The Doula’s role during labor should be one of advocacy, education and physical support. On way too many occasions, as an L&D nurse, I have witnessed where the clients came in with their doula totally dependent on her to “make” decisions for them. Things like what position she should use. Should she lay in the bed, sit in the chair or get in the tub? Even including whether she should have pain medication or an epidural.
A woman does not give up her rights to make her own decisions.
Having a doula does not mean the woman is giving up her right to make her own decisions. The Doula’s role is to be present for the mother so that she is empowered. This builds her confidence in herself when it comes to making decisions. It is not the Doula’s role to make decisions for her. Nor try to persuade her to choose the options that the doula feels would be “better”.
Nurturing and protecting the woman’s memory of her birth experience should be the goal of the doula
The goal of the doula should be to help nurture and protect the woman’s memory of her birth experience. I have heard new mothers apologizing to the doula after the delivery for “having given in and taking the epidural”. No new mother should ever feel like she has to apologize for the choices she has made during her labor. Utilizing an epidural to assist with the pain does not make her a “failure”. She should never feel ashamed that she needed more assistance with coping with the pain.
Empowerment starts during the first prenatal visit
So, how do you empower a woman to feel confident in making her own decisions? Empowerment starts at the beginning of the woman/doula relationship. During the prenatal visit, you can help prepare her to start believing in herself and her body’s ability to labor and give birth. The initial interview you should be assessing her knowledge of labor and birth so that you can find out what she knows and what she still needs to learn.
Assuring her she is strong boosts her self-esteem
Sharing information with her gives her knowledge and builds up her confidence allowing her to feel more prepared to face the unknown. Her self-esteem is boosted when you act confident of her abilities. It gives her assurance that she is strong enough to go through this experience and can give her the conviction that she can do whatever it takes to birth this child. Preparing a birth plan with her will help take away some of the fear of the unknown.
Offer suggestions for comfort and coping
During labor she can draw upon her inner strength and you as the doula can continue to nurture those feelings throughout her labor. It is more than okay to suggest trying new positions. Helping her to find ways to cope with the contractions but telling her what she should or should not do is not the best way to support her.
When overwhelmed with labor she may ask what should she do
In those tough moments of labor, she may be feeling overwhelmed and unable to cope. When faced with having to decide about her care she may ask you “what would you do?” When a woman asks me “what would you do?” I say: We are both very unique individuals and, in this instance, the only thing we need to consider is what do you want to do?”
Knowledge is power
Too many, knowledge is power. Providing information such as “what happens if I do versus what happens if I don’t” can help the mother to understand what her options are.Then she can make the decision based on facts and what seems to fit best for her. If you, as the doula do not know all the facts then do not be afraid to speak up and say so. There is no harm in admitting that you do not know something but there is great harm in pretending that you do.
Don’t hesitate to ask the medical professionals for clarification
If there is a question that you are unsure of the answer, encourage the mother or her significant other to ask the questions of the nurse or provider. There’s been times when I was acting in the role as a doula when I personally have asked for information or clarification from the nurse or provider to explain what something meant and what alternatives if any were available. Even if I thought I knew what the answer was already, I would still ask as it helped to build the rapport between the nurse/provider and myself. It helped them to feel respected by me and not “threatened” that I was there to “usurp” their authority.
Each woman labors and gives birth in her own unique way
At the end of the day (or after the birth in this case) it comes down to is each woman labors and gives birth in her own unique way. Each woman has her own “lessons” to learn and it is not the Doula’s role to “protect” her from her choices. If we take away her choices, she is being denied the opportunity to learn and grow from her experience. If we allow her to make her own choices and empower her to do so, she will feel stronger and more confident in herself. She will experience the satisfaction of knowing that she did something she didn’t think she could. This newfound strength lends itself to giving her the conviction that she can now take on the task of parenting this beautiful child she has brought into this world.