What Doulas Do: The Nitty Gritty
What We Do: The Nitty Gritty
…And what we don’t do, because that is also important.
Doulas get asked what we “do” all the gosh durn time. And like my former partner in California, Stephanie Freeman, explains in her related musings (that I just conveniently linked for you to catch up with), it isn’t always easy to articulate. So much of what we do is wrapped up in the preparation for birth. Do we “hold space” for people? Absolutely. Do we rub their feet during labor? Sure, if that is one of the things that helps. But we do so, so much more. Both before and after the birth of your little cherub.
To start with the basics, we need to address the pregnant elephant in the room. There are no Doula police, and because of this, what Doulas offer varies from practice to practice. Doulas focus their education on areas they’d often like to specialize in. Like me? I have no interest in encapsulating placentas, even though Stephanie LOVES IT and it is a fantastic service we offer. And Stephanie has little interest in the belly binding course I just took. Czarina is our sleep specialist, and when I hear “baby” and “sleep” in a sentence I want to vomit. But I say all of that to say this: While we all share common themes, it is often the extras that set us apart. We do more than what people see in the delivery room, and understanding that is key to knowing if you are a good fit for Doula services. Yes, yes. I said it. You may not be a good fit for Doula services. “But Abby! This is your career! How could you say that!? ” and the answer to that is pretty easy, and two fold.
First – expectations. We don’t fart magic rainbows that carry you out of the pain. We don’t use our magic carpet to transport you to your perfect “easy” medication free birth. We educate you. We educate on the stages of labor and how to cope with them in your body and in your mind. On medications available and when to use them for optimal pain relief and rest. On medical solutions to what you are going through, and the routine medical recommendations they are often confused with. Shit- those last two sound so similar you may be scratching your head right now trying to come up with an explanation for why I phrased it that way.
And. Yet. I. Phrased. It. That. Way. Because it is so important that you understand before you’re in labor how to navigate those two things. Which brings us to number two:
A desire to learn. A humble reverence for what you do not yet know. An acceptance that outside of the hospital, there are puzzle pieces you need to find and place to complete your own birth puzzle. While you are voraciously absorbing every resource we send you, your Doulas are doing constant research – evidence based research. We want our clients to not only know more options are available, but to understand the benefits and risks of each. This isn’t just for our birthing people either. We spend a huge amount of time educating whoever you’ve chosen as a support partner.
We spend a significant amount of time educating our clients on navigating the medical system, and especially now. Not only is the birth of a child often (obviously not always) a family’s first significant parlay into the medical world, but now they have the added bonus of having to decide where Covid-19 fits in this puzzle for them as well. Is my hospital accepting Doulas? How do I know? How do I protect my family and baby? Add that to the list of what we do. We are in constant communication with our clients over a variety of topics that aren’t just their vagina/uterus/baby. Speaking of our clients, we never let them forget that we respect them as autonomous human beings who can make their own decisions for themselves and their baby.
That means more than just our showing up physically with a brain full of facts about the uterus and how to change diapers. When we are with our birthing families, we are listening to the sounds our people are making, and we are listening to the silence between the sounds as well. We are listening to the doctors and nurses in the room. We want to hear if they are offering all of the options. If not, part of our training is to make sure you know what your possible options are and how to ask more about them.
Now I know some of you may be thinking “why do we have to ask if you are there listening?” and I am so glad you asked that question! This harkens back to the conversation about expectations. It isn’t your Doulas job to speak for you. We literally can not speak for you. That honestly brings a whole shart ton of liability issues that I assure you our insurance doesn’t cover and we aren’t interested in. We can let you know there is more to discuss with your care providers and how to bring it up confidently, but we can’t say it for you. Your body. Your birth. Your family. Your support partner. Your decisions. It’s our job to have educated you in advance. It is our job to make sure we are teaching you from the most current, evidence based, research available to us. It’s our job to listen, to soothe, to comfort. We wear a lot of hats. None of those hats cover speaking for our clients. When our clients are in labor, sometimes various augmentations are offered that don’t jive with their hopes and expectations of their labor. This is an opportunity for us as Doulas to encourage our families to take a timeout to reevaluate the risks and benefits of what is being offered. Just because it wasn’t initially desired, does not mean there is no place for it in the delivery room.
One of the most important items to take away from this to have an honest, open line of communication not only with your Doulas, but your support partner as well. You need to sit together in the discomfort and talk about how you would cope with an unplanned cesarean. You need to have a conversation about pain relief beyond “I’ll just see how it goes when I get there!” You need to push beyond what you consider your “ideal birth.” You both need to be on the same page so if we can’t be there (yay Covid) no-one will be caught off guard by the bombardment of decisions you have to make from the moment you walk in the door.
When you prepare for a test, do you only study the material you like the most? Or do you cover everything just in case? Part of setting realistic expectations surrounding labor and delivery (and PARENTING in general) is knowing that plans change. Accepting that although things may not have gone exactly how you initially anticipated, you were given all of the information you needed to make an educated decision that makes sense for you and your family. Doulas walk you through all of that.
That’s what Doulas do.