Category Archives: Doula

You thought I’d forgotten this series, didn’t you?

So what does a doula do for an unassisted birth, an accidental birth, or a birth with an unlicensed care provider?

The SAME THING SHE DOES FOR ANY OTHER BIRTH.

Catch that?

Mid-wife:  noun.  a person qualified to deliver babies and to care for women before, during, and after childbirth

Ob-ste-tri-cian:  noun.  a physician who specializes in obstetrics.

Dou-la:  noun.  a woman experienced in childbirth who provides advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth

Information, emotional support, and physical comfort.

I do not deliver/catch babies.  I do not carry a doppler.  I do not carry a blood pressure cuff.  I do not carry medicine.

I do believe that women deserve to be supported by another woman no matter their birth choices. 

I love midwives.

I am not one.  I do not desire to be one.  At a birth, I am not the substitute midwife until the real midwife arrives.  I am not the midwife’s assistant though I am glad to lend a hand if needed.  My job is first and foremost the emotional and physical support of the birthing woman.  My second job is to serve her birth partner and other family.  If I’ve done my job during prenatal meetings, everyone is clear about my focus and role.

Unassisted Childbirth (UC):  If a woman chooses to birth without a medical caregiver, I will have a mutual interview with her like any other potential client.  I will be very clear about my role.  It is carefully written in my contract.  Should we agree to a contract, I will behave the same way at her birth as any other.  She has deliberately and mindfully made this choice.  More than anyone, she doesn’t want me to play the part of a midwife or doctor since she has purposefully chosen to birth without them.  I’m the brow-wiper, smoothie-maker, cleaner-upper, emotion soother, foot-massager.  I’m not the babycatcher.

Accidental Birth:  For the record, I’ve not experienced an accidental birth (i.e. mom gives birth on the side of the road or before we leave for the hospital).  I would call 911 and support the birth partner in the steps of emergency childbirth.  If the birth partner was unable, I would assist the mom in birth as needed.  As any friend or bystander would.  And I’m certain I would throw up afterwards from the adrenaline of such an experience.

[ETA:  I have now.  And I didn’t throw up.  I didn’t experience any adrenaline at all which really surprised me.  It was a super calm birth even with a big potentially scary complication.  I also did not call 911 since the midwife was almost there]

Birth with an unlicensed care provider:  There are all sorts of reasons why a woman might choose an unlicensed care provider.  One of my friend’s mom was a midwife in another state.  Another woman might want a VBAC out-of-hospital.  Someone else might resonate with an unlicensed midwife she met on a forum.  In some states, there is no licensure.  And there was a time when all communities had a woman skilled in birth.  She learned from the woman before her.  That was her license.  Anyway.  As a doula, I go where the birthing mama goes (hospital, home, birth center, RV, waterfall, idyllic glade, whatever).  And I don’t decide who she invites into her glade.  It does not affect me or the role I play.

Other doulas may not feel comfortable in these scenarios (although there isn’t much to be done about #2).  That is ok!  There are certainly plenty of scenarios in which I would not be a good fit.  That is why we do a mutual interview to tease out our personalities and styles.  Frankly, my comfort level is that the birthing woman has carefully considered her choices.  She is informed.  She is making a decision thoughtfully and with understanding of risks/benefits/alternatives.

In the end, I speak no judgement to the woman who chooses an elective cesarean or an unassisted birth.  If she honors me with an invitation to serve her in this powerful and intimate moment, I come.  It isn’t my birth.

I’m not the main character in the story.

The most common question I get:  What exactly does a doula do?

I can’t speak for all doulas but I don’t have a “scope of practice.”  I do whatever my families need me to do.  There is no “exactly.”  I’m going to do a series, then, on what we do–in general.  I’ll carry it on until 1)  I get tired of it.  2)  I forget about it.  or 3) I reach the end of all that doulas do (which means I’ll post about it forever).

Today I’m going to look at one thing I do.

I ask questions. 

I didn’t go to medical school.  I’m not a midwife.  I don’t read obstetric textbooks in my spare time (anymore).  I don’t know all the answers.  Sure I keep up with some research.  I peruse the Cochrane database and read blogs like this and this.  I have a doctor and a midwife on speed dial when I have burning questions.  But I don’t kid myself into thinking that I have some special knowledge.  I probably know enough to be dangerous.  Which is why… 

I ask questions. 

To the family, questions like “Have you considered?”  “What is most important to you?”  “What would that look like to you?”  I carve out the space for families to ask their questions, express their concerns, tease out informed consent.   

To the caregiver, “Can we wait?”  “Could they go home?”  “Could we try?”  “What are the benefits? risks? alternatives?”  “Can we wait?”  “Can we wait?”  “Can we wait?”

I ask questions.

I do not make decisions for families.  That is the glorious privilege of the new parents.  My job is to support them in whatever decision they make.