There is a lot of talk about what doulas can do to help families, backed up by anecdotal accounts of how helpful doulas were to birthing parents and even statistics showing better birth outcomes for moms who had a doula. But can we talk for a minute about what doulas don’t do?
Doulas don’t save you from a care provider who isn’t a good fit. On message boards and in moms’ groups when I hear a mom talking about her feeling uncomfortable with her care provider’s beliefs and priorities not aligning with hers, oftentimes the next thing I hear is someone chiming in that she should get a doula. While I certainly won’t argue with someone wanting the support of a doula through her birth experience, that mom’s most important task is getting herself a doctor or midwife who is on the same page as her.
This could mean having a conversation with your current doctor or midwife to clarify where you’re coming from and making sure everyone is working toward the same goal, or changing care providers altogether. If you’re worried about having a difficult “break up” conversation with your current doctor or midwife, I have good news. After you interview and find a care provider who is a good fit for your family, schedule an appointment with them. They will request your records from your previous care provider, and the most uncomfortable thing you have to do is call the receptionist and cancel the appointment you had set up with your old doctor/midwife.
Your choice of care provider is the biggest decision you can make to affect the course of your birth. It’s very important to create a birthing environment for yourself where your support people want the things you want. If you feel like the people in your birth space are your adversaries, it will be much harder to let go and drift off to Labor Land. It could even make it more difficult for your body to labor effectively if you’re feeling defensive.
A doula’s scope of practice does not include arguing with care providers or speaking on your behalf. She should not be the intermediary between you and your doctor/midwife. What a doula CAN do is remind you of important questions to ask and conversations to have as circumstances arise in your birth, based on the talks you have had prenatally about what is important to you. She should be there as someone who’s got your back. Someone who can help you think clearly in a moment clouded by fatigue, pain, and hormones. Someone who will show up for you physically and emotionally regardless of what happens in your birth. She is not there as a gatekeeper, body guard, or proxy for your voice.
So by all means, hire a doula to help you cope through contractions, stay home longer during labor, bring comforting words and touch, help you navigate the unfamiliar terrain of birth, and bring continuous, loving care throughout your labor. But please, don’t hire her to be your knight in shining armor to defend you against the system. Take a step in self-care by setting yourself up for success in your relationship with your doctor and hospital, or midwife and birth center.
Nikki Shaheed CD(DONA) Certified Birthing from Within Mentor