The Opinion of Your Doula

BetterBirthDoula.orgWhen I am hired to be someone's doula I work very hard to get to know them. I want to know their birth hopes, wishes, plans - how they envision their birth. I learn about their health history & their emotional journey that brought them to this point. I ask why they decided to hire a doula, what special concerns they may have, what their fears are. If I've not worked with their careprovider and birth location then I research those as well. When they have family or friends attending the birth I ask about them. I want to know as much as possible to best support them through their birth experience.

I also remind my clients that I am their doula - and my opinion doesn't matter. I'm not there to judge or boss you around, I don't have an agenda for how I want your birth to go (beyond what you tell me you are hoping for!) I'm not going to tell you what decisions to make. I'll remind you of your birth hopes, I'll help you remember your questions for your care provider, I'll ask you if you have more questions as a gentle hint before they leave the room, I'll take notes for you! But I don't even have the authority to speak to hospital staff for you (beyond asking them to let me back into the refreshments room to get you more juice or heat up the rice pack for you.) At a birth my opinion does NOT matter. I'm there for you. If you tell me you want something then I'm going to verify that's what you want (especially if it's something different from what we've previously discussed) and then I'm going to help you get it. Period. Maybe you told me you wanted one thing during the pregnancy and you changed your mind during labor? Cool! Let's make it happen! I will double check with you, but then I'm going to roll with it. That's my job.

However, during your pregnancy things are slightly different. We're working together as you create your birth "plan" or wish list, we're talking about options, you're exploring what you want and what you don't want. During our prenatal visits I am often asked for my input on a variety of things, and if you ask I will answer! It would be a disservice to my clients to keep my mouth shut when they are seeking more information. Of course they are still going to make their own informed choices, but they are hiring me in part to help them become informed - to offer ideas & tips, to point them towards credible resources, to give them access to my lending library, to help them see all their options. What decisions they make are their responsibility, but MY responsibility is to make sure anyone seeking information is able to find it.

While I do NOT offer medical advice in any way, if someone has received a suggestion from their OB or midwife and isn't comfortable with it then we're going to talk about that! If they trust or don't trust the source, if that's the right caregiver for them, places where they could find credible research, ways they can talk further about this with their midwife/doctor, list questions and concerns they have, etc. I help people feel more comfortable asking their questions and finding answers - that's what a doula does. I don't pretend by any stretch to have the answers, but I am pretty good at knowing where to look to find them!

But if it's not a medical issue and you ask for my input then yes - you're going to hear my opinion. 🙂 If you trusted me enough to be your doula and you want my opinion then you're going to get it! Whether you're wondering a good position to try laboring in or if herbal baths are helpful or what to do about engorgement - I'm going to tell you what I think!

And if you tell me you want to have a birth that involves a, b, and c but you are planning to use this caregiver at this hospital and they are very well known for births that involve x, y, and z then I'm going to tell you! I'm absolutely going to share my opinion that your birth goals and your care provider/location are not in harmony with each other. (Not to say you can't have an abc birth with xyz, but it's going to be harder.)

Analogy that may not really work but we'll go with it - I rarely eat meat. Maybe twice a year and it usually ends up making me ill. If I'm looking for a restaurant to have a birthday celebration then the brazilian steakhouse, regardless of the rave reviews and beautiful decor, is probably not the best spot for me to have an enjoyable meal. Maybe it would taste delicious, but chances are high that I would end up sick and really not enjoying my experience there.

There are more and more hospitals catering to the requests of birthing moms, which is a great thing! I've read news articles about the "spa like labor & delivery unit" and there are moms giving rave reviews about these places. But if the changes involve nicer rooms (good!) and fancier meals (nice!) but come with high intervention rates, continuous fetal monitoring when not indicated, 1 in 3 (or more!) moms being told they need a cesarean, on demand inductions, above average NICU admissions, and rougher recoveries for moms then that is not necessarily the best option for where to birth! It may be gorgeous, and the perfect fit if you're planning a cesarean or want an early induction or want to get that epidural placed the moment you first feel a contraction. But if you're hoping for a less invasive birth environment then you need to explore other options.

Back to that restaurant - it may be harder for me to find a vegetarian restaurant for my birthday dinner. I may have to drive farther, it may even be more expensive (or it may be much less!) and it takes effort on my part to research. But chances are when I find it that the entire experience - the environment, the food, the ambiance, the people owning and working there - are going to be much more in tune with what I'm looking for in the experience. I hear those brazilian steakhouses are wonderful! The people who go there love them, but that doesn't mean they are the right fit for everyone.

So that's my opinion. 🙂 Spend some time thinking about the birth experience you want. Then explore ALL your options. Don't just look and thing something seems nice, whether that's a lovely hospital room or a homey birth center. Do your homework, and find out the details. Then go birth at the place and with the caregiver that's best in harmony with your goals. You may not find a perfect fit - maybe you wanted that birth center but you really need to birth in the hospital for medical reasons, maybe you wanted a vaginal birth but a cesarean is needed... but the more you know the better you can make an informed decision. And if you hire me as your doula, I'm going to help you find that info so you can make the best decision for you, then I'll support you through your journey.

This comes up in part because of conversations with other doulas about how candidly we speak with clients, and potential clients. If someone contacts us and is planning to birth with an OB who has proven to be NOT ideal in the labor room then do we tell them? What if they say they want a natural birth but the hospital they chose has a crazy high intervention and cesarean rate? Do we tell them if they are a potential client? A client who has already hired us? Or do we bite our tongue and smile and support their choices? While I do support your informed choices, part of my job as a doula is to help you become informed - and not by forcing my opinion on you by any means, but by letting you know resources to find out accurate information. So yes - I share. If you can't trust me to be candid about your care provider and birth location how can you trust me to be candid while supporting you in your birth? I'll be tactful as possible, but if you hire me to be your doula I presume it's because you trust me to be honest with you, even if the news isn't what you were hoping to hear. At the end of the day it's your birth experience and I'm going to cheer for you whatever decision you make - but I want the decision to be YOURS, which means I'm going to do my best to help make sure you know your options when making choices. I'm your doula, but this is your birth. You're in charge, I'm just sharing my opinion. 🙂

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