Doulas often feel that they are accountable for their client’s positive and healthy birth experience. While this is somehow true, it certainly does not dismiss the couple’s efforts to achieve their desired birth experience. The presence of a doula at the birth should not by itself be perceived as a guarantee to a healthy and active childbirth. When couples choose not to engage in other types of labor support and preparation activities such as pregnancy physical activity, prenatal yoga, or childbirth education classes, there is a high chance that the doula will be the only one accountable for their positive birth experience. In this case, both parties risk a complicated relationship which might involve disappointment and lead to a non-satisfying birth experience.
Whether you are a childbirth educator or a birth doula, you know that most expectant couples you’ll teach and support plan a hospital-based birth. The statistic is that out-of-hospital births are less than 5% of all births. I trust you to be deeply invested in your clients’ well being as they prepare for their nearing birth, and that’s why I am going to teach you how to lead them with respect to their choice of birthplace. I intend to show you how to do these two things:
- Recognize your client’s context around the place in which she chose to give birth.
- Lead her in a way that doesn’t evoke internal conflict and resistance between her choices.
As I was looking for more studies about the drastic increase in birthing mothers who get an epidural for childbirth, I found the following research, published by Stanford medicine, titled: Study shows women prefer less-intense pain at the cost of prolonged labor. Here is what the researchers did: ”For the study, Carvalho and his colleagues gave a seven-item questionnaire to expectant mothers who had arrived at the hospital to have labor induced but were not yet having painful contractions. The questionnaire pitted hypothetical pain level, on a scale of zero to 10, against hours of labor. The women took the survey a second time within 24 hours of giving birth. A sample question asked, “Would you rather have pain intensity at two out of 10 for nine hours or six out of 10 for three hours?” Both pre- and post-labor, women on average preferred less intense pain over a longer duration, according to results published in the British Journal of Anesthesia.”I find this study to be somewhat disturbing but revealing at the same time. It is even useful from a coaching perspective. The questions the researchers asked were misleading. Women were asked to weigh their options and choose between coping with labor pain or having a prolonged birth as a potential implication of getting an epidural. But – – are these the real options they weigh? Is prolonged labor the risk associated with taking an epidural in childbirth, or is it a side effect that might lead to many other potential risks?
For the past six years, I have practiced prenatal coaching with my birth clients. By incorporating between four to six prenatal coaching sessions into my doula practice I was able to identify six habits of thinking, or repeating themes, which could harm your clients’ birth experiences. Whether they are aware of these thinking habits or not, these themes run like an underground stream that will find any possible ‘crack’ to emerge and surface. This blog post is dedicated to these six habits of thinking and the coaching strategies you can apply to address them:
1. Perceiving childbirth as dangerous.
2. Confusing discomfort with pain and avoiding both these sensations.
3. Avoiding information that challenges her mentally and emotionally.
4. Adopting the cultural dichotomy of natural childbirth vs. medicated childbirth.
This year, World Doula Week has an additional substance for me as I celebrate my 20th year practicing as a birth professional.
Yes, of course, I still support birthing mothers individually, and I wonder if I’ll ever stop. During these 20 years, L&Ds and other birthplaces have been my synagogue; where I strengthened my faith in the universe, in nature, in people, and in my body. Witnessing my clients in their moments of triumph strengthened me from within and taught me that I am a powerful force. Supporting them through low moments of pain, despair or doubt reminded me I’m a vulnerable human being. Stepping aside allowing couples to have their moments of touch, love, care, and the deepest connection we experience during birth, made me realize how precious my marital relationship is to me. I am lucky to have found a supportive partner who is an amazing father to our three daughters.
It is my understanding that doulas try to protect themselves – their souls and their hearts – by being choosy about clients. They want to commit to those who demonstrate the highest level of commitment to physiological and unmedicated childbirth and to those who are also most likely to choose a like-minded caregiver.
Curing the Dramatic Drop in Childbirth Education Attendance
Recent studies found a dramatic drop in childbirth education attendance. Taking that the new consumers of childbirth education are millennials, it is not surprising. Millennials were born into the era of online information, and they are consuming knowledge on Google, Facebook, and Youtube. Integrating coaching principles and strategies in your childbirth education classes will make you attractive and uniques. It will draw potential students that are looking for more than knowledge and information they already got online. It will magnet students who are ready for the next step of self-discovery – clarify their belief system about childbirth, their wishes, and their goals, and carve their desired birth experience. You will be able to lead them toward clarity and to elicit their accountability to their desired childbirth experience.
The advocacy dilemma in the field of childbirth support is a tough one to crack. The dilemma lies in the tension between certain components of birth support practice, such as serving and supporting, and other components such as being a change agent in our society and a birth activist. By relying on coaching principles and strategies, I suggest that you can be sure to practice within your scope of practice and to refrain from projecting or engaging any ‘activists agenda’ in your relationships with your birth clients. Coaching is the pathway to client-centered relationships and care.
Does an ‘Expert Position’ serve birth support pros or clients?
Do you consider yourself an expert in ‘how to give birth’? If you are a childbirth educator, a birth doula, a midwife or a labor and delivery medical staff member, I’m almost certain that there is a confident voice inside your head saying, “Yes, I know all about giving birth, it’s my profession and what I do for a living”. I believe that since the seventies, with the beginning of birth activism, birth givers have been torn between two types of “experts” – “medical experts” and “natural birth experts.”
Maybe it’s time to rethink our position: Can anyone be an expert and say how another person should give birth?
Is your birth client as accountable as you are for her birth process?
A couple of days ago I had a beautiful mentoring session with two local doulas; we will call them Iris and Lily. We were going over some challenging cases they experienced recently and exploring how the Birth Coach Method’s strategies and tools help. Pretty early in our discussion, I learned that their ‘typical birth clients’ represent some degree of polarity: Iris works only with clients who are strongly committed to an unmedicated birth. She feels that potential clients who are “willing to try [birthing] with no epidural but leave themselves open to the option of taking it” are not a good match for her. Lily said that her clients are hiring her in order to “Check the box” of doula services; meaning that they read the statistics showing doulas reduce cesarean rates and they are hiring her to avoid a cesarean.