What does a Doula do?
Part one ... what you may not expect I do
Believe it or not, my role as a Doula is not to just hold your hand and rub your back throughout contractions or surges (although I can do that if you like). I am not there to check your labour progress, "protect you from the system" or act as an intermediary between you and your care provider. So just what do I do?
As your doula, I am your companion throughout pregnancy, labour, birth and postpartum. We spend many hours together, before birth, building our relationship to help you recognise the skills and capacities YOU need for autonomy in YOUR birth.
The 5 areas we work together in
1. Your Values
What sort of birth do you want and what is the best care model for you to achieve this?
How do you want to feel during and after your birth? Not just physically but emotionally too!
In what circumstances are you happy for your care provider to make decisions for you? Would you prefer that decisions were made together between you, your partner and your care provider? Did you want to make informed choices for yourself - do you know you have the legal right to do that?
Your values will affect the decisions you make about your preferences for care and whilst no-one can guarantee the outcome of your birth, our work together will ensure you feel confident and in control of your choices.
2. Your Options
As a doula I am employed by you, not the hospital or your care provider and as such I am not generally bound by their policies and procedures. I am guided by your wishes and my ethical and legal responsibilities.
This means we can discuss ALL the options, not just the ones presented by routine procedures, and look at all the pros and cons of these options before you give birth.
Are there policies you agree with, policies you are happy to find a mutually agreeable compromise about or policies that you don't agree with and if you can't find a compromise, would it suit you better to find a more compatible care provider or birth setting?
There is always more than one option available to you!
Active participation in your health care requires effective communication and collaboration between you, your partner, your family, medical staff and others. Together we can explore how to respectfully state your views or express your concerns assertively, discuss the best questions to ask to get the information you need to make an informed decision or even role play various scenarios you may come across.
4. Your Decisions
"Women do not make choices or experience pregnancy and birth in a vacuum. Their partners, families, peers and health-care providers all influence the process of bringing a child into the world." I recognise that you do not make decisions in isolation and prepare you to use various decision making tools to weigh up the benefits and risks where required. My responsibility is to facilitate the skills and capacities you already have within you so that you feel listened to, more knowledgeable and so that your choices reflect your values, reducing the possibility of remaining undecided or regretting your decisions.
Reflective practise is a way of using past experiences as learning situations, especially helpful for previous births and decisions. We look at how you made those choices, were they in line with your values and at being responsible for your actions. If there is a difference between your expectations and the outcome, how can you do things differently this time so that your actions align with your goals?
I believe these five areas are some of the most important skills we can work on as they promote what YOU can already do and work towards fostering your self-confidence and trust in yourself, your body and baby and your birth team.
Stay tuned for Part 2 of What I do as your Doula.
This blog is based on the work of Sandra Meadow and the Doula's role in fostering relational autonomy
ABOUT THE AUTHOR
Kelly is a birth and postnatal doula working in the Adelaide area. She has a strong belief in families making informed decisions about their health care and happily works within the following hospitals: Women's & Children's, Lyell McEwin, Flinders Medical Centre, Burnside, Calvary, Ashford and North Eastern Community.
You can contact her here to book a Birth Clarity Session or to hire Kelly as your Doula.