Who’s in charge here? Why a doula is not going to save your birth.

I’ve received several emails from moms, seen birth stories go awry and known people, who are completely unaware of one simple fact: a doula is not in control of your birth.

 You are.
 
With that said, just as finding the right doctor is important, the right birth place (hospital, birthing center or home) and having the right birth team are all crucial to a great birth: nothing holds the “power” over your birth like you do.
 
Let me explain.
 
Moms are growing more aware that they may meet some resistance with their birth plan/vision therefore they enlist the help of a doula. The intentions are different for everyone, but I have seen many a couple shocked to hear that the doula’s role should NOT include making decisions “on your behalf.” Meaning, you’ve written a birth plan and now it is up to the doula to make sure it happens.
 
1. Mom is the only one that can consent to anything. The opposite is true as well. If you have on your birth plan that you want skin to skin with the baby immediately and any procedures that need to happen can happen while baby is on your chest, and the nurse has the baby and is trying to get all her “stuff” done as quickly as possible, the doula can say, “Can we get baby to mom for skin to skin now?” If the nurse shows any resistance, as a doula I can only repeat my sentence. But if mom, who wants her baby, looks over and says, “I’d like to hold my baby now.” Guess what? They do it. And even if they say, “oh but i was just going to do this one last thing and be done.” If that is not what you want . . . YOU (alone) are the one to say “No thank you. I want to have my baby.”
 
This is true with anything on your birth plan. If you are being asked to do something that you don’t want to do, the doula is not in the place to answer for you. You have to speak up. Because even if your doula does say “she doesn’t want to do that,” everyone else in that room (including the doula) knows that it holds no water if the momma doesn’t say it. You see, you are the patient. Informed consent only applies to you. Not to your husband and not to your doula.
 
What the doula does: the doula can remind the doctor/nurse of your birth plan, and advocate for those items, but they can not “make” anyone do anything. Especially if it means an argument would ensue between her and the staff. That is NOT the role of a doula.
 
2. A doula does not give medical advice. On your last prenatal visit your doctor recommends that you get an induction. You immediately call your doula to ask what she thinks. Instead of opening up a long discussion about how insane your doctor is, your doula should respond in a different way.
 
What the doula does: The doula should help get information to you that would help YOU make a decision. The doula’s role is to help you realize that YOU have what it takes to make the best decision for you and your baby. Not based on what the doctor thinks OR what the doula thinks. **Everyone has an opinion, the doctor as well as the doula, but the ultimate decision is yours and both (doctor and doula) are to support you in whatever you decide.**
 
3. A doula does not guarantee birth plan success. However, it does increase it. Yes, there are studies showing the continuous support of a doula does increase your chance of having the birth you planned for. However, there are times where changes are necessary. Medically necessary.
 
What a doula does: A doula’s role in the face of a change in the birth plan is to buy you time for the opportunity to discuss it with your partner. If the doctor comes in and says that he thinks it’s time to consider pitocin, the doula may say, “Jason and Samantha, would the two of you like some time by yourselves to discuss what you want to do?” The goal there is not to say, “umm, I think ________” because doula’s don’t give medical advice. We can guard your space and allow you the time to make the decision for yourself. **I am aware there are times where time is of urgency, in those times it is different. But in most cases there is time for you to have a discussion to determine if there are other options.**
 
So you may be left asking yourself, “why do I need a doula then?” A doula knows the process of birth, is a huge resource for physical support, suggestions for comfort as well as tips to get labor to progress naturally. A doula helps you from start to finish and never leaves your side. A doula is there to support you and what you decide, and to offer information (covering all sides of a decision) to help you know your options. Just like you don’t want your health care provider making decisions for you, same goes for the doula.
 
It’s best if that part is left up to you.
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