STEP 1 - Complete SBA Registration Form
SBA MENTORSHIP FEE: $500
The Workshop Fee is due in full in order to reserve a spot in the workshop.

To register for a Sankofa Birth Ambassador Mentorship, fill out the form below.

PLEASE ANSWER THE BEST YOU CAN. THIS SURVEY WILL ONLY BE USED TO GUIDE OUR SESSIONS. IF YOU DO NOT KNOW AN ANSWER IT IS OKAY TO SAY THAT YOU DO NOT KNOW. YOU SHOUD NOT RESEARCH ANYTHING TO COMPLETE THIS SURVEY. ALL TOPICS WILL BE COVERED DURING THE WORKSHOP SESSIONS.
First & Last Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
Age *
Your answer
What is motivating you to work in birth? *
Your answer
What is a DOULA? What does the word DOULA mean? *
Your answer
Have you ever observed or been a part of a birth other than your own? Have you ever been with someone in the delivery room during a vaginal birth? *
Briefly describe your own birth experience(s). Have you had positive and/or negative experiences? *
Your answer
Describe some things that are unique about how the pregnant and birthing body works? *
Your answer
How do you think childbirth scenes on television differ from how childbirth happens in real life? *
Your answer
What are some important things for pregnant mothers to consider about the primary care provider or medical professional they choose? *
Your answer
What are some important things for pregnant mothers to consider about the hospital or birth facility they choose? *
Your answer
What are some important things for pregnant mothers to consider about the support people they choose to have with them in the birth room? *
Your answer
Before they grab their C.O.A.T., what are some things that pregnant mothers should consider IF their bag of waters breaks? *
Your answer
How can a mother (and partner) use her B.R.A.I.N. when making decisions about her and her newborn's medical care? *
Your answer
What are some medical interventions that may be used during labor and delivery in a hospital? *
Your answer
If a birthing mother is told that she needs to be induced, what type of questions can she ask to get an idea about how "ready" her body is for labor? *
Your answer
How is P.A.I.N. experienced in labor different than other pain we may feel in our daily lives? *
Your answer
What is one thing that can improve the way people birth? *
Your answer
Name something that happens in the woman's body that can hinder the birthing process? *
Your answer
What is the name of the first test newborns are given after they are born in hospitals? What does it check for? *
Your answer
Have you ever been around a breastfeeding woman or breastfed a child? *
What has your personal experience been with breastfeeding? *
Your answer
How can a person encourage mothers' breastfeeding relationship with their babies? *
Your answer
How can family, friends and/or community support mommies and babies during the postpartum period, the first 6 weeks after birth? *
Your answer
Please share any questions you have that you would like addressed during the workshop.
Your answer
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