Most doulas attend a two or three day workshop with a certification organization (such as DONA, ToLabor, Birth Arts International or CAPPA) and then pursue certification individually. This includes reading A LOT (each group has their own required and recommended reading list, but anything about pregnancy and birth is helpful) and attending births. The number of births depends according to organization. The doula-in-training usually writes about her experience at the birth and has someone (the mom or dad, or one of the healthcare professionals, depending on the organization). Each group has their own exam after these requirements have been completed.
Of course, certification is not necessary to attend women in labor. A woman may call herself a doula even if she is not certified. The advantages to certification include potential reimbursement from Medicaid or private insurance, and provides some confidence to the expectant parents that the doula is qualified and knowledgable.
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