who are looking for that outside validation.
Emily Edwards: Exactly. And that's where I feel like I really need to express that. I am not saying whatsoever that training is not an important piece of this. I really, really think that there are actual hard skills that are incredibly important to learn as well. But that, again, rarely comes from one spot. I describe it as a toolbox. You can take teachings from many different places, and you really should be. You should not be seeing a one-stop educator shop. Or again, if you're seeing guest educators or affiliate educators or partners, make sure those people are being paid and their face isn't just being used on the advertisements. Really dig in.
But the training's important. Continuing education is important. All of that's there, but it does not have to be from one place. And I taught the birth trauma prevention training on the weekend, and someone was asking, "does it qualify for continuing education units or credits?" So I looked into a few different options, and technically yes, but I can tell you I will not pay those organizations to give me a gold star on my training. If you want to pursue that, if you want to ask them if they would accept this, here's my speaker profile, here's the agenda and the content of what you're learning, but I'm not going to waste my time there. And I think that is a piece that some people don't appreciate, is how much people are paying to appear legitimate.
Kyleigh Banks: Yeah. I have never gone down that rabbit hole of continuing education for maybe for DONA or even for nurses or anything like that. I bet that opens up a whole other can of worms.
Emily Edwards: That is mind-blowing, how regimented some are and how very open others are. And yes, it is a can of worms, and that's where I really push people if they know that that's something that's important to them, provide me with what you need or ask me for what you need. But I'm not bending over backwards for that.
Kyleigh Banks: People ask me sometimes about insurance, and it's that exact same thing. If you're playing the game with insurance, you got to jump through the hoops and follow their rules. And then comes the, well, it's not fair that you don't offer insurance. And I hear that a lot, training new doulas who want to offer insurance, how I'm not teaching them how to do it. But then also clients. And actually when I hear that, I think that's such a limited view, because there's so many other ways to offer scholarships and discount your services, and make enough money doing something else that you can attend someone's birth for free. There's so many other ways you can impact without playing in that system.
Emily Edwards: And that's one of the big barriers here specifically in Ontario for doulas, is one of the only ways to be insured as a doula to work, is to be a member of the association.
Kyleigh Banks: Oh my gosh.
Emily Edwards: Which has a limited list of training organizations that they accept, one of which is owned by what was the former chair of this association. So again, that was the moment that I was like, "this is messed." When you limit people from accessing business insurance at an affordable rate, I think that's the big thing, is there are other ways to access it. But the thing is, this association offers a significant group discount, which really is making it accessible. Because as we know, not everyone is really planning on working with clients where they're going to be making exorbitant amounts of money, or whatever the reason is. It's really, really crazy that is the only option. So I'm really working hard with some people kind of behind the scenes to see what we can rustle up, but it's really messed when you think about that there's one way in.
Kyleigh Banks: And of course if the family member owns the...
Emily Edwards: It's the same person. No, the same person was in both roles. I'm not sure if that's still the case. I dropped it a little while ago, but at one point it was. But yes, the insurance piece, I get that a lot to be honest by clients that come to me personally, because I'm an RN by trade and my RN hat can't come off. I can't be, "I'm a birthworker now. I'm a nurse now." That's just not how it works, but people are shocked that RN hours are almost impossible to bill through private insurance. So even people with extended health benefits, again here in Canada, unless it's wound care or very specific foot care by prescription from a physician, you're not going to get RN hours covered. You actually may have more luck with some insurance companies as an actual doula coverage than you would for nursing hours, which can be a deterrent for some people.
But I offer it as if you need me to write a letter, how can I advocate for you to push with your insurance if need be? Or we have health spending plans too... But at the end of the day, I'm not going to become certified or check a box. So that's going to work there for other people. Yeah, because you're not going to get the same me if I have to do that.
Kyleigh Banks: That is the no-bullshit answer. It is just so real, and there's just so much truth behind that decision, I love that you made that decision. Was it ever hard at the beginning? Did you ever find yourself running into places where they wanted you to be certified so you had to pivot or do something else?
Emily Edwards: No, I think one of the big pieces was I always worked virtually, just how things have happened. And a lot of my clients actually were folks looking for VBAC support after a really tough first birth. So our work really focused on figuring out the previous birth and making a plan for the one ahead. With that type of support, no one ever asked me. I also think the fact that I don't lead with I'm a nurse. I try not to, but at the same time it comes through and I think that's where people find the trust and the connection.
But I also try to do my absolute best to express my skillset, my knowledge, and my capabilities in all of the other ways. So sometimes it's an afterthought. It's, "Oh, by the way, are you certified?" Or "Who did you train with?" I often find it jumps up more when I'm trying to join an online Facebook group for doulas. And the mandatory question for entry is, "Who did you train with?" Or "Where are you certified?" I think that is more so than actual client challenges.
Kyleigh Banks: Yeah, I love that you say that because that's, I think, a fear for a lot of new doulas. I think when you're not actually doing the consultations yet and you don't have the inquiries yet, you imagine that's the first thing that matters to a lot of people. I think one consultation ever even asked me or mentioned where I've trained. And I love that you said you lead with your experience. Your experience is in nursing, but I mean with other people, it could be pharmacy, it could be education, it could be just your own life experience and traumas you've been through, honestly. And all of that is really important when it comes to being a birthworker, way more than a certification. Because when someone gets a certification, we don't know if it was an awesome program with a bunch of mentors who are all being paid correctly, or if it was a 40-minute video online, then you just printed out a certification. So I love that you led with your own experience, your education, and just your passion too.
