Tampa General Hospital OR/PACU Doula Training & Certification

What Doulas and Birthing People Need to Know

In February 2024, Tampa General Hospital (TGH) Labor and Delivery staff introduced a Doula Training and Certification as a mandatory requirement for doulas to enter the operating room (OR) and post-anesthesia care unit (PACU) in order to continue supporting their families who require a cesarean birth or have birth circumstances that require them to be cared for in the OR environment (e.g. multiples, vacuum assisted birth).

Prior to the training being introduced, doulas were inconsistently able to access the OR and PACU with the birthing family they were supporting, and the Labor and Delivery staff at TGH were keen to address this inconsistency, which the doula community greatly appreciates and welcomes. Whilst this training is a vital step forward in centering birthing people in their right to continuous doula support irrespective of the birth they have, aswell as strengthening collaborative working between doulas and TGH, ensuring that the many doulas who work with families across the Tampa Bay area (and beyond) become aware of the training, and are able to complete it in a timely manner, is an ongoing concern.

Doulas who support birthing families at TGH are located across a large geographical area, not all are static, some travel in/out of the state to support their clients and many new doulas enter the role on an ongoing basis. Doulas work in many different ways, including independently, in collectives, within independent Midwifery practices and for nonprofit or state/federally funded organizations. This rich tapestry of doulas, and the automous way in which they work, means that reaching them to ensure they are notified of the mandatory training is challenging, and ultimately, some birthing families will miss out on continuous support from their chosen doula, should they require care in the OR, simply because their doula was not aware the training existed. It is imperative to acknowledge the barriers that mandatory within hospital, training certifications place upon doulas, particularly for those doulas who practice more traditionally, are less prominent in the doula community, do not utilize social media or are not connected in spaces where information about the training would typically be shared or gatekept.

It is also of vital importance to protect the autonomy of the doula role, and the sanctity of the doula-client relationship as a key foundation to improving birth outcomes. This is particularly relevant to the birth outcomes for families who are Black, Indigenous or of color (BIPOC), or those who hold other marginalized identities or socio-economic disadvantage, for they are at greatest risk of poorer outcomes compared to families that hold power, positionality and privilege in the community. Requiring doulas to complete mandatory within hospital training certifications, is an additional challenge that doulas must navigate, which can disproportionately prevent the most vulnerable families from having access to their doula of choice, simply because their doula was unable to access and complete a training mandated by the healthcare system.

As TGH is often seen as a leader in healthcare, it is so important that the structure of this training program be carefully considered, as it may become a blueprint for other healthcare sytems and the hospitals within them. If this were to occur, doulas would be required to navigate completing mandatory training certifications across multiple hospitals in the Tampa Bay area and beyond, which is a signficant concern. As a doula, I acknowledge the role that power hierarchy, time, resources and infrastructure play in shaping the training, as well as how regularly sessions can be run. I appreciate that these factors contribute to how many doulas can access, and complete the training in a timely manner.

I also acknowledge the challenges and many moving parts that exist within systems of healthcare, and appreciate that the Labor and Delivery staff at TGH provide the training in addition to the demands of their daily professional roles, with the positive intention to improve services and provide access to continued doula support. Myself and doulas who have attended the training have given thanks to all staff involved for their time and comittment to delivering the training program, as well as their willingness to consider feedback regarding alternative training formats that would make the training more accessible and readily available.

Key Points for Doulas

  • The OR/PACU Doula Training Certification is a MANDATORY requirement to enable doulas to continue their support with birthing people who need to birth in the OR.
  • Doulas cannot be present in the OR if the birthing person requires general anesthesia. The doula will be able to continue support in the PACU.
  • A certificate will be provided to each doula who completes the training and copies of the certificates will be kept in a binder at the Labor and Delivery Nurses station.
  • The Labor and Delivery Charge Nurse will be responsible for checking if a doula is certified before the doula is able to enter the OR.
  • Doulas are advised by TGH to keep an accessible copy of the certificate on their mobile phone.
  • The next training is March 4th 2024. There are approximately 25 spots at each training. The waitlist should be cleared after this session.
  • There is no training session planned for May 2024. It is proposed that training from June 2024 onwards, will run in alignment with the Childbirth Education Class schedule.
  • Additional training dates can be requested if small groups of doulas identify there is a need (which there will be, as there are many doulas across the Tampa Bay area and beyond that provide doula support to people birthing at TGH).
  • Individual doulas can email TGH to be slotted into the next available training. The direct point of contact to arrange this, to request additional training or to ask questions is – Deb Esenwein, email desenwein@tgh.org, tel: 813 844 8945
  • The training lasts 2.5 hours and includes presentations from Labor and Delivery staff on current labor care pathways and clinical decision making for cesareans, collaborative team working, communicating with the team and reporting concerns. There are also group tours of a labor room, the OR and PACU
  • There are lots of opportunities throughout the presentations and tours to ask questions and give feedback – please come prepared to do so. It is so important to make use of the training as an opportunity to have your voice heard in shaping care that best meets the needs of people birthing at TGH.
  • Please connect widely with the doula community – share this blog and my social media posts about the training (instagram @allisontatebirthcompanion) with any doulas that you are connected with, and encourage them to do the same. We need as many doulas to be trained as possible so that birthing people do not miss out on essential support from their chosen doula, should they birth in the OR.
  • Be sure to complete the feedback form at the end of the training – a QR code will be provided at the session.
  • If you would like to work in collaborative doula community to contact other healthcare systems and hospitals to review their current policy regarding doulas accessing the OR and PACU, please contact me! hello@allisontatebirthcompanion.com

Key Points for Birthing People

Your needs and expectations of your care during pregnancy, birth and beyond are my central focus as a birth companion, and I always want your voice to be heard!

  • If you have concerns about the OR/PACU Doula Training Certification and how it might impact your care experience, please reach out to me and I can support you to take your concerns forward to the staff at TGH.
  • If you plan on hiring a doula, or already have a doula, please ensure that they are aware of this training and take the necessary steps to become trained before your estimated due date, if possible. You can also share any concerns you have about the training with them.
  • Please share this blog with any other pregnant people you might know! I really want to ensure that they become aware of this training and for their doula to have adequate time to become trained if necessary.
  • If you have social media or any other platforms, please share this blog there. I have also made posts on my instagram account (@allisontatebirthcompanion) which you can share if you would like to.

Allison Tate (she/her) is an advocate birth, loss and NICU companion, birth assistant and reproductive justice activist, serving families across Hillsborough and surrounding counties of Florida.

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