I’ve been a doula for a long time.  You could say that my doula career is old enough to vote and it’s closing in on being able to drink, legally of course.

I wanted to take a minute and discuss a discourse I often see among many in the doula community that has been troubling me. The conversation surrounds the idea that we are responsible for educating our clients on all the possible risks, benefits, outcomes and that this is our responsibility as doulas. It is an expected part of our job.

While providing information is a part of what we do, forcing information on clients is not. Let’s use an often discussed situation as an example.

Mary is 39 weeks, and at her prenatal visit with her provider, an induction is scheduled for 40 weeks. Mary calls her doula later that day to update her on her prenatal visit and notifies the doula of the induction date next week.

ProDoula teaches that we are to provide non-judgmental support to clients. This means that it is not our place to push our opinions or judgments onto them. We are to support them in their choices, even when we disagree. How we respond beyond that depends on the client and their personality style.

The discussion may look something like one of the following scenarios and always depends on what the client is saying to us and the context of that message:

• “Hello (doula) Jane. I’m calling to let you know I have an induction scheduled for Monday. I don’t expect I’ll need you there immediately, but wanted to give you a heads up that we will be getting labor rolling early Monday morning.”
  • “Great! What time do you want me to meet you at the hospital on Monday, or would you like to touch base that morning by phone and play it by ear?”
• “Jane, I had my appointment today and my doctor and I scheduled our baby’s birth for Monday.  I’m so excited to meet my baby and my friend Molly was induced, I think I told you about her. I’m nervous and excited. My baby will be here on Monday!”
  • “Thanks for letting me know. I recall you telling me about your friend Molly who was also induced.  Do you have any questions that I can answer for you?”
• Hello, Jane. I had my OB appointment today and we did a non-stress test and an ultrasound.  We talked about scheduling an induction for Monday vs waiting a few more days to see if labor started on its own. There was also some discussion about my last birth and how it turned out as well. Anyway, we scheduled the induction for Monday because my doctor felt that this was the best option given my history. I wanted to let you know. Does that work for you?”
  • “Sounds like you had a busy appointment. How are you feeling about meeting your baby on Monday? I am available Monday and will be ready to meet you there whenever you’d like me to arrive.”
• “Hey Jane, I wanted to give you a heads up that my doctor has scheduled an induction for Monday. I’m not quite sure what that’s going to look like or entail, but I wanted to let you know so you can plan accordingly.”
  • “I appreciate the heads up. Is there any additional information you feel like you may need from me? Would you like to talk through what the induction process will likely look like for you?”

It is not a part of our role to assume that the client has not made an informed choice.

I often hear many doulas say, “I would educate her on the risks and benefits of induction so that she can make an informed decision.” What this translates into is “I only support clients who make informed decisions, and I am the measure by which informed will be judged.”

When we bestow upon ourselves the responsibility for making sure that clients are “informed” according to our personal standards, we set ourselves up as the judge, jury and responsible party for how their birth turns out. When doulas assume responsibility for the outcome of their client’s births, they lose the ability to provide non-judgmental support and ultimately set themselves up for burnout.

There is a place and time for in-depth discussions about risks/benefits and alternatives:

When the client requests this information. Clients who hire a doula realize that we are well informed on topics relating to childbirth. They are capable of asking for more information.

When you are teaching expectant individuals as a childbirth educator. It’s important to keep the roles of the doula and the educator separate. These are two different hats, and while there is a crossover between the two roles in terms of information, the intent of the relationship is inherently different.

Students come to childbirth education classes to learn their options, become informed on topics related to pregnancy and childbirth and are actively seeking and pursuing education.

Doula clients are seeking support. While we also provide information and hands-on care, the intent of the relationship is more personal, more intimate and not educationally focused in the same way childbirth education classes are.

When in doubt:

• Ask how the client is feeling about the choice, intervention, or next step
  • “How are you feeling about how your appointment went today?”
• Validate the client’s feelings
  • I hear you saying that you’re excited to meet your baby next week.”
• Ask the client what they need from you
  • “How can I best help you prepare to welcome your baby on Monday?”
• If the client expresses a need for more information, provide that information
  • “You asked about options for induction. I willl email you some information on the various ways an induction can begin. If you have any other questions, feel free to reach out.”
• Maintain your non-judgmental approach
  • “I’m so excited to help you welcome your baby next week. Let me know if there is anything I can do for you between now and then or if there is anything you need from me.”

Angela Horn – ProDoula Labor Doula Trainer
Owner – Tucson Doulas

May has come and once again the annual No Child Wet Behind event will be hosted in over 20 cities across the United States.

One in three families with diaper-aged children will experience diaper need.

To find a No Child Wet Behind Diaper Drive and 5k Family Fun Run near you please CLICK HERE