I am the founder of Birth Coach Method and am celebrating 20 years of leadership in the field of childbirth support. Throughout my career, I have been honored to provide doula support and teach childbirth ed. classes to hundreds of expectant couples, as well as to direct two birth resource centers. I am also a doula leader in my community in the South Bay area of Silicon Valley in California.
Doulas’ Dilemma #2: The Doula Scope of Practice
This is the second blog in a series of three that I began writing in November. I am very passionate about the doula profession. That’s why I feel called to write this series before it is too late. And by “too late” I mean that I think our profession is in danger. Being a doula trainer and at the same time an approved continuing education provider for obstetric nurses, allows me to be connected and empathetic to both sides of the conflict – doula and medical caregivers. On top of listening to nurses’ pain points in their relationships with doulas, I recently have been invited to speak at a few OBGYN and midwives’ practices and heard that they are on the verge of banning doulas
Additionally, recent events confirm what I have been fearing – the current practice of doulas’ who share evidence-based information that supports better obstetric practice (while not being medically trained and bearing no liability for their clients’ health) is going to hurt us.
- It puts our relationships with medical caregivers at risk.
- It will lead more cities to follow New York in attempts to license doulas.
- It will lead our best friends – hospital-based midwives – to ban doulas or have blacklists of unwanted doulas that they don’t trust.
- It might also make it harder for us to find paying clients because they hear more and more stories about doulas who break the trust and rapport that couples have established with their medical providers.
Since the seventies, those who provide education and support to birthing individuals have all been called ‘Labor Coaches’. In that group are childbirth educators who teach about childbirth and deliver a body of knowledge, usually in a group setting. Also in that group are doulas who are trained to provide emotional, physical and informational continuous support throughout the birth. We all got used to thinking about childbirth as an event in which our role is to help the birth giver cope with labor strains while providing information, reassurance, and applying comfort measures.
On the other hand, coaching, a growing industry generating $11 billion in the USA, is an entirely different practice that stands by itself. It is the practice of leading competent and healthy individuals to optimally perform in order to achieve their goals.
Birth support coaches that are trained here at the Birth Coach Method, likewise, are also trained to coach expectant individuals towards achieving their desired birth experience.
I wanted to quit, but I discovered coaching and got excited again about being a doula.
After a decade of practicing as a doula and childbirth educator, I was about to quit. I was burnt-out. The rising rate of medical interventions led me to doubt my ability to fulfill my role and facilitate healthy and positive birth experiences. Additionally, the growing gap between doulas’ approach to childbirth and the approach held by the medical caregivers that our clients trust for their journey, triggered a lot of tension in me. These circumstances, in addition to the given hardship of the doula practice, made me reconsider my career path.
Ten years have passed since I felt under-resourced and I still enjoy practicing as a doula and training doulas. How did this happen? I discovered coaching!
In the last couple of years, I have come to learn that I am not the only one to have gone through this professional struggle. In spite of ACOG’s recognition of doulas’ benefits and some big headlines reporting the many celebrities who hire doulas for their birth, doulas experience a few major dilemmas that cause great hardship.
This uneasiness reflects in social media and doulas’ blog posts, and I can sense the confusion, frustration, and disputes that percolate within the doula community. Being passionate about doulas and our valuable stewardship position, I’d like to share my personal path that helped me resolve the three major dilemmas doulas face:
Prenatal yoga instructors, you are first in line
Out of all the birth support professionals, prenatal yoga instructors probably are the ones to begin supporting expectant individuals the earliest along their journey of pregnancy and childbirth. From a coaching perspective, I see it as a huge advantage, so if you’re a prenatal yoga instructor, you can make miracles leading and empowering expectant mothers to strongly hold not only yoga poses but important convictions about their childbirth experience. Just like the practice of yoga helps individuals to connect with their breath and their body, coaching strategies help them connect with their beliefs, inner truth, values, and needs.
Are you curious about what happens in our Birth Support Coaching course?
It’s exciting to lead the first group of birth professionals who joined the Birth Coach Method’s first coaching course. We have participants from all around the globe: The Netherlands, Israel, and the US (East and West Coast). We all come together on consecutive Tuesdays for eight weeks using the Zoom platform. It is a group mentoring session in which I get to expand on the topic of the current lesson studied prior to the meeting. In addition to highlighting important concepts, we all brainstorm scenarios and engage in powerful coaching exercises.
Exciting steps towards improved communication between L&D nurses and their patients
I’m constantly searching for coaching props and strategies that can help me coach expectant parents throughout pregnancy and childbirth. I have been developing tools and strategies for some time now and excitedly shared them with the community of birth support pros in previous posts and in my book. So, you can imagine my excitement when I came across a few resources affirming the use of white dry-erase boards in L&D for improving communication and maternal care.
Are your birth clients overwhelmed by the overload of information?
Being overwhelmed by the overload of information is a state of consciousness that many expectant couples struggle with. It disempowers and damages their ability to make mindful decisions and perform well. Beating it requires a shift in our practice rather than providing more information. You can help your birth clients beat this overwhelm by coaching them.
In my practice, I often encounter the overwhelm that my clients
experience being overloaded with information. Seriously, it feels like it enters the room when they do. How often are you being called to resolve this overwhelm as a childbirth educator or a doula? There are conflicting opinions and expectant parents don’t know what advice to take or what to believe while all along trying to do the right thing; they want to find what is best for the mother and the baby. The overload of information creates a ‘noise’ that interrupts our internal conversations with ourselves. Feeling overwhelmed is not only disempowering, but it’s also exhausting.
Is birth plan the goal or the strategy?
When birth workers, such as doulas and childbirth educators, first envisioned the birth plan in the eighties, the main idea was to help expectant parents prepare for the physical and emotional aspects of the birth process, explore how they want various situations handled during their actual birth, and provide a tool for parents to communicate with each other, their care provider, and the hospital staff prior to the birth (Simkin, 2007; Simkin & Reinke, 1980). As sometimes happens, the mean comes to be associated with the goal, and as such, expectant couples and some birth workers, associate writing the birth plan with achieving it. This association may evoke some unexpected outcomes:
What are the additional challenges of a birth giver who wishes for a VBAC?
While the coaching strategies are valuable in supporting and leading every expectant woman who would like to give birth healthily and experience high levels of satisfaction, they are even more crucial when supporting and leading a birth giver who wishes for a VBAC because of the additional elements or challenges she faces.
The process of childbirth presents birthing women with some recognized moments of emotional crisis, as well as some unexpected ones, related to the unfolding of the birth. My experience has been that the known and expected emotional crises occur during transitions or changes occurring throughout the process. It is common knowledge that the transition from one phase of birth to another triggers an emotional reaction. For example, the transition from the early phase of labor to active labor is symptomized by the emotional change in which excitement and self-confidence give way to fear, despair, or self-doubt. Birthing mothers express these new emotions in a variety of ways: If they are talkative, they might express them by sharing their thoughts, such as: “Do you think it’s time to head the hospital”? Or “Do you think all these contractions are doing anything”?, “Do you think I’m progressing?” and “How much more painful will this be”?