Doulas: Why You Need To Be Nice First

Feb 17, 2014 by

A doula was complaining on Facebook in response to one of my posts about getting along with nurses.  “Why do I have to be the one to put forth the effort?  I wish some nurse would try to get along with me first.”  Here’s why it’s up to the professional birth doula:

  • You are a guest in her house.
  • Making the first move sets the tone for every communication and interaction that follows.  Why not use this opportunity to your advantage?
  • You only get one chance to make a first impression – and it takes three times as much experience with you to change someone’s mind.  Make those first minutes count.
  • You are an ambassador for all birth doulas.  Your actions reflect on all of us.
  • Social skills and emotional intelligence are a significant part of a doula’s success.
  • “Hostess” is implied in our job description.
  • Hospitals are set up for the mass production of a number of patients moving through the system.  When you ask the nurse to change what she usually does to personalize care for your client (even when it is evidence based), she may get flak from other nurses or doctors for doing so.  Therefore you need to be grateful when you hear “yes” and accept “no” graciously.  (It doesn’t mean your clients stop trying – it means you are polite.)
  • The last doula may not have behaved optimally.
  • As unfortunate as this is, a client may be treated negatively by the nurse or medical care provider for a poorly behaving doula.  I think we can all agree it is unacceptable to stress out anyone at a birth over our behavior.
  • When you make an effort, especially a big one, the “norm of reciprocity” states the nurse will naturally want to keep things in balance.  So you get what you give.




  1. faerylandmom

    It’s always best to be the first one to lay a foundation for a good bridge between everyone in the room. Even if it means sticking out my hand, smiling, and introducing myself to a staff member who may or may not feel a bit of hostility toward me. Why should I be the first?

    Why not?

  2. I agree with Ellen!! In my experience when they are judging me as a doula based on a poor experience with another (unprofessional) doula… kill’em with kindness and you’ll win them over! Then they are excited to see you next time you are “in their home.” Make friends not an enemy.

  3. Here is my question for you.
    When arriving at the hospital with a “Natural Birthing Client” how do I the birthing doula request a more natural birthing nurse/nurses or is this up to the my “Natural Birthing Client”?

    Thank you very much.

    • Amy Gilliland

      It’s always better to have your clients speak up for themselves rather than speaking for them. We can help remind them to advocate for themselves simply by saying, “Did you want to tell the triage nurse about your birth plan?” In fact, if your client calls ahead to let the hospital unit know she is coming, that is also a good time to mention it (especially if that is unusual for this hospital). It gives the charge nurse more time to arrange a nurse who may be more open to her support wishes. Something as simple as, “I’m planning an unmedicated birth and was wondering if there might be a nurse who would like to support me in that tonight? I just wanted to let you know in case there might be some choices.” Of course, you can’t reserve a particular nurse. It’s usually first come, first served. But if two moms arrive between your call and your arrival who can’t wait to get their epidural, it might make a difference! It certainly can’t hurt if its said politely by the mom or her partner (while understanding there are no guarantees). If its not unusual for a mom to have an unmedicated birth but not usual either, then waiting to ask until triage is probably okay too. It really depends on the facility, how many births they do, how large they are, their epidural & c-section rates, and their culture about nurses supporting patients.

  4. This hits the point exactly! Every doula needs to be professional and “nice” when meeting the mother’s birth team (nurses, doctors, family, friends, etc.) She isn’t making an “effort,” she is doing her job. Any doula who feels otherwise should probably reassess why she is there in the first place. We are not there to “save” mom, we are there to preserve the sacred space and assist her through HER experience, not the doulas. Bringing conflict into that sacred space no longer makes is “sacred.” Thank you for posting this!

  5. “You are an ambassador for all birth doulas. Your actions reflect on all of us.” You can’t say that enough. I had an OB yell at my laboring client because she chose to have a doula, because of a bad experience he had had with another doula weeks before.

  6. I agree. In my experience the nurse is likely to be your best friend in there. She is the number 1 go-between between your client and her care provider. You want her on your side. If she acts like she want to do hands on patient care- let her… it’s in her job description too. Eventually she will be too busy or must leave the room and you can step right in. It takes a team to help the mom have a good experience.


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