Postpartum Doula Application
Welcome to CVD. Thank you for taking the time to complete this application. This application is to work as a contracted postpartum doula. If you are interested in being a volunteer birth doula please email programdirector@chicagovolunteerdoulas.org.
Full Name *
First and last name
Your answer
What City do you live in? *
Your answer
Zip Code *
Your answer
Primary phone # *
xxx-xxx-xxxx format
Your answer
Email address *
Your answer
Organization where you took your weekend postpartum doula training. If you did not complete yet please enter N/A *
This is a doula training from a Doula Certifying agency.
Your answer
Date when you took your postpartum doula weekend training. *
If you have not completed yet please enter today's date
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Are you a certified postpartum doula *
Date of certification or expected certification date
If you are not working toward cerficication please skip
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Have you assisted at least 5 postpartum clients in the past 2 years? *
Postpartum related training? *
Breastfeeding, massage, etc.
Your answer
Other languages
Please list language(s) and level: Beginner, Moderate or Fluent
Your answer
Any other relevant information?
Your answer
When CVD decided to become a birth justice organization we did so with the belief that improving birth is only possible when we are also working on economic and racial justice together with the communities we serve. For many of us, this means continually learning more about the roots of racial and economic injustice that have led to birth and breastfeeding disparities. It also includes personally committing to the ongoing work of unlearning and dismantling these oppressions. This can be extremely difficult work for everyone involved, especially those who have lived the realities of racial and economic disparities. To support doulas in this work, CVD will offer training and ongoing education including anti-oppression workshops. *
How do you feel about incorporating this into your doula work with CVD and about CVD’s approach that birth justice work inherently includes working toward a broader goal of racial and economic justice?
Your answer
CVD is working to expand our work with families in vulnerable communities in Chicago who are in need of postpartum support. *
How do you feel about traveling to any part of the city where you might be needed including the north, south and west sides?
Your answer
CVD has adopted language into our vision stating “Chicago Volunteer Doulas is committed to being able to support all pregnant people prenatally and in labor, birth, and postpartum with complete compassion and care no matter what their reproductive choices or history." *
Can you support any client regardless of whether they have chosen abortion in the past? And, are you ok with volunteering for an organization that may refer a CVD client to another agengy for abortion doula support?
Your answer
What does our mission statement mean to you and does it align with your personal birth philosophy? *
Mission Statement: Chicago Volunteer Doulas is a birth justice organization providing comprehensive doula services with a focus on vulnerable communities in the Chicagoland area
Your answer
Reference #1 *
Name AND email address of a family you provided postpartum services for. If you have not assisted a postpartum client yet them please list someone who can be a reference to you as it relates to your passion and commitment to birth work
Your answer
Reference #2 *
Name AND email address of a family you provided postpartum services for. If you have not assisted a postpartum client yet them please list someone who can be a reference to you as it relates to your passion and commitment to birth work.
Your answer
How did you hear about CVD? *
Your answer
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