New Certification Process Has Launched

I am thrilled to announce that the new certification process has officially launched! Streamlining the process to better serve you has been our main priority since January’s Strategic Planning meeting, and the board and I are eager to offer these great new opportunities.

ICEA is now your one-stop shop where you can get all of your maternal-child health certifications at an affordable price!

Below are the general changes to each program. If you are currently certified through ICEA, specific changes related to what you owe will be sent in the coming weeks.

Changes for All ICEA Certification Programs

  • Membership is now included with all certification payments so you don’t have to pay ICEA several times in each certification cycle.
  • Membership and certification deadlines are now the same so it’s easier to remember when your certification is up for renewal.
  • We now offer more equitable pricing on a global scale so ICEA certificants can flourish in the international community.
  • You now get a 5% discount on all certification payments if you hold more than one ICEA certification so obtaining all your maternal-child health certifications through ICEA is more affordable.
  • You will now pay 40% less* for combined certification and membership so you save money. (*Slightly varies depending on current certification and phase of certification cycle.)
  • All forms and certification processes have been streamlined so the process is less confusing and complicated.

Changes to the Childbirth Educator Certification Program

  • Traditional Pathway: You must observe 3 births before you take the exam instead of 2.
  • Experienced Pathway: To qualify for this pathway, you must have been certified with ICEA or another recognized childbirth educator certification program within the last two years. Otherwise, you must enroll through the Traditional Pathway. Additionally, 6 position paper post-tests must be passed instead of 5.
  • Recertification: You no longer need to observe other classes, have your classes observed, observe births, or complete a self-evaluation.

Changes to the Birth Doula Certification Program

  • Exam: There is now an exam* for this certification to assure that ICEA is the GOLD standard of birth doula programs. (*If you enrolled in this program prior to July 20, 2017, you will still need to take the exam, but there will be no additional charge.)
  • Exam Application: You will now have two years from the date of enrollment to provide all documentation to take the exam and become certified.
  • Experienced Pathway: You no longer need to provide 2 letters of recommendation.

Changes to the Postpartum Doula Certification Program

  • Exam Application: A resource list is no longer necessary to apply for the exam.

If you have questions about any of these changes, please don’t hesitate to reach out to me, the board, or staff. We are honored you chose ICEA as your certification body, and we’re excited about your participation in our streamlined certification process.

Please Note: During the transition period, prices reflected on the website for recertification are not necessarily equivalent to the fees that will be requested from you. Expect to see an email 90 days prior to your certification expiration with the correct fees listed. As always, you can contact with any questions.

The board and I are incredibly excited for this next step, and we are certain these programs will serve your needs. We look forward to working alongside you to improve birth outcomes for all families in the international community.

In your service,

Debra Tolson, RN, BSN, ICCE, IBCLC, CPST
ICEA President, 2017-2018

Present at the 2018 ICEA Conference

ICEA is excited to announce that we are now accepting abstract submissions for our 2018 Conference, April 19-21, in Louisville, Kentucky, USA!

The conference theme focuses on ICEA’s newly defined core values:

  • COMPASSION: We believe approaching maternity care with compassion and a nurturing spirit improves birth outcomes for all families.
  • COLLABORATION: We practice a culture of collaboration based on the knowledge that mindful engagement with diverse groups advances positive, family-centered maternity care.
  • CHOICE: We support freedom of choice by training professionals committed to empowering expectant families through informed decision making.

If you have an idea for a presentation centered around one or more of our core values, we’d love to hear it! We’re accepting submissions for concurrent sessions, hands-on skills stations, and poster sessions.

All abstracts must be submitted through the online system by 5:00 PM EST on September 1. Abstracts will then be reviewed by the ICEA Conference Committee. Share your expertise today!

If you have any questions about submitting your abstract, please contact the office.

Submit Your Abstract

New Certification Process Launches Next Week

Throughout March and April, we unveiled exciting changes on the way for ICEA, and all of them benefit you! So far, we’ve released our Strategic Map, revitalized member benefits, and our new website.

Most exciting of all, we gave you a sneak peek into our streamlined certification process. Now, it’s time to announce that that the new certification process will launch next week!

Once the new programs are unveiled, you can expect to see:

  • Certification bundled with member benefits
  • More equitable pricing on a global scale
  • A process that is straightforward and easy to enroll in
  • A more nurturing organization that will mentor students
  • Reduced pricing for certifications purchased after initial certification

ICEA is now your one-stop shop where you can get all of your maternal-child health certifications at an affordable price!

