Tuesday, September 3, 2013

Celebrating the Doula Training with Midwife Roots

I am thrilled to be able to say "Happy 30th Anniversary" to toLabor, the oldest national doula training program.  In 1983, Rahima Baldwin began offering birth assistant trainings through the organization Informed Homebirth/Informed Birth and Parenting.  Originally a course for midwives' assistants, the program evolved into a doula training offered throughout North America.   In 1995 the organization's name was changed to ALACE, and in 2009 it became toLabor (The Organization of Labor Assistants for Birth Options & Resources).  I was proud to serve as Assistant Director of the program for seven years, which is how I met Thérèse Hak-Kuhn.  Thérèse is the mother of six children, a doula trainer for sixteen years, an assistant midwife, and the organization's current Director.  The toLabor program is treasured by participants who resonate with the midwifery model of care.  As for myself, I knew little about birth when I began my doula career, but the more deeply involved I became with the organization, the more I discovered that its woman-centered approach to birth fit my values perfectly.  To locate an upcoming training or find a toLabor doula, visit http://tolabor.com/.  Below, Thérèse Hak-Kuhn explains the life-changing impact of the program.

It was the quality and quantity of care that I received from my midwife during my pregnancy, labor, and into my postpartum that forever changed me and began defining my life’s work. I realized that my experience should not be rare, that I should not be considered “lucky” or “fortunate,” nor should you have to birth at home to receive what I had, what my baby had.  I realized that everyone, every one deserved to have compassion present at their birth; it was unimaginable to me that that wasn’t obvious, and I believed it should be the intention right beside the statement, “we want a healthy baby and a healthy mother.”

Years later, these beliefs infuse toLabor and what makes it such an outstanding training program. On the one hand, yes, our training is about being a doula.  We want participants to be clear on the role of a doula, understand the value of the role, feel confident that they are capable, and understand that it is an ongoing learning process; we want them to be motivated to begin attending births the day they leave the workshop. But the workshop is about so much more and our attendees understand this. The workshop is about life and how to live, how to treat others, how to be treated, how to be an advocate for our own lives so we can be role-models to those we work with.  It is about creating a peaceful world.

There is room for compassion at every birth. It is a civil right. It is a human right. These words aren’t just a slogan, they are the essence of who we are and what we want everyone to understand when they leave a workshop with toLabor. What I learned from my first midwife, what I continued to learn from the others, what I learned from being a mother, from sitting in the rooms of birthing women, and what I learned in the hundreds of workshops I have facilitated, is that we all want to be safe. To have judgment suspended. To have love present, and unconditional support. We set this as the intention at each workshop. We dialogue about this, working with one another to listen and be listened to. This is how we create a peaceful world.

We speak in our culture about informed choice and informed consent but in most cases, the pregnancy year being the perfect example, it would be more accurate to call it limited informed choice and consent. Commonly, decisions are made based on information that may not be well-rounded, without all sides, options, choices, risks and benefits presented and defined. So often informed consent is requested without full disclosure that one also has the right to refuse to give consent. We speak a lot about this in our workshops. We speak about human rights, but we also speak about our civil right to have our voice. This is about accepting responsibility for your choice. If a person feels they were actively participating in the decision-making process, there is very little room to lash out, looking for someone else or something else to be responsible for the outcome. Our workshops are about becoming active participants, activists in changing the culture of birth, which in return we believe changes the culture of parenting, education, and systems of all kinds.

I often speak about parenting in terms of its importance:  what could be more important, what job could have more significance, than raising a child? Babies are coming into this world planned, unplanned, wanted, not wanted. The intention of toLabor is to have those babies welcomed with dignity, grace and compassion, ideally into the arms of parents who feel empowered to be strong, vocal yet peaceful advocates for themselves as well as their children. This is what changes the world.

