10 Key Points from a Doula
There are many things to consider working as a Doula, from the time you are hired well into postpartum support. It's easy to get caught in your own headspace, or feel unsure of the right thing to say in any given situation. I have collected several key phrases or things to remember through my years working as a Doula, and I wanted to share these little bits of wisdom with you! I frequently read them before writing an article, interviewing with a client, or attending a birth. If you are here searching for ideas to support your partner through the birth process, this will be equally as helpful for you!
Management of pain is not everything!
To expand on this, avoidance of pain is not everything! Mothers who have experienced labors with a supportive birth team encouraging her report more satisfaction with their births, no matter what level of pain they report! This means that if she feels heard and supported, she will be happier with her experience no matter her physical pain level.
Are we listening to the birthing woman's wishes?
Another good way to phrase this question is, "How will she remember this?" Always consider your tone of voice, your body language, and your actions before handling any situation with a laboring woman.
Women never forget the words spoken to them during labor. Positive or negative! Her senses are heightened and she will remember any snide comment, sigh, or roll of the eyes. Support is non-verbal, whether you like it or not!
Top 3 Priorities
Aside from healthy mom and healthy baby, every couple has a few priorities that need to be respected to ensure a beautiful experience. If they desire quiet, time alone, and minimal interventions, those are the most important things for you as a Doula or a partner to protect. This will be different for every couple but is incredibly important.
RAVE- Reassure, Acknowledge, Validate, Encourage
Most Doulas know a "Take Charge Routine," or a way to calm a mother down who is experiencing panic during the birth experience. For a partner or a Doula who isn't familiar, there are four steps to take if a woman is suffering, upset, or experiencing too much pain to think clearly and make decisions-
- Reassure- "I'm here with you, this is part of the process"
- Acknowledge- "I know it hurts. I hear what you're saying"
- Validate- "This is really hard work. I know you're doing what you can"
- Encourage- "Breathe with me, that's it, just keep breathing through this"
This is a good place to mention that we never want to predict what is going to happen next, what mom feels, or what the care provider will say. Our job is to keep the birthing woman focused on the task at hand with minimal interruptions or distractions.
If we say something like "You're almost done!" or "The baby is almost here!" and she is still hours away from delivery, you could put her into a spiral of timing herself, give her false hope, and waste energy that she needs for the ongoing contractions.
Here are your options, what seems best?
There are going to be moments where she doesn't know what she wants, or contractions become overwhelming. During those times, it's best to give her two or three options and let her direct your next move. Good ideas for this might be "We need to keep you moving, would you like to take a walk, bounce on the birth ball, or use the restroom first?"
If nothing sounds like a great idea, keep breathing with her and use the Take Charge tips above until she can make a choice.
Emotional stress doesn't go away with pain relief
I touch on this subject in my article, E is for Epidurals, but this is an important point for partners and Doulas alike. When a woman gets pain relief, such as an epidural, some birth teams take it as time to rest, get food, and regroup.
While it is a great idea to refuel, keep in mind that labor is still ongoing. Many women are surprised to find they still cannot rest with an epidural, and need a lot more support emotionally and mentally than they expected.
High Stress/VBAC Advice
Many times when a woman has experienced a traumatic birth before, there was a point that "it all went wrong." Whether that was at 40 weeks when induction was pushed, when she was told she needed a cesarean at 6 cm, or when she "gave in" and asked for the epidural.
This moment usually is difficult, it's hard to revisit that space and push through. Some phrases that may help if things stall or she begins to panic are reminding here that this is not last time, every birth is different. Keep breathing, take charge if necessary, and this moment will pass.
The partner is the birth coach
The most common question I get from Dads, above all else, is "Won't you take my place as her support?" The answer is absolutely not!
Dad or the partner is the coach, the Doula is the playbook. We give you all the tips, suggestions, and ideas to keep things moving, but we could never take your leading role. I also like to remind partners that they know and love the mother more than anyone else in the room, so they will always be her most important team member.
Support the partner at his comfort level
As much as we focus on the mother, Doulas support dads, too! We know how to keep partners involved, get them food or drinks, make suggestions for labor progress, and much, much more. What is important to remember is that every partner is different, just like every birthing mom.
As two examples, if a Dad were to be anxious about crowning and delivery, have him support her at the head of the bed holding her hands or offering comforting words. If he wants to be more involved, he could be coaching his partner through breathing during the pushing stage.
Every couple and their birth team will be different, so we have to be aware of different roles at play and what that means for a Doula. If you're a partner, this advice is useful for a family member or friend who might be present.