If you’re already certified with ICEA, then great changes are in store for you too. The new recertification process includes updated and simplified procedures making the process less of a headache. Plus, recertification fees will be more cost-effective, and reduced pricing will be offered on second and third recertifications.

Please Note: During the transition period, prices reflected on the website for recertification are not necessarily equivalent to the fees that will be requested from you. Expect to see an email 90 days prior to your certification expiration with the correct fees listed. As always, you can contact with any questions. 

The board and I are incredibly excited for this next step, and we are certain these programs will serve your needs. Stay tuned for the official launch next week.

In addition to the streamlined certification programs, you can expect many more important and exciting changes to ICEA. These will all be steadily rolled and include:

  • Revised handbook and bylaws
  • Updated scholarship, mentorship, and volunteer programs

If you have questions about any of these changes, please don’t hesitate to reach out to me, the board, or staff. We are honored you chose ICEA as your certification body, and we look forward to your participation in our streamlined certification process.

In your service,

Debra Tolson, RN, BSN, ICCE, IBCLC, CPST
ICEA President, 2017-2018

Five Secrets of Teaching Better Breastfeeding Sessions

by Terriann Shell, BS, RN, IBCLC, CHES, ICCE, FILCA

I’ve always thought that once you know how to teach adults childbirth, you could teach any subject. While this may be true, I find that teaching breastfeeding is a sacred and special calling. We are preparing expectant parents for the first independent task we ask of their newborn infant. We are shaping that once-in-a-lifetime special period- the “golden hour” when they meet their new baby for the first time and help shape a life-long relationship and the parents don’t evenknow how special this is-yet! If we are giving our sweat and knowledge to expectant parents and their support people, we really want our information to be helpful! Here is where we can share what is working in our sessions and what we’ve tried that didn’t work.

1. Use Catchy titles (but not too cutsie)

No one wants to go to hear “breastfeeding basics” or “breastfeeding 101.” Start with a catchy title because you have to get people in the seats before they can hear your good information. You want the people to attend to then go out and spread the word since word-of-mouth will be your best seller with their expectant friends. Give them a meme to share on their Facebook page or on Instagram. A catchy title says your class will not be boring and continue to carry the catchy titles out in your class information segments. You want to let them know you are professional, but fun.

What ideas can you share that you found effective for increasing session attendance?

2. Make sure you are teaching the most up-to-date information.

If you are still teaching the same information and the same way as you were five years ago, you are probably coming off as stale and outdated to your parents and support people and word gets around. We can now talk about expressing colostrum prenatally, when appropriate, and the incredible value of skin-to-skin for at least the first hour birth. If you are teaching prenatal preparation of nipples before breastfeeding, taking baby off the breast after X number of minutes, encouraging drinking of a lot of fluid or avoiding specific types of food, using nipple ointments for prevention or treatment of nipple discomfort then you may need to update your information.

What breastfeeding information have you updated recently? What “old” advice are you still hearing?

3. Be Concise with your agenda.

How much can someone absorb at any one sitting? Now add pregnancy brain into the mix! Encouraging support people to attend with the expectant person would be wise because they will also be around mother, supporting her after they have the baby and they will most likely remember more than the pregnant brain will.

We need to do our part by now giving every single fact we know about lactation. I suggest you think of your top 3 objectives and leave it at that. You will be more effective! Of course, each of these three objective may include several subtopics. For my sessions, my simple outline is something like this:

  • Why breastfeed?
  • How milk is made and how it is moved
    1. Simple anatomy
    2. Simple physiology (positioning, latch, moving milk)
    3. How to tell baby is getting enough
  • Resources for breastfeeding help

Notice what is missing? No discussion of sore nipples, engorgement, or mastitis. Who would want to breastfeed if the discussion focuses on everything that can possibly go wrong? Would they even remember the “fix” for any of these? Probably not and if they get off to a good start, they hopefully not need any of this information. If they do need help, then they have the resources to find it.

I also suggest watching your spiel for telling your audience what we once though or taught since that is useless information now unless you are talking about poor advice they might hear from others. Also dig through your audio-visuals and getting rid of that VCR tapes (nothing says outdated as a VCR!).

Watch the resources you recommend or have available. Are they from a company that sells a product? Are they from a source that is compliant with the World Health Organization’s Code of Marketing of Breast Milk Substitutes?