Do I feel the frustration, the anger that others feel when we hear of what is happening in maternity care? Absolutely! As a young woman, I felt a lot of anger towards the many injustices I was aware of in my own life and in the world at large. I was a fighter and a survivor. I thought you could be heard if you shouted loudly and with a fierceness that showed your power and showed that you were not afraid. What I found was a lot of anger coming right back at me and not a lot of change. I learned quickly that my voice could not be heard if it was full of anger. As a mother I found my voice when I was given the opportunity to feel safe that it would be heard. What we work on in the workshops is how to take that anger, how to harness it, how to recognize that it is based on our passion and that instead of anger, we can turn it into com-passion. We talk about changing the verbiage that is used, removing the words fight, battle, war, enemy from our conversations involving the pregnancy year. Our words carry power and these are words that convey and encourage violence. The birth of a baby should not be surrounded by such negative energy. This is how we create a change in the world.

We recognize that our three day workshops emulate a long labor, and that birth will occur. We see the seeds of a doula’s work being planted, nourished and cultivated throughout the weekend. At the closing what becomes apparent is that the work we have been doing all weekend was successful, as each person shares their insights of the workshop…overwhelmingly they feel safe and they feel inspired and they feel ready. This is what we strive to give to our clients, so that when they birth their babies they will feel safe, inspired and ready to be parents.

This is what creates a peaceful world.


  1. Love, love, love Therese's work and all that ToLabor does in a culture hungry for empowered birth. Thanks for this wonderful piece. Happy birthday, ToLabor!

  2. This is just beautiful. ToLabor is truly unique in its approach, and those who do a training are never the same. We are agents of change in this world. thank you, Therese and thank you toLabor for your 30 years of service.

  3. Therese is an inspiration just not to me as a doula but as a woman. Knowing that she is spreading the word and advocating for compassion at birth and empowering families to do the same is a gift that will be granted a thousand times over with each doula that she trains and family whose birth she attends.

  4. Therese has said it perfectly again!

  5. I have been wondering what happened to ALACE.

  6. Congratulations and happy birthday to an extraordinary organization!

  7. Hmmm...this is not what I think Rahima would have said (IH/IBP) or Jessica (ALACE). I joined IH/IBP in 1986 and evolved with ALACE. For several years after Jessica sold it, ALACE was a dormant organization until it became ToLabor. Nothing against ToLabor, but to claim it as 30 years old makes me feel really uncomfortable. Even though she bought the business, Therese's incarnation of it is really only 4 years old. This is not a comment about her message - which I have no objections to - it's the opening line about the 30th anniversary. Too much time in academia I guess!!

    1. Amy, it is great to hear from you! I began working at ALACE in 1995, and then I was part of the committee that guided ALACE through its transition in 2009 which resulted in toLabor. (Jessica retired before that but did not sell the organization, as it was a nonprofit at the time.) There was no dormant period -- we considered doing that but we actually decided to keep operations going continuously, and the doula trainings carried on without interruption. The reason I wrote my opening line about the 30th anniversary, and the reason I asked Therese to write this guest post for my blog, is that I truly do see it as an unbroken lineage back to 1983. Therese was part of IH/IBP, and she began teaching for ALACE in 1997. The toLabor training is the only national doula program I know of that still resembles a midwife assistant training -- incorporating labor support as well as all the experiential learning exercises such as palpation of pregnant models, taking blood pressure, the introduction to vaginal examinations, etc. I'd love to have a future blog post about why we've continued to incorporate those aspects of the training for 30 years. Jessica liked the essay on toLabor's Facebook page, so hopefully she approves of the way Therese and I told the story! Thanks so much for adding your perspective and giving me the chance to try to clarify a couple things.

  8. I wanted to remind folks that there are several toLabor Doula Training Workshops coming up all over the country: Boulder, CO Richmond, VA, Brunswick, ME, Chicago, IL, San Diego, CA, Houston, TX and more...
    Check out the full schedule at: http://tolabor.memberlodge.org/Default.aspx?pageId=1209274