There’s no way around it — doula work can be isolating.
The fact that any independent birth worker is a small business owner provides a lot of huge benefits to that person in so many ways. It can be exciting and empowering to own your own company, be your own boss, have ultimate power on business decisions ranging from how your website looks, to how many days a week you work, to which clients you take.
There are also downsides to running everything on your own, but one of the biggest is the feeling of being alone in the woods when it comes to your skills and performance.
One HUGE thing doulas can start doing to combat the issues of accountability and isolation is forming and attending peer reviews.
These are the basic components of a peer review :
1. First and foremost, this is a confidential and nonjudgmental arrangement. What is said in peer review stays in peer review. Even if the topic at hand is a complaint or concern, the advice given is done compassionately and in an effort toward improvement, not pettiness.
2. To conduct a peer review, there needs to be at least three peers present. In the case of most colleague peer reviews, there will be three doulas who are able to sit or present or both. In the instance that peer review is called as arbitration between parties, there will be a panel of at least three doulas in addition to the parties presenting their issue.
3. The order of peer review is as follows : One person presents a concern, uninterrupted, for 20 minutes. Following that, those who are there to “sit” may ask questions and offer advice for another 20 minutes. There is a quick check in with the presenter to make sure they feel ok about what’s been discussed and then the next presenter goes. This repeats until everyone who came with a concern has had the opportunity to be heard. In the case of peer review being offered as a form of out of court arbitration, the party presenting a concern goes first, followed by the person to whom the issue is being addressed, then the panel can ask questions of either party and give advice till a resolution is agreed upon. If there is no conclusion made, the next step would be to repeat the process with a third-party mediator brought in.
Peer review or professional performance review is a common practice in many professions, and it should be more common in doula work. This is both for our ability as care providers to check in with our community, work through trauma, obtain valuable resources, connect with one another, and grow as well as to holding our profession to the highest standards. Particularly as issues around certification and self-definition emerge, peer review can serve as valuable grounds for finding weak spots in our profession / community and addressing them from within so they’re not mandated over our heads.
This isn’t to say that peer review should be an intimidating process; quite the opposite. The point shouldn’t be that there is a firing squad or mob to tell you that you’re doing something wrong, but that you have the backing of your peers in working through the common issues in our difficult work. The rules and structure of a peer review — confidential, contained, focused on moving forward productively — can go a long way toward giving you applicable tools rather than tossing you to the sharks of online chatrooms and closed groups on social media alone. These in-person gatherings ensure you’re talking to colleagues familiar with your local community, which can make a much bigger impact on addressing your concerns, too.
Being able to offer the existence of a structured peer review system as a form of out of court accountability can be a huge selling point to expectant parents. Whether it’s through your doula agency, collective, or group, letting parents know that you are expected to live up to the standards of our profession and that they’d have resources outside of the tediousness of small claims court can offer them a sense of trust and relief when signing into a contract with you.
Additionally, peer review should be part of the membership requirements of any community doula group. It offers an amazing opportunity to get to know the other doulas in your area on a deeper level, to disseminate important information about primary care providers in a HIPAA compliant and professional manner, strengthens referral networks, and offers an avenue for handling the occasional bad seeds amongst us.
If you don’t already have a peer review system in place in your doula group or agency, will you consider starting one? It might take a few tries to get people feeling comfortable with this process, but it’s a truly essential part of brining this profession out of the shadows. It’s low-to-no cost, too, so its an accessible way for doulas of all stripes and experience to gain knowledge from one another. It’s also a really good way for us to each grow as individuals. Understanding how to give and take constructive criticism and utilize it effectively in our lives can have lasting benefits to ourselves and our clients.
If you want to learn more about starting peer reviews, join me for my webinar on the subject on July 9th from 4:30-5:30 pm PST. You can register for that on my website at https://www.rosewoodbirthconsulting.com/classes-and-workshops-1. Hope you’ll join us!
Emily Flynn has been a birth and postpartum doula for over a decade, additionally working with hundreds of families a year as a birth attendant, educator and student midwife. With her legal research background and focus on broader policy issues around pregnancy and birth options, Emily has begun supporting doulas through writing better contracts through workshops and private consultations. She is also a gentle infant sleep coach and educator, and trains doulas independently and with Cornerstone Doula Trainings on infant sleep basics and sleep coaching. She currently lives in Felton, CA.