I am called to support my colleague and friend. How do I step up for her?
I have been practicing as a doula for almost three years. I love this role of supporting families. My main goal is for them to feel supported and loved as they welcome their baby to the world. I was a teacher for over ten years prior to launching my doula career, so planning and organizing was a big part of what I did. I like structure. As a doula, I try to structure my prenatal sessions. It helps me get to know the needs and goals of my clients in a systematic way and to understand how to support them and meet them where they are at. As part of my service, I also fill in any educational gaps as needed. I want to help them understand their options.
But what happens when I have a client who is a doula? How do I inform her? Do I just offer labor support and skip all my sessions with her? I usually offer each client three to four sessions. This client didn’t need to practice the tools of labor support with me since she is a trained doula and prenatal yoga instructor. She also had taken a childbirth class with her partner. So I felt like the bulk of what I usually offer my clients was off the table. Now what? I needed to go beyond informing and all the way to coaching.
Highlights from my coaching process
I already had a good rapport with my client. We had built trust by sharing our experiences as doulas and attending a doula training together. I needed to challenge myself and be open to supporting her in a different way. I believe this was a real opportunity for me to focus on using my coaching tools. The process was messy. I felt like I had to wait for the moments to coach, but I also learned that coaching is not as structured as teaching, so I was allowing it to happen organically. Here is how the process unfolded and my reflections.
Step #1: Saying ‘goodbye’ to old ghosts & ‘hello’ to current goals and wishes
In our first meeting with my client and her partner, we talked about their first birth experience. This conversation was unavoidable. It was a cesarean birth because the baby was in a transverse position. My client knew she had only one option: a cesarean section. At the time, she was okay with the option. She did not think much of it. Later, she learned more about birth and realized that she did have more options that the doctor did not communicate to her. She felt cheated. I actively listened to her story and the feelings it brought up. We explored what her options were now. I was hearing a lot of what she did not want for the upcoming birth, and I knew we needed to create clarity on what she wanted. So I changed the focus to creating a list of priorities – what was important to her and what was important to her partner. This then led to envisioning her ideal birth experience. We set up some action items for her and her partner to complete. The top action items were creating a birth plan and attending a childbirth class to explore the option of using self-hypnosis and relaxation techniques during pregnancy, labor, and birth.
Step #2 – Reviewing the birth plan; communicating her desired vision
In the second meeting, we reviewed the birth plan that she created. Some important highlights from the birth plan that surfaced included to give birth at a very specific hospital location due to access to midwives, to hold off on vaginal exams until there was an urge to push, to perform monitoring only intermittently, and to avoid IVs.
I got an impression from my client that it was going to be a fight. She felt like she had to fight for specific wishes that don’t follow hospital protocol. This is the last thing that I want my client to feel going into her upcoming labor and birth. What a buzz kill. We want oxytocin flowing not adrenalin. My client decided to tackle her requests ahead of time. Her next step was to present this plan to her doctor and start a conversation about her desired birth experience. This was an important action to ensure that her birth plan would be respected and honored when giving birth.
Reflecting back on this experience with my coaching mentor, Neri Choma, I now recognize that this session had a theme to explore. Does advocating for ones’ wishes have to be a fight? How does fighting serve you in this situation or any situation? Can your needs be met without a fight? Can you make a request? Fight or flight is a hormonal experience that should be avoided during pregnancy and birth. A way to shift the focus and avoid the fight or flight response is to explore the possibility that no one will fight or that the medical staff will just be okay with it.
Step #3 – Coaching around doubts and fears
After our second meeting, I was sensing a lot of fear going into the birth but I didn’t know how to address it in our session. She had doubts that weren’t being voiced about giving birth. I sensed it in her tone and body language. I am a novice at incorporating coaching tools and didn’t know whether I should be the one to open this discussion. This encouraged me to be creative with strategies on how to coach my client. I might have been drawn toward informing in order to reduce fear. Instead, I facilitated a ceremony to release fears. We had a small gathering with close friends and doulas, women who are supportive of my client’s journey. The gathering was very nurturing and supportive. As a group, we wrote down fears and shared them out loud. We named them and released them by burning the written fear. This process helped my client to explore her current reality, namely doubting her ability to give birth vaginally. The ceremony inspired her to take action and to prevent her fears from sabotaging her goals. Just talking about fears is very abstract, going a step further and performing a tangible action benefited my client. I observed a release in her tone and body language. She was going into labor and birth with confidence. Or was she?
Step #4: Coaching for the WIN – facilitating alignment
Usually, I spend the last prenatal meeting with my clients practicing coping techniques and positions and doing a test run for the birth. This client did not need this, as she is already an experienced birth professional. Instead, something very rich came up for her and it was an excellent opportunity for me to practice my coaching tools. I found an OPENING to coach!
My client shared that her OBGYN offered to do a membrane sweep in her last prenatal. My client was seriously considering it. Her partner and I were surprised that she wanted a membrane sweep. There was a lack of alignment with her priorities. Her thinking was not aligned with her birth intentions, nor with her beliefs. At this moment, I observed her being very uncomfortable.
I inquired trying to understand why she wanted to get a membrane sweep. Her partner started asking excellent search questions. I was giving him a thumbs up on the side. It took some time for her motivation to surface, but then it did. We all discovered that she did not want her baby to be born on December 24. Why? Where is this going? I asked: “What happens if your baby is born on December 24? What does that mean to you?”
In her mind, it is the biggest holiday of the year. She would be robbing her daughter of a special day because it would be overshadowed by the biggest holiday of the year in her country. I asked her, what if your baby is born on December 24? Can you accept that? A plan had to be made in order for my client to accept this possibility. And so, she came up with a plan: If my baby is born on December 24, we will celebrate her birthday in the morning with a cake. And what about the decision about the membrane sweep? We did not pressure my client to make a decision on the spot. Based on our discussion, she was going to decide what to do in her upcoming appointment.
Would I have discovered this if I only educated and informed my client? I highly doubt it. To me, this session was a breakthrough. It taught me how valuable it is to be with my clients in the moment and wait for those coaching openings. Look for the opening! Go beyond informing and coach your clients to a healthy birth experience.
My client decided not to have a membrane sweep. She went into spontaneous active labor on December 23 and met her baby girl on December 24 in the early morning hours. My client had a vaginal birth after a cesarean section. This was her goal and she achieved it. And I got to offer her new insights about herself as her coach and doula!