Will you be my advocate?

I often get asked this at consults.

It’s tough because I know there’s this movement happening that is telling people that is what a doula does.  I know that in a way we are advocates, but the way this happens is different depending on who you talk to.  Doulas included seem to not be in agreement.

The more I do this work, the more I see what a tight rope walk it is.  On one hand, we are there to inform families about what is happening to them.  On the other hand, we are not care providers.  Our role starts to go into grey areas when we begin to speak about what actions should be considered or taken.

I’m not saying it’s wrong or shouldn’t be done, but it’s the grey area that keeps bringing me back to the word advocacy.  I’ve been thinking long and hard about where I fall on the spectrum.  I’m flexible in ways, but I have come to see that I have formed some beliefs on the issue that might help those seeking out my service make a better decision.  

Given how this has put my mind in circles, I figure it’s worth sharing here.  I may have missed some items, but these are the main themes that keep coming to my mind as I continue my work as a birth doula.         

I believe that…

  • The care provider/patient relationship is a personal one.  We all have our reasons for why we choose who we do.  
  • It is not my place to change the way a provider cares for their patients.  They have their own experiences and comfort level with birth given how they have seen it unfold.
  • The environment we choose is also a personal one.  Maybe we want easier access to the epidural in the event we want one.  Maybe it’s the NICU team that puts us a ease.  We all have different values and priorities when it comes to these things, and it is not my place to change or judge what a person chooses. 

When it comes to advocacy I believe… 

  • It starts while pregnant.  It is through the choices we make, from the team we choose to what items we choose to communicate about.  It’s about following our instincts when we sense our team is not going to support us in the ways we need.
  • Birth plans are a nice start, but they do not replace the communication that needs to happen in order to ensure that support will be given. 
  • Birth is not the time to be fighting for what we want.
  • As a support person, I’m there to help families understand their options.
  • I’m there to remind families about their right to informed consent or refusal.

When it comes to doula support I believe…

  • I am an expert in comfort measures for pregnancy and birth.  
  • I have knowledge and personal experience with the variations of normal and complications, but my role is one of encouragement and support no matter what happens.  
  • My support is unconditional and comes from a non-judgemental place.  Even with the most thought out plans, sometimes people change their mind.  Only the person(s) experiencing it knows what they truly need in that moment.
  • It’s not my birth, baby, or life!  We are all different and have our own comfort level with medical care once things start deviating from what we were expecting.    

All that said, these are my own personal feelings and beliefs.  I respect those who choose to doula on the other parts of the spectrum.  We all make choices based on our own personal walk in life.  Just as care providers do with choosing a style of care on the active versus expectant care spectrum.   

Hopefully this helps to shine some light on the differences that exist within this role that is growing in popularity. 

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