Emily Edwards: It makes it a lot easier that way too. The nursing piece is less about, I didn't work L & D, that wasn't my background. And I think that surprises a lot of people, and they're, "Well, how are you doing this?" And it's "Well, system navigation is a real passion of mine and caregiver support and making health education accessible."
I'm not sure if you're familiar with Dr. Sue, she's a Canadian nurse and her show is syndicated in the US and all of this stuff. But she made education so accessible, and that I think is really where that piece comes in for me. The rest of it comes from supporting a lot of clients who have had really awful first birth experiences too. I've listened to those stories and I've pulled apart and found those common themes. When a lot of the time for me, it boiled down to their doulas didn't know what to do. Or their doulas did not have that skill set that they really thought they had, which again, doesn't come from a certification. And being able to be really honest about that really lit the fire for me. How can I help these new doulas or experienced ones that are just feeling just as stuck as their clients are?
Kyleigh Banks: For anyone listening, Emily taught in my first cohort of my doula training program, she came and did a live workshop for everyone. And at that point, I've been a doula for less than five years, so I definitely still consider myself a baby birth worker. But I remember you asking a question of, "Okay, all the doulas that are here," maybe 50 people, "Hey, what would you say if you actually witnessed a care provider assaulting their patient, a supposed care provider, assaulting the patient?" And everyone in the chat, it just blew my mind, because, and this is not a dig or anything, it's just an awakening for me, people were, "I would say, 'Hey, excuse me, nurse, can we have some time to chat with my client?'" Or, "Hey, actually my client declined the cervical check. Can you please give her some space?" And I'm just sitting there, and you are witnessing someone being assaulted and you are saying, please and thank you?
There should be one word and it should be “stop.” It is clear as day to me. But it was in that moment that I just realized just because something is so clear to me doesn't mean that it's clear to other people. And I definitely went back into my doula training program and was just, okay, this actually needs to be a bigger part of this training. Because I had imagined literally every person would know that if there's an assault, you can use your words and make it short and make it quick and stop it, if you can. But I know there are other doula training programs out there that just say, "Don't do anything. You're not there to advocate." And so, man, to be a new doula in this world, a little unsure of yourself and a little unsure of boundaries and listening to all these different people with all these different opinions, that must be an interesting world to navigate.
Emily Edwards: And I have to say, I had a really great point made in my most recent training that I think I don't express out loud enough and have it inside of me, but I don't say it clearly. It’s that even in situations where you feel confident and you feel like you have the tools to speak up and stop something, we all are human. And the freeze, fight, flight response is real too. And to not beat yourself up over that. But the fact is, we still have to talk about it, right? That's the thing, is figuring out how can we do something different next time. Or how can you respond, you just can't shut down the conversation and say, "Oh, we don't advocate, so it doesn't matter." There's more conversation to be had, for sure.
Kyleigh Banks: Yeah. Okay. I can't do an episode with you without you actually sharing where people can find you, what you do, what offers you have for doulas, give us everything.
Emily Edwards: Amazing. My favorite hangout is Instagram, so you can find me @thegoodbirthco. I am the person behind the account. I answer my DM's, I am the person behind my email as well. So Emily@thegoodbirthco.com is always a great place to reach me.
And in terms of ways you can connect and what offers I have, that birth trauma prevention, advanced skills training. The last offer of 2022 just happened this weekend, but coming in the new year, that full-day training workshop will be offered again virtually. And who knows, there might be even a fun destination option later in 2023 for a full-day training as well. I love to travel, so if anybody is looking for in-person education, I'm your person.
I love connecting with doula agencies or collectives or groups of people that are already doing it together, because I really find that taking that training together, figuring it out, having a conversation about what is impacting your community makes it a lot easier to go forward. Yet if you're on your own, that's totally okay too.
I also offer a program called Unbury Your Birth. So that is a birth processing program for pregnant folks, people who have had births before. And I also really, really recommend it for anyone who has witnessed a difficult birth, be it their own, be it a client, be it a friend, it can help you strategically work through what that birth was and what actually happened. So that's something that's self-paced, and online as well as, again, in 2023, there will be the virtual group option as well. So we come together as a group rather than on your own.
And if anybody's looking for one-and-done options, I always am available for one-off consults. So either 45 minutes or 90 minutes. And that's again, birthworkers or actual pregnant humans, postpartum humans. I'm happy to chat. And my big thing is the more, the merrier. This is a big, giant topic. It is full of nuances. It is not straightforward, but it is one we have to talk about because it's not going away.
Kyleigh Banks: And I can't say how important it is to tackle this kind of stuff early before it's even needed if possible. So if you're listening to this today and you're just getting into birth work, maybe reach out to Emily now and just see, maybe you can do a one-on-one with her and get yourself set up to have those tools so you can know what to do if you're witnessing trauma or to help yourself unpack a birth you've been at because it is bound to happen as a birth worker. You just do some quick math and you'll find out that you are going to witness potentially a lot of traumatic births in your lives. And it's hard on you as a doula too witnessing that. So get ahead of it if you can.
Emily Edwards: Absolutely. And that's the reminder that your community around you is so important. Be it your virtual community, your online community, and in-person, local geographic one. If meeting mentors or people who are telling you that you absolutely cannot advocate, you can't make waves, shut your mouth, all of those things, it's okay to politely back out of those spaces and find somewhere that's more suitable for you. Because that's not the case. And if that's how they do it, that's cool. It doesn't have to be your way.
thank you for listening
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Meet your host, Kyleigh Banks, a side-gig doula turned CEO of a multi-six-figure birth-focused business. Her passion? Teaching birth nerds, like you, how to build an incredibly successful doula business that allows you to quit your day job, stay home with your kids, and most importantly, make a lasting impact on the world.