I am so pleased to share this guest post from doula Jessica Martin, who discusses the distinction she makes between providing information and ‘giving advice’ as she supports her clients. It provides excellent food for thought about the role of a doula. What/how much information should a doula provide? Is it ever appropriate to give advice to clients? How can we support women to be autonomous?
When we are working with a woman, our role is not to give advice, it is to empower her to make her own choice. We have many resources we can share with her, but we are not there to tell her she should do one thing or another. If a woman listens to our information and chooses something that we disagree with or that will likely increase her chances of an undesired outcome, it is not our place to say, “I wouldn’t do that if I were you.” We are there to back her up; to help her feel strong in her choices, not to cause her to second guess them.
My sister, a paramedic, recently gave birth and choose not to learn about labour or birth because she felt that the nurses at the hospital would know how to help her get her baby out naturally. In the end her baby was born by C-section and she had some of the related problems regarding difficulty bonding and breastfeeding. (This may or may not have been different had she done more personal preparation.) That said, it was her path to put her faith in the medical system and experience its benefits and drawbacks. I offered beforehand to share with her some things that I thought were important to know about birth and she declined. I let her know that there was good information out there and she chose not to pursue it, which was the right choice for her at the time. I supported her by listening when she had something to share with me and by not forcing information on her.
Another, more subtle, example is from a birth I attended last month where the mom, my best friend, wanted to aim to avoid pain medication but also wanted to leave the option open in case she changed her mind. When she was considering an epidural at one point in her labour, I felt a twinge of failure thinking that she might get one. I felt like if I were providing her adequate support she wouldn’t need one. The self-reflective process tells me that I was pretty invested in her having the sort of birth that I thought she should have. It was hard, but also felt very right, to let that attachment go and just be there to support her the way she needed so that she knew that she could do it!
In both of these cases, it doesn’t matter at all what my own beliefs were, what choices I would have made in their shoes or whether or not I agreed with what these two women wanted or chose. My role was to provide information (even just that information is out there, in the case of my sister), and not advice. It is so important for us to remember this and to be very aware of how we act in situations where we are uncomfortable to any degree with a client’s choice. This is when we may make a comment that subtly (or overtly) conveys our disapproval, something the mother does not need. We are there to inform and support her, not to guide her choices. Whatever choice she makes is the right one for her. Even if later she thinks she would have preferred something different, at the time it was the right choice for her to make and the right thing for us to support.
On my business card it says, “Support for empowered birthing.” In the end, my client will feel more empowered if I give her information and support for her to find her own voice and make the choices she wants to make (and has the right to make) than if I tell her what sort of birth (I think) she should have. If I force my belief on her (about natural childbirth, vaginal delivery, etc), however subtly I do it, I am no different from the type of medical staff who do the same thing only in the direction of medical intervention.
Jessica is a birth doula in Guelph, Ontario. She also practices yoga and Buddhist meditation. She can be contacted at email@example.com.
photo by Rosen Georgiev