Not Any Woman Can

Jun 30, 2014 by

One of my most hated myths about doula care is the idea that any woman can be a doula.  Just put a person born with a uterus in a labor room and she’ll be able to help effectively – with no preparation.  This is a myth that devalues what doulas do, and gets in the way of us being perceived as professionals. It also devalues the men who offer good doula care.  The myth that “any woman can” is even perpetuated by doulas, who may not realize the damage this idea does.

Effective labor support requires sophisticated emotional skills that rise to the level of a skilled counselor.  A good doula has to be able to correctly read everyone’s behavior in order to positively influence the emotional tone of the room.  She or he needs to know the mother’s need before the mother knows it.  In my published research on emotional support skills [pdf: GillilandMidwifery], it became clear that these skills take many births to master.  The components of emotional intelligence are at the heart of doula work.  Good doula support cannot be accomplished without keen self-knowledge, empathy, emotion management, and relational skills.

In addition, doulas utilize a wide variety of positioning techniques and comfort measures.  In order to establish a position correctly, the subtle placement of a shoulder, foot or ankle can make the difference between comfort and pain for days after the birth.  Having a wide variety of ideas and stamina are essential for the physical demands of labor support.

The key to understanding empowerment is knowing that a doula cannot empower anybody.  A person has to take advantage of an opportunity presented to them to state what they want and to ask questions.  Doulas create these opportunities.  But it only happens smoothly by using complex communication strategies.  Doulas need to be able to relate to everyone’s concerns:  medical care providers, nurses, the mother and her immediate family.  This begins with keen observational skills and compassion for conflicting agendas.  Her choice of words and attitude is deliberate and intentional.

These are not skills possessed by most people!  They are cultivated, practiced, and honed over years of attentive living and attending births.   Doulas go over and over each support experience they have in order to squeeze as much knowledge as possible out of it.  They learn that birth is about what the mother wants and not what the doula wants.  This is central to labor doula effectiveness.

In this post, I’ve only begun to scratch the surface of what birth doulas do.  Its necessary to establish a rapport with strangers and educate without overwhelming at prenatal visits.  Many births involve trauma prevention and navigating the landscape of past abuse.  After the birth, doulas are critical to recovery from a difficult birth or normal postpartum challenges.

We MUST establish our own value in the world.  The work of birth doulas is vitally important in people’s lives!  It cannot be done by just anybody.  When we don’t value the complexity of our carework, no other professional – nurses, doctors, or midwives – can do so either.

 

Upcoming:  How Doulas Undermine Our Own Value (it’s not money)

8 Comments

  1. “The key to understanding empowerment is knowing that a doula cannot empower anybody. A person has to take advantage of an opportunity presented to them to state what they want and to ask questions. Doulas create these opportunities. ” *applauds*

  2. We get at lot of women in our area (and I’m sure this goes for everyone else) that say “I’d like to be a doula!” and I have to tell them the downside because I really think “Meet the Midwives” has romanticized birthworkers roles. Many SAHMs think it’d be a good way to make money and we have explain that you have to have reliable daycare for your children at a moments notice in the middle of the nite sometimes for an undeterminable amount of time. And then you have to pay that person a decent wage to get a person to do that for you as well as your travel expenses before during and after the birth, literature for the mums, advertising and insurance. It’s not a huge money making racket….you do indeed have to be very passionate about your work. Happy that you were my birth doula educator even tho I’ve not become a birth doula do to having babies myself and the extreme competition in my area. I’m working towards post partum work as there is a tremendous need. However birth work has never strayed far from my mind and a group of local doulas and myself have just launched a non-profit aimed at providing childbirth education, lactation counseling, and doula care to those who couldn’t normally afford it. Especially but not only teen mothers.

    • I couldn’t agree more with you Katie!!!! I run a nonprofit organization and can’t tell you how many times women come to our group saying they want to be a doula, we train them and work with them and then once they need to be on call they rethink it. For some it doesn’t matter how many times we explain it they just don’t get it until they start to get those middle of the night calls or long births. Of course, there are those women who hear about it and back out right away, but for every five we take into our group maybe one will actually work out and make it into the full fledged program.

  3. Tara Snide

    You are 100% right. This applies to postpartum doulas as well. What we offer is unique and extremely valuable. (and I just upped my packages…again) 😉 We are continuously learning and giving our all to fill the needs of a birthing family. It takes a huge amount of energy to help them have a positive experience, a happy memory, a feeling of control/contentment, emotional and physical safety…AND to accurately read/respond to all of them. Navigating with “emotional intelligence” is a skill learned over time and is something that many people cannot do. Fifteen years into this real profession…I am still amazed at how many doulas themselves feel like doulaing is not a “real”job. It most certainly is. We are blessed to be able to do something we love, make a true difference in the world…and get paid to do it.

  4. doulaChristy

    I really enjoyed reading this and I especially enjoyed sharing it with my husband. I have been a doula since 2006 and he has listened to many stories through the years. Though he supports me and is a great proponent of doulas, I think this description gave him a new insight into what it is I really do.
    It also validated me as an experienced doula. I am excited for new doulas to come into my area and I am happy to mentor them and help them in their journey. I sincerely believe that more doulas can only benefit all of us in the long term. With that said, I was finding it challenging to articulate what it is I bring to the table that a less experienced doula may not have developed just yet. This article beautifully explains how my years of education, experience, and life have impacted my skill set and will only continue to develop these skills. I think I will be linking this post to my website for potential clients to read. Thank you for the work you do, Amy!

  5. Bonita Katz

    Thanks for this, Amy. I like the phrase “sophisticated emotional skills.” That is key to being an effective doula – and also very intangible and often difficult to describe. We are lightening rods and teleprompters, Kevlar vests and security blankets. We protect, deflect, and reflect. Birth is exhausting for a doula – not always for physical reasons. When you are truly with woman you are there heart and soul. It can take days to decompress and process a birth. Thanks for giving us a fresh perspective on our worth.

  6. I really liked what you have to say. It’s making me think more about what my skills really are. I have known for a long time that the emotional support is deep and complex but I never thought of “emotional intelligence” as the skill I employ most. These are not things that can really be taught or certainly not taught in a training session. I learned then in Al Anon, individual therapy, group therapy, personal growth seminars, journaling, massage school & years of work with massage clients, and some was just who I am: quiet and observant, then there’s the life time of trial and error in communication with others- not any kind of school that I know can teach this. Compassion cannot be taught , not really, thoughtfulness, thinking on your feet, plugging in to your intuition, and yes, the reading people thing is really important but so is knowing how to respond to what you read! and I do go over and over each birth to “squeeze as much knowledge out of it” as I can. I notice what was different , what surprisingly worked or what didn’t, and I try to figure out the why. I review births with birth peers to sort out areas of concern or in question. I like to think I am a very good doula…. in order for me to doula well, I cannot take on a lot of clients. and the more complicated emotionally the situation the more tiring it is. Then there are the overnights- not every one can deal with that change in sleep, loss of sleep, interrupted sleep, and cope well with it. That can’t be taught either. The other thing I always tell other doulas is: we are human beings, not human doings, Our being there, our compassionate attentive presence, does more lots of times than any tool in our bag, position, or suggestion. Maybe that ability to step outside ourselves, our ability to put the clients first for hours at a time, is something others just can’t do.

  7. Oh my word, I loved reading this! Thank you so much! I agree, not very many people were made for doula work and having many births and life skills is hugely important. Can this be taught? I question this! I came to birth work after years of high end retail, military life, and some college toward social work. (Many years in athletics as well) We doulas need to take pride in our work and our well developed skills!

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