During my work as a doula the past 3 years, I have received many questions and comments regarding my role as a birth doula. Oftentimes, potential clients will ask a number of questions pertaining to my assumed role during our initial intake call, which is normally our first point of contact. The following are the 5 most common misconceptions people tend to have about doulas:
Doulas are advocates that speak to care providers on behalf of their clients.
Doulas replace the need for partner support.
Doulas only attend ânaturalâ births.
Doula support isnât necessary if you have already hired a care provider, like a midwife or a doctor.
Doula support is a new, trendy concept.
In this blog post, I am going to break down each of these commonly held misconceptions with the hope that I will bring to light the truth about what doulas DO and DONâT do.
Myth #1: Doulas Are Advocates.
Are doulas advocates? No - not in the typical sense of the word. đ But before you jump to any conclusions - let me clarify what I mean.
Do doulas speak to healthcare providers on behalf of their clients? No. This is totally OUT of our scope of practice. It is not our job to act as âthe bridge between our clients and the healthcare provider.â (Iâve heard this one, too.)
To quote my partner, Nicky Quick, we advocate for you - THROUGH YOU.
Let me give you an example of how we DONâT advocate in scenario #1 and how we DO advocate in scenario #2.
Scenario #1 DONâT:
Medical Provider: âLooks like you have not progressed much over the last few hours. Why donât we try some Pitocin to help speed things up a bit?â
Doula to Medical Provider: âOh no! On her birth plan, she said they did not want to be administered Pitocin because it makes contractions a lot less manageable. Can we wait a little bit longer to see if things progress on their own?â
Scenario #2 DO:
Medical Provider: âLooks like you have not progressed much over the last few hours. Why donât we try some Pitocin to help speed things up a bit?â
Doula to Client: âDo you guys want to take a few minutes to talk about this option?â
Client to Medical Provider: âCan we please have a few minutes to discuss this decision?
See the difference? Doulas help slow down the birth process when various situations arise. We remind you to use your BRAIN (what are the benefits to this intervention, what are the risks, are there any alternatives, what is your intuition telling you, and what happens if you do nothing) to effectively make decisions during labor and birth.
It IS our job to share with you questions to ask a potential medical provider, the latest evidence surrounding routine hospital procedures, and the most common reasons for inductions and cesareans.
It IS our job to educate you on the female anatomy, the natural birth process, and the stages of labor. âŁ
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It IS our job to help you compile a birth plan, explain the differences between birther-led pushing and coached pushing, and tips on how to reduce the chances of tearing. âŁ
So, yes, we are advocates. Just not in the way you may immediately think we are. đ
Myth #2: Doulas Replace Partners.
For a first-time dad, or a partner who is unfamiliar with the role of a doula, the idea of hiring a stranger-albeit an experienced and professional stranger, nonetheless-can raise some questions.đđœââïž
đâWouldnât a doula impede on our bonding time as a family?â
đ âDoesnât the ______ (nurse, midwife, OB) do that?
đ âWhat can a doula do that I canât?â
đ âWonât a doula bring an agenda with them?
đ âWhat if my wife wants to have an epidural? We donât need a doula because we are planning on getting pain management.
đ Will we feel pressured to have a certain type of birth?
Perhaps one of the biggest myths surrounding doula support is that we take the place of partners, and this is FAR from the truth.
Doulas support the laboring mamaâs physical, emotional, and informational needs, and is also there to care for the fatherâs needs as well. When doulas and partners work together, they create a support system that combines knowledge of pregnancy, birth, newborns, and breastfeeding with an intimate understanding of the new mom and her needs, emotional responses, and communication style. Not only do doulas not replace partners - but they help dads-to-be support their laboring loved ones even more effectively than they could on their own.
See how great a team we make together?
Myth #3: Doulas ONLY Attend Natural Births.
Countless times I have heard someone say, âI really wanted to have a doula! But I was inducedâŠhad a c-sectionâŠwanted an epiduralâŠetc.â Today I am debunking another commonly held belief that many people tend to believe about doulas: that we ONLY attend intended ânatural,â vaginal births.
This could not be FURTHER from the truth!
I have conversations with expecting couples and curious individuals all the time about the types of births I attend, and the majority of the time - they are surprised to learn that I support birth in ALL its forms. Yes, I specialize in helping families achieve medicated-free labors and births by utilizing a number of counter-pressure, visualization, massage, and meditative techniques.
But! Guess what? Doulas also consider themselves experts on providing evidence-based information on the type of birth YOU want to have. Whether that isâŠ
đđœ A scheduled induction at 40 weeks.