What topics do you feel is important for expectant parents to know after your session? How long do you feel an introductory breastfeeding session should be?

This leads into the next suggestion:

4. Use a variety of audio-visuals!

This may include teaching in new styles like offering quizzes on an app or clips from excellent internet resources. For example, the short clip of Jane Morton teaching hand expression is priceless, yet freely available online and if you hand each attendee a “breast” stress ball, they can practice along with Jane’s, “press, compress, relax,” incorporating more interaction increasing retention. Use dolls, bunch of grapes (to illustrate the milk “factory”), model breasts, YouTube clips, DVDs or downloads, and examples from today’s actresses and pop stars. Let people try positioning with soft dolls or stuffed animals, give them resources to watch videos over and over, as needed, to reinforce what they’ve learned, and present the information in a few different modalities.

What are your favorite resources for sessions? How do you make your classes interactive?

5. Leave ‘em wanting more!

Two of the topics that is most requested but not covered in my sessions is employment and pumping milk. I cover hand expression when talking about keeping a good milk production. How much do you think the audience will remember when the time comes, if you cover the differences between breast pumps, when and how to pump, storing and thawing milk, and or how to go back to work and express milk? That is a whole class in itself! Again, this goes back to giving them resources for when they need that information. You might want to have them come back for this class when the time gets close.

What topics do you leave out of your sessions or think you don’t need to teach in an introductory session?

Finally, one suggestion for a different, but effective breastfeeding education session is to ask the audience what they came to learn when opening the session and doing introductions. Write the topics down and then check them off as teach each topics on the list, throwing in essential information that is on your outline. This way everyone gets what they came for.

What other suggestion do you have for a quick class or for an how-to class on breastfeeding?

Terriann Shell has been teaching childbirth education as an ICCE through ICEA, since 2003 and has been an IBCLC since 1988. She holds a Bachelor in Health Science with a focus on health education and a minor in education. She is also a Certified Health Education Specialist and a Registered Nurse. Terriann moved from one of the smallest states, Delaware, to the largest, Alaska 20 years ago to run sled dogs and raise kids. She lives in Big Lake, Alaska with her family of 7 now-adult children and 11 grandchildren. She works at 2 hospitals doing lactation rounds and teaching childbirth and all the related classes. She served twice on the Board of the International Childbirth Education Association and also serve on the International Lactation Consultant Association.

Road Map to China

By Tamela Hatcher, MEd

I am thrilled to have been asked to share my story regarding my experience teaching ICEA Professional Childbirth Education (PCBE) and Birth Doula workshops in China. This journey reminds me of the Penny Simkin Roadmap to labor. I have traveled the scenic route, in which I have experienced the expected and normal things. I have traveled some bumpy roads that posed great challenges.  On other occasions, my foreign travels and teaching have moved forward so fast that I felt like I was on a super highway.

The Super Highway: In October of 2015, I facilitated a concurrent session at the ICEA/Lamaze joint conference.  Three ladies from China attended this conference.  I remember looking at one lady during the 90- minute session and wondering how effective my presentation was for someone that spoke a different language and was thankful for the pictures I had added. However, I made a mental note for future presentations to be more aware of ICEA as an international organization.  It is the first word in our name, and yet I had never put myself in the role of the international member.

Shortly after the conference, I received an email from China requesting that I facilitate a workshop with a grassroots birth organization called YANMA, a trustworthy and honorable organization.

In January of 2016, I had my visa, passport, plane ticket for this 14-17 hour flight, and enough vacation time from my job to embark on this journey.  I was excited, scared, anxious and happy all at the same time. I reminded myself that this was similar to how many families feel at birth.

Our ICEA birth work and collaboration in China has been very productive.  More than 500 ladies and 1 gentleman have attended the workshops.  Many have gone on to certify, and some have started successful and thriving birth businesses.

The Bumpy times:  We had some communication issues and misunderstandings along the way, which required some difficult conversations.  These bumps in the road taught us some valuable lessons.

We realized some things were extremely difficult or impossible to achieve in other countries, such as observing three births. Some of these were simple to fix, like our ICEA required reading list of books that were not available in China.  The authors, Amis and Green, were quick to come to our aid. They gave us permission and helped to develop a plan to translate this popular book into Chinese. It is projected to be available to our students in July of 2017.

