Let’s talk about doula advocacy.

Advocate is not a dirty word. Here’s why this doula is more than OK with being called one.

I’ve seen several posts written recently by doulas echoing the sentiment that they are not OK with being called an advocate. There are definitely some great points made in these posts. In summary:

  • A preference is much more powerful when it’s expressed by the woman giving birth or by her partner. So true.
  • It’s unfair for the doula profession to get a bad name because of the few who are doing vaginal exams and purposefully catching babies. Also very true.
  • A calm, professional demeanor ensures that we will be well-received, which is important so that we’ll be able to continue providing the emotional support we’re known for. Yep.

So with all of this in mind, why do I still feel so strongly that I am an advocate (and have no problem telling my clients that I am ready and willing)?

Because birth and birth support are not cut and dried. Each labor and delivery comes with its own set of factors: physical, environmental, emotional and spiritual (even if you do not consider yourself a spiritual person).

What every woman wants is respectful care, no matter what. And women are not getting that.

Some women hire a doula with a strong personality because she believes that doula will speak for her. She wants that because she doesn’t want to be the one to rock the boat. So honestly, I don’t have a big problem with that so long as it doesn’t compromise safety and is done with kindness and with the best intentions in mind.

My preference would certainly be for the woman to feel empowered enough to speak up for herself. But that may not be her preference. A skilled doula will provide plenty of opportunity for the mother to find her voice and use it.  I am absolutely on board with strategies designed to help women and their partners feel empowered so that they can speak up for themselves. This comes in the form of education, insider tips for navigating the hospital, and so much more that doulas provide during prenatal meetings.

However.

Birth is surprising. It has twists and turns. Some women literally (and I mean physically) cannot speak during birth. She is either completely focused inward (yay, Hypnobabies), which usually allows for her to speak after a contraction is over, but she doesn’t always choose to. Or, she is having feelings of losing control, usually due to an unpleasant external influence. Because of this “noise,” she may be unable to verbalize what she is needing or recall the preferences that were so important to her or carefully thought-out during her pregnancy.

Sometimes women are limited to a certain medical care provider because of insurance and unfortunately do not have their choices supported. And hey, even the best midwives and OBs have bad days. So women who have access to a great provider may still need advocacy.

Yes, the partner should be, and generally is, intimately familiar and involved with her birthing goals and preferences, and gosh, we spend SO much time on this type of “training” during Hypnobabies classes.

However.

Dads have emotions and get tired sometimes too. Sometimes these factors get the best of them and they need… you guessed it, support and advocacy. Reminders about where we’ve come from and where we’re going. Team work. So while I always aim to have a conversation privately with the family to give them the best information I have available that they may be asking for, that scenario might not always be possible or even preferable. I’m also very careful to provide a balanced view so that it doesn’t get taken as, “There’s only one right answer to this and that’s zero intervention!”

But what if it makes more sense to speak up when a nurse or care provider is in the room so that we can hopefully all get on the same page? What if it’s true that as a doula, I’m an expert in other things that the doctor may simply NOT be an expert in? (Hint: it is! Doulas don’t get training for nothing!) You bet I will speak up for you, because I advocate for what YOU want. I will always promise to reiterate only what I know to be true about you in this moment. (And if that’s feeling the need for an epidural, then I’m going to advocate for THAT to happen as quickly as possible!)

To me personally, it’s not about being hired to do someone’s dirty work. It’s just about supporting and loving the mother. Period.

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