đđœ A birth in a hospital, birth center, or home.
đđœ An unmedicated water birth.
đđœ A planned, family-centered gentle cesarean.
đđœ A birth with a planned (or unplanned!) epidural or IV pain medication.
As your doula, it is my goal to support you to help you achieve the birth YOU long for. And, sometimes - our best made plans change, and thatâs okay, too! My desire is to be there for you and your family every step of the way, continually supporting you physically, emotionally, and informationally.
Myth #4: You Don't Need A Doula If You Have Already Hired A Midwife (Or Dr!)
This could not be any further from the truth! Letâs dive in on the differences between midwives and doulas. âŹïž
Doulas and midwives undergo differing levels of training and licensing and play distinct roles during pregnancy and the birthing process.
MIDWIVES
đŽ The three most commonly recognized types of midwives are CNMâs, CMâs, and CPMâs. Certified Nurse Midwives (CNMâs) must have a bachelorâs degree in nursing, a masterâs degree in midwifery, and be certified by the American Midwifery Certification Board, Certified Midwives (CMâs) must have a bachelorâs degree in nursing or a similar field and be certified by the American Midwifery Certification Board, and Certified Professional Midwives (CPMâs) must meet various requirements through the North American Registry of Midwives.
đŽ Some of the types of services midwives can perform pre-conception include, but are not limited to: annual gynecological exams, family planning, treatment and counseling for sexually transmitted diseases, breast exams, and medication prescription.
đŽ During pregnancy, midwives: monitor your babyâs growth by measuring your bump, listen to your babyâs heartbeat using a doppler or a fetoscope, educate pregnant moms on ways to stay healthy-like exercise and healthy eating, and offer support and advice if/when complications arise during the pregnancy.
đŽ During labor, birth, and the immediate postpartum, midwives: provide informational and emotional support, monitor your labor progress, listen to your babyâs heart beat using a doppler or fetoscope, suggest strategies and positions to help your labor advance, offer pain management, repair perennial tears, and perform the newborn assessment.
DOULAS
đ” Doulas undergo various levels of certifications and trainings. There are many different organizations that offer doula certifications, like BEST Doula Training, DONA International, ProDoula, and Madriella Doula Network. Being certified is not necessarily a requirement for becoming a doula - however, since the beginning of the pandemic, some hospitals and birth centers have implemented protocols that only allow certified doulas. So, if you plan to support a client in a place that has these requirements in place - it is necessary to be certified. âŁ
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đ” Some of the types of services that doulas can provide pre-conception include, but are not limited to: education on pre-pregnancy health, nutrition, and overall wellness, support with the emotional toll of a miscarriage, and information on pre-pregnancy resources like finding a care provider, the benefits of seeing an acupuncturist and a chiropractor, and ovulation tracking. âŁ
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đ” During pregnancy, doulas: educate you on your birthing options and standard hospital and birth center procedures, help you compile a birth plan if you choose to write one, teach relaxation, positioning, movement, and breathing techniques, and offer evidence-based information on navigating potential complications that could arise during labor or birth. âŁ
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đ” During labor and birth doulas: create a calm birthing environment with the use of music, dim lighting, and aromatherapy, soothe the laboring mom with the use of counter pressure, massage, and cold or hot therapy, educate you what you can anticipate throughout the laboring process, and provide nourishment in-between contractions. âŁ
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So, as you can see - midwives and doulas differ in a number of ways, but share a common passion for helping expecting parents have a healthy, evidence-based, empowered pregnancy and birthing experience.
Myth #5: Doula Support Is A New, Trendy Concept
Although it may seem as though professional and career doulas have just recently started gaining popularity and traction - the role of a doula has actually been an integral part of the process of childbirth for literally centuries.
The term âdoulaâ in the Ancient Greek literally translates to âa woman who serves.â Long before it was so customary to have a baby within the 4 walls of a hospital, it was common practice for women to birth amongst mothers, grandmothers, sisters, aunts and friends - those in their community that had given birth before and could be helpful in assisting with the labor and birthing process.
In the early 1900âs, birth began entering hospitals and, in turn, community-supported childbirth was no longer the reality for many birthing moms and their families. During this time, women birthed by themselves or with very minimal support, which - clearly - was not ideal. Between the 1960âs and 1980âs, the doula occupation came about as a result!
So, although the profession of a doula officially made its debut between 40-50 years ago, the concept of continuous, communal support during labor and birth is truly as old as time.
It is my hope that this post brings some clarification to the role and scope of practice of birth doulas! Questions? Comments? Leave me a message below! —ïž