The ICEA organization has made concerted efforts to become more global-friendly.  We have moved the exam to an online format that can be taken in English, Chinese, or Spanish.  We have updated our website.  We are collaborating with members from other countries to develop key documents in other languages. Most importantly, we are working on providing alternatives to observing births in the hospital settings and streamlining our certification programs.

Most women in China are required to labor in bed without the assistance of husbands or birth doulas.  Some midwives communicated the trials and frustration of caring for as many as 17 moms in a day.  Shared rooms, overcrowding, and the lifting of the one-baby policy all posed new challenges for health care facilities.  The cesarean rates are very high, and everyone seemed committed to finding solutions. We all want safe, kind, compassionate and empowering births.  How we achieve this and what it looks like varies.

The scenic route: This part of the journey has been amazing!  I have met some incredible and passionate birth workers.  I have learned so much about this beautiful and gentle culture.  During 2016, my husband and I were elated to reciprocate the hospitality that has been extended to our family by hosting five of my birth colleagues in our home as they learned first-hand about birth in the United States.

Indeed, this has been a rewarding and beautiful journey.  The people are so appreciative of the ICEA education and workshops.  We have found creative work-arounds for our language barriers and have enjoyed learning about and celebrating our differences.  I have had the privilege of touring new birth businesses, hospital birthing facilities, and confinement centers for postpartum women, meeting many talented and committed birth doulas, aspiring professional childbirth educators, doctors, midwives and hospital administrators. I have enjoyed sharing many meals, experiencing Chinese traditions, Chinese medicine, massage, yoga, bath houses, temples, train rides, Uber transportation, the circus, We Chat and many new APPS, and climbing a mountain where I enjoyed tea with one of my new friends.

I have embraced the two hour lunch/nap times that are taken daily.  I must admit, the first time I was given a mat and pillow, I spent the time feeling anxious about all of the things that I should be doing.  Now, I look very forward to this quiet time to reflect, embrace and recharge.

Is teaching hard work? You bet it is!  Is it worth it? Absolutely.  During this short time, I have been able to witness a shift in healthy birth practices.  Some fathers are now allowed to participate in the birth of their children.  Some hospitals have welcomed birth doulas.  One lady from our first ICEA workshop recently shared with me that she had the birth of her dreams. She was supported by two other students from that first class.  One was a doctor and the other a midwife, who served as her birth doula.  She wore her own fun clothing, had her husband with her, enjoyed food, drinks, friends, and literally danced her adorable baby into this world.

I am so thankful for the great teachers and maternity workers that have paved the road for me to do this work.  Because of them, I am living my dream.

Tamela Hatcher, MEd, has been fascinated with birth for as long as she can remember.  When Tamela was five years old, a wonderful maternity nurse placed Tamela’s hand on her pregnant belly, and Tamela felt the nurse’s baby kick.  Tamela was amazed and curious.  By 12 years of age, she had read every book about birth she could get her hands on, and she knew she wanted to work in the maternity or education field.  Tamela had a great middle school teacher who said, “Why don’t you do both?” The teacher talked to Tamela about a couple of fairly new organizations started in the 1960s called ASPO (now Lamaze) and the International Childbirth Education Association (ICEA).  Tamela has enjoyed teaching childbirth education to more than 3,610 couples. Currently, she serves as the Education Director for ICEA, and has coordinated birthing education and doula services for 26 years. Recently, Tamela retired to pursue her love of traveling and teaching.

Is Distracted Parenting a Problem?

By Donna Walls, RN, BSN, ICCE, IBCLC, ANLC

A relatively new phenomenon is occurring with some possibly serious implications for infants and children. Concerns are being expressed related to “distracted parenting”. These concerns center around parents whose attention toward their children is now directed to electronic devices, especially cell phones.

In a study in the journal Pediatrics, the authors observed parents dining with their children (ages birth to 10 years) at fast food restaurants. The researchers noted about a third of parents spent the entire meal fully absorbed with their mobile devices, with no attention given to their children. The children who sought attention from their parents were often ignored by their parents who were engaged only with their devices.

Dr. Jenny Radesky, MD, a pediatrician, the study’s lead author said: “One child tried to raise his caregiver’s face to look at him and not the screen, another said he wasn’t done with food that was thrown away, and each time the caregiver just went back to the screen.”

Other child behavior experts cite concerns including research showing high tech using parents are less likely to share family meals and less likely to report satisfaction with their leisure family time when compared to lower technology using parents.

