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Dear Friends,

In recent weeks, a petition calling for doula education and certification organizations to stop providing Rebozo training has circulated throughout the worldwide birth community. We have heard from those within the Indigenous Mexican birth community, as well as many others who hold this issue in high regard, and we agree that it deserves much care and consideration. We have also been in touch with the petition authors and hope to speak with them at length this week to find common ground and pursue mutual understanding – especially at a time in our world when unity is paramount.

As the president of DONA International, and as a Mexican birth professional with more than 40 years of experience across four continents, it is my personal desire to bring quality doula education and training to all people groups in every country, thereby empowering mothers and families and improving infant and maternal health globally.

Our leaders and trainers – representing a myriad of races and ethnicities – share this desire and strive to equip our members with all of the evidence-based methods of comfort and support available to them in their care of birthing people – regardless of where those methods originated. We welcome and honor contributions from all cultures to the birthing experience and believe that every birthing family ought to have access to the collective body of knowledge which stretches backward through time – including the proper use of the Rebozo for comfort during labor.

We stand with all of you in affirming that doulas who use the Rebozo should receive formal training from qualified and experienced teachers. We also believe that this training, when done properly and with sensitivity to historical context, can benefit birthing families worldwide. As such, we hold that any person – regardless of race, color, national origin or any other defining trait – who holds the necessary knowledge and experience and has acquired that knowledge and experience in a manner that respects the culture and history of the Rebozo, should be permitted to share their knowledge with others. This stance is consistent with our non-discrimination statement and the anti-racism work we have undertaken in recent years, which you can read about at DONA.org/antiracism.

While Rebozo training is not part of the core curriculum required for doula certification by DONA International, we sometimes incorporate Rebozo techniques for comfort into professional conferences and continuing education courses. Our position on Rebozo education within DONA International is that it be taught by qualified individuals as a comfort-only measure, and not for interventive use. Interventive use of the Rebozo extends beyond a doula’s role in childbirth support, and the misuse of the Rebozo for intervention could cause harm to a birthing person.

When the Rebozo petition began circulating, I and other members of our executive committee began reviewing the specific Rebozo-related educational courses that our organization has offered to determine whether our past practices align with our current standards. While our review is ongoing, we wanted to share our early findings with you in the spirit of transparency and accountability.

Our records indicate that we have partnered with and compensated Indigenous and traditional Mexican midwives to provide Rebozo training for comfort at our professional conferences and for continuing education credit. We have also welcomed qualified, non-Mexican birth professionals to do the same. However, we discovered at least one instance in 2010 where a DONA International educational session featured information on the Rebozo for interventive use, rather than for comfort only. In hindsight, this was a clear violation of our longstanding position on Rebozo education and should not have occurred. We sincerely apologize for this glaring oversight and are working to ensure it does not occur again.

Additionally, we know that some DONA International trainers teach Rebozo techniques as part of their own unique service offerings as birth professionals. These independent business owners are free to decide what topics to incorporate into their curriculum beyond what DONA International requires. Should they choose to provide Rebozo education through their businesses, we uphold that they should seek training from individuals who hold extensive experience in the use of the Rebozo and who understand its cultural and historical context. We also advise our trainers to teach Rebozo methods for comfort only, and not for interventive use. However, we recognize that some DONA International trainers may not adhere to this counsel, which reveals an immediate need to better communicate organizational expectations and strengthen trainer mentorship. Therefore, we will be developing an action plan to address these needs in the coming months.

We will also pursue a partnership with members of the Indigenous Mexican birth community to further ensure that our members and trainers receive the highest level of education on the use of the Rebozo for comfort during childbirth. As part of this partnership, we hope to make available accurate, research-based information about this treasured practice which has provided great comfort to birthing people for generations.

Our multicultural, volunteer-led board of directors has sought to create a culture of continuous improvement where we are always learning and always open to adjusting our policies, practices and curriculum. Accordingly, we would like to thank the Rebozo petition authors, a group of Traditional Mexican Midwives, and others who have brought this issue to light, which has in turn given us the opportunity to better serve our members and ultimately, birthing families.

We deeply value the Mexican culture and its contributions to the birth community, and we look forward to continuing this important discussion in a manner that adequately informs and rightly dignifies all people.


Elena Carrillo
DONA International