It’s often the first question I’m asked when a new mama calls. “So, I’ve heard about doulas, but what exactly is it that you… do?”
A doula is part of your support team for your birth. In a hospital birth setting, your doula works alongside your medical care provider (your doctor or midwife) and the hospital staff. Each person on this team has a different role. Your doctor or midwife takes on the responsibility for the well-being of you and your baby. The nurses are responsible for tracking mother and baby’s vital signs, recording appropriate information, and communicating these to your doctor or midwife, among countless other tasks. A doula provides encouragement, emotional and physical labor support, comfort measures for birth, and the informational support necessary for you to make your own informed decisions. It’s statistically well-documented that women who have doulas are far less likely to have cesarean births, epidurals, and other interventions for a myriad of reasons. Doulas help mamas feel safe and relaxed so her body can open.
Equally important is understanding what doulas do not do. This is sometimes a more difficult part to comprehend, and can be a point of contention even among doulas.
A doula can not make decisions for you, or tell you what to do. The births of my own three children are the only times that my personal opinion has had any bearing whatsoever. Each person, each birth, is unique. There is no “right” way to have a baby, there is only what is right for your birth of this baby.Your doula might remind you of what you have stated your priorities to be, such as trying a change in position before pain medication. She might ask questions about your preferences, or inform you of options. It remains the role of the mother and her partner to make their own best choices.
Sometimes, I feel nervous when I hear, “Oh, I really don’t like my doctor. He thinks I need a c-section. It’s a good thing I’ll have my doula there.” A doula cannot, should not, will not go to battle with a practitioner you aren’t liking, even if he or she is being a bully.A mother has every right to say that she wouldn’t like surgery, and to have that conversation with her practitioner, asking “What would need to happen to have your support for what I would prefer?”, or “Is there any medical reason why this is now necessary?” A mother has every right to ask “Why?”, to receive complete answers, and to say “No, thank you” to interventions that are not medically necessary. It is also the mother’s responsibility, long before the baby comes, to choose carefully a practitioner or group of practitioners that she knows she can trust to make sound medical judgement calls if it happens that her birth needs help.
Your doula cannot stop a c-section from happening, or refuse any interventions on your behalf, or even say “Jane doesn’t consent to that. It’s in her birth plan.” A doula is the lowest ranking girl in the birth room, as far as authority to call the shots goes. In fact, it is a breech in the doula’s code of ethics to speak to a practitioner on a mama’s behalf. This is also true of doulas choosing to speak to the medical professionals instead of to the mother and partner. The only result that will bring is the doula’s being asked to leave and not return to that hospital again, which serves the higher good of no one at all. A doula might say “Jane, you had mentioned that you had a question about getting baby skin-to-skin right away. Do you want to ask the doctor about that while she’s in the room?” Doulas are often skilled facilitators of conversations, like a moderator or other neutral party might be. The power to say “no”, however, rests in the hands of the birthing mother.
A doula’s role is to empower the mama to create her own birth by knowing her options and communicating her own desires. A doula provides the comfort, the passion, the encouragement, and the language to ask for what you want and need. Mama, your birth belongs to YOU. I want you to have a birth story that you are completely and utterly content remembering. I want you to know the bliss of feeling your own strength rising up like you’ve never known, to bring your child into the world in courage and wisdom. Don’t give that power away – not to your doula, not to anyone. It’s yours. Claim it, rise up to it, and take on the responsibility of creating your own birth. Speak up for yourself, even if your voice shakes. Your birth is worth it.