Technology preoccupied parents may also lead children to “act out” as a means of getting their parent’s attention. NBC News’ Brian Alexander reported that distracted parenting can contribute to developmental delays in speech and cognition, and lead to behavioral issues, such as temper tantrums, anxiety and resistance to discipline. “In extreme cases of neglect, with very little interaction between parents or other caregivers, children can develop a variety of pathologies.” Children may be more likely to feel abandoned and unworthy and as they grow older and  may likely be at risk of becoming depressed and angry.

In a new animal-based study published in the journal Translational Psychiatry, scientists show that distracted parental attention may sometimes have detrimental effects on babies’ development, especially their ability to process pleasure.

“The fact that the adolescent mice showed signs of compromised pleasure sensations suggests that just like with sensory systems such as sight and hearing, there may be a critical window in which newborns need to be exposed to certain behaviors from mom in order for their nervous system to develop properly. In this case, the lack of consistent, repetitive and reliable attention appeared to affect the animals’ ability to develop proper emotional connections to help them understand pleasure. “It makes perfect sense,” says Baram. “We do need rhythms and consistent exposure beyond the ears for them to be capable of discerning complex patterns in speech and music. We need patterns for the visual system to develop. I guess we need predictability and consistency for the emotional system to develop”.

“What we are proposing is that there is a sensitive period in which maternal care needs to provide consistent patterns and sequences of behavior so the baby’s brain can perceive them to develop normally emotionally. The predictability of maternal care seems to engage the pleasure system, and the pleasure system needs to be engaged so the neurons involved will fire together and then will wire together,” she says.

In the past five years, research studies of this phenomenon have multiplied. Linda Blake and Ben Worthen cite studies showing a correlation between increased incidents of child playground injuries and parents’ technology-induced inattention. Another study at Boston Medical Center, conducted by pediatrics specialist Jenny Radesky shows that parents and other caregivers using hand-held devices were more likely to punish children harshly for minor mischief.

In recent news from Ohio, a 7 year old died in a car crash when the mother was preoccupied and talking on her cell phone. The mother survived the crash.

Another concern is the possible negative health effects of radiation exposures. The International Agency For Research on Cancer, American Cancer Society and the National Institute of Environmental Health and Sciences all agree that studies have raised some concerns and further investigation and research should be conducted, according to the National Cancer Institute. In 2011, after reviewing evidence from a study conducted by 31 scientists around the globe, the World Health Organization categorized non-ionizing radiation as a “carcinogen hazard” next to lead, engine exhaust, and chloroform.

What microwave radiation does in most simplistic terms is similar to what happens to food in microwaves, essentially cooking the brain,” Black said. “So in addition to leading to a development of cancer and tumors, there could be a whole host of other effects like cognitive memory function, since the memory temporal lobes are where we hold our cell phones.”  -Dr. Keith Black, chairman of neurology at Cedars-Sinai Medical Center in Los Angeles.

With growing bodies and developing brains, cell phone radiation could potentially have an even greater effect on babies and young children, so minimize their exposures by:

  • Moving phones several feet away from infants and children
  • Turn off when not in use and in close proximity to a child
  • Do not place your phone in the infant carrier or stroller
  • Put your phone on airplane mode while holding or feeding the baby
  • Do not allow infants or young children to use the cell phone as a toy.
  • Use a protective cover while breastfeeding your little ones if you use your cell phone during nursing sessions.

Some experts are beginning to caution against extended cell phone use during breastfeeding or bottle feeding, as numerous studies have found that the feeding time is critical to mother-child bonding and socialization. Dr Kateyune Kaeni, a psychologist specializing in maternal mental health at Calfornia’s Pomona Valley Medical Center says eye-contact is vital in building a secure connection between mother and child.

Dr. Kaeni continues “If baby is trying to make contact with you by making noises or smiling and they can’t, they learn over time that they can’t rely on you to respond, it runs the risk of them becoming either anxiously attached to your or insecurely attached to you and they will ramp up their behavior until you pay attention.” She added that a distraction such as a smartphone could mean mums are missing cues that baby is “full or they’re still hungry”. Texting while breastfeeding as even spawned a new term- “brexting”- cell phone use while nursing.

In the breastfeeding (and bottle feeding) arena there are other concerns associated with parental inattention. Mothers may miss feeding cues, skip or delay feedings and endanger the infant’s nutritional status and compromise her milk supply. They may also miss subtle cues that the infant is latched incorrectly leading to poor milk transfer. Mothers and their ≤24-week-old bottle-feeding infants (N=28) visited our laboratory for a video-recorded feeding observation. Findings demonstrated that “mindless feeding” is associated with greater infant formula/milk intakes and lower maternal sensitivity to infant cues.

On the other side of the coin, some mothers have reported that having technology time provides a welcomed and often necessary reprieve from the responsibilities of parenting. Some felt like they could be more “present” with their infants and children when they had some technology break time.

Other parents reported feeling like the use of technology and cell phones has brought their families closer. Some felt that mothers/parents have always had “distractions” like radio, TV or even older children requiring their attention which is no different than technology distractions.

Is this a topic that might be considered part of the childbirth education classes or included in parenting or breastfeeding classes? It certainly is an intriguing topic that will certainly become more relevant in the near future. Until then, an awareness of the concerns may help us to respond to parental questions or concerns.

Brunstrom JM1, Mitchell GL. Effects of distraction on the development of satiety. Br J Nutr.  2006 Oct;96(4):761-9.…/201412/are-you-distracted-parent…/brexting-impacts-baby-bonding-during-breastfeeding

For Decades, Research Has Verified the Benefits of Doula Care

The word “doula” first used in an article published in 1969 by Dr. Dana Raphael, a medical anthropologist who believed in the need for female companions to guide mothers through pregnancy, birth, and postpartum. In the midst of their research on maternal-infant bonding, Drs. Marshall Klaus and John Kennell verified the benefit of labor support.  They first published an article documenting these benefits in the New England Journal of Medicine in 1980. Several years later they followed up with more research published in the Journal of the American Medical Association.

The Cochrane Library published its first review of literature in 2003 affirming the benefits of labor support.  That publication has been updated several times (the last time being in 2013) and the results remain the same: doula support results in many benefits and with no adverse effects. To quote the executive summary:  “The review of studies included 23 trials (22 providing data), from 16 countries, involving more than 15,000 women in a wide range of settings and circumstances…. Women who received continuous labour support were more likely to give birth ‘spontaneously’, i.e. give birth with neither caesarean nor vacuum nor forceps. In addition, women were less likely to use pain medications, were more likely to be satisfied, and had slightly shorter labours. Their babies were less likely to have low five-minute Apgar scores. No adverse effects were identified. We conclude that all women should have continuous support during labour. Continuous support from a person who is present solely to provide support, is not a member of the woman’s social network, is experienced in providing labour support, and has at least a modest amount of training, appears to be most beneficial.”

An article published in 2013 in the American Journal of Public Health Katy Kozhimannil, PhD and others demonstrated the financial benefits that doula care can have on the health care system.  Because of the lower intervention rate, paying doulas is actually cost effective.  Several states now either have or are considering Medicaid reimbursement for doula care.

The American College of Obstetricians and Gynecologists (ACOG) have now released two Committee Opinions in support of doula support during labor.  Safe Prevention of the Primary Cesarean Delivery published in 2014 suggested doula care as one of many ways to help lower the primary cesarean birth rate.  Citing data from the Cochrane meta-analysis mentioned above they stated, “the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery. Given that there are no associated measurable harms, this resource is probably underutilized.”

The most recent ACOG support for doula care was published in February 2017. Approaches to Limit Intervention During Labor and Birth stated that “women benefit from continuous emotional support and the use of non-pharmacologic methods to manage pain. Support offered by trained labor coaches such as doulas has been associated with improved birth outcomes, including shortened labor and fewer operative deliveries.”

For decades the benefits of doula care during labor and birth have been researched and documented.  The results have never varied: women and their families benefit in many ways from the emotional and physical support that doulas offer. This is World Doula Week.  Help spread the word! #worlddoulaweek #doulasbenefiteveryone

American College of Obstetricians and Gynecologists. (2017). Approaches to limit intervention during labor and birth. Committee Opinion No. 687. Obstet Gynecol;129:e20–8.
American College of Obstetricians and Gynecologists. (2014). Safe Prevention of the Primary Cesarean Delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123: 693–711.
Kozhimannil KB, Hardeman RR, Attanasio LB, Blauer-Peterson C, O’Brien, M. (2013). Doula care, birth outcomes, and costs among Medicaid beneficiaries. American Journal of Public Health. 103(4), e113-e121.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7.
Roberts, Sam. (2016). “Dana Raphael, proponent of breastfeeding and use of doulas, dies at 90”. Retrieved March 15, 2017 from