What to expect of a doula before your birth.

[littleberlin]

I'm just curious as to what sort of level of support one can expect from a doula before the actual birth. Recently I've been feeling quite anxious (perhaps it's last-minute nerves) as the end of my pregnancy approaches. I posted elsewhere about feeling some pressure from my OB to induce on account of a suspected 'big baby' (a pressure I'm not all that interested in giving in to, based on vague estimates), and since that time I've felt my confidence ebb a little.

I have broached the subject with my doula, and I'm not sure if I am expecting the wrong sort of support from her in relation to this. I suppose my idea is that she is going to be present for the very intimate event of my child's birth, and therefore voicing my concerns is just another intimate act that she would share in. I know that a doula is not a counsellor or psychologist, but I don't feel like my concerns have necessarily been acknowledged. On a few occasions she has asked if I have any concerns or anxieties surrounding the birth, but I don't really feel as though we've been involved in an actual dialogue about such matters.

I suppose what I am trying to determine is whether this kind of support falls outside of the realm of what a doula does. Do you think it is being too demanding to want pre-natal emotional support, given the fact that I also have a significant other who is very much in tune with how I am feeling? Are my expectations of my doula out of whack? Although we have had prenatal visits, is it more realistic for me to think of her as there primarily for the birth, with little emotional involvement outside of this event? I'd really appreciate anyone's thoughts on this - my brain is a bit foggy with anxiety at the moment anyway, so I'm not sure if I am being too demanding with this.

Thanks!

[SamiH]

Hmmm, to me it sounds like you aren't in sync together - do you trust her totally, get along well etc??? My doula and I could chat about everything - and when discussing the birth and hopes etc was not forceful with her opinion, but helpful in putting things into context unemotionally for me, as well as understanding my headspace and supporting my way of thinking too.

I would be surprised if you were not getting some level of emotional support because it will be one of the most emotional times of your lives You need to trust her implicitly - do you?

[littleberlin]

We do get along well, and we do have an easy rapport with one another. She is quite flexible, and my husband and I get the sense that she is adaptable and will be able to follow our lead to assist us during the birth.

I'm not sure about the trust thing, though...I feel as though that takes a lot longer to establish than a few meetings and emails swapped. She is also still training, and hasn't yet had a baby herself, so perhaps it's a matter of her having more of a theoretical grasp on the physical side of pregnancy, rather than the emotional? Though you are correct - it is an incredibly emotional time!

[Midwife Melissa]

Hi there,

I think there are 2 issues here:
1. the emotional support that you're after at this moment
2. clinical advice around your possible induction.

You mentioned your doula is training - maybe she feels out of her depth on the emotional support stuff - she might not see how / why it is significant for you.

Re: the clinical advice around induction - this is beyond the scope of a doula, so she most likely feels uncertain about how to respond to this. Maybe you could consult with a private midwife - this might free up your doula to support you better emotionally, knowing your clinical concerns had been addressed.

[Just Me]

LittleBerlin - I am interested to see the responses to your question too because I would have assumed that it was a doula's responsibility to listen to your concerns about an induction and even advocate on your behalf. I guess I don't understand the purpose of a doula very well and am interested to know what exactly their responsibilities are and what falls outside their responsibilities. I would have thought that some amount of antenatal care and postnatal care was part of a doula's role. I don't know if I would see the point of having a doula if they are just going to rock up to the birth. Very interesting . . .

I guess as far as the trust thing goes with your doula, it would be easier to trust her if you felt she had your best interest at heart. Just a thought.

[belfie]

will be able to follow our lead to assist us during the birth

It's an interesting question - i had a doula and was also in the situation of possible "big baby" (insulin dependant gestational diabetes + a tall hubby had my obs convinced....).

I think there's a really fine line of what is a medical recommendation versus feeling emotionally comfortable and confident to make the right decisions for you. Your words above (plus your post) suggest to me that you don't feel you are being supported quite as you'd like to be... and you're looking for some validation around that.

I struggled with balancing the very medical recommendations I was getting, with the ideal birth situation from a doula perspective. In the end I decided to proceed with an induction (for a number of reasons) but I needed to talk this over with my doula because there were many shades of grey and fears and anxieties for me, naturally enough. Personally, I think having someone who you can explore this with this very important, because, at the end of the day, why do you have a doula? She's not there as your medical support person... she's there as a birth support person... and birth/emotion go hand in hand - let's face it, how many people approach birth as just a "project" to be completed? I believe that my doula needed to understand what was in my head/heart to be able to support both me and my DH as effectively as possible during the birth.

As you said, she has asked if you have any concerns, but it sounds as though you feel she isn't in touch with your current feelings, but you don't want to be perceived as being too needy. And I know exactly what you mean, and it sounds like you don't feel fully connected. Whether your feelings are last minute nerves or not - regardless I think you need to feel comfortable that she understands where you're coming from. Maybe it's worth saying some of what you said in your post, to her? And clarifying what you both believe her role to be, and how she can most add value/support to your experience?

[littleberlin]

Thanks so much for all your responses to this! I should probably clarify that I certainly don't expect my doula to offer me medical advice - I know that is not her responsibility, and it would be putting any doula in an awkward position if you were looking for medical recommendations from them. After having a think about things and reading your posts, it does seems like I am looking for a different mode of communication/discussion from what is currently happening. I suppose the tricky thing is though - how to implement that? I don't want to offend her in any way, but I am a little uncertain as to how to broach the topic. I suppose I could always say to her that I am feeling at the moment that I am needing more emotional support, and am wanting to talk through things...but again, is that too demanding? It's a first-time experience for my husband and I, just as it is for our doula, so I suppose to some degree we are all trying to find our feet. I don't know...it is a new experience for all of us!

The question of advocacy in relation to a doula is incredibly interesting, though; I think that initially I had a very different idea about what a doula does and does not do. I remember I had some kind of image of my doula barricading the door to the birthing suite to keep out any unwanted visitors (can you imagine the tension that would cause in a hospital setting?!), but soon came to understand that the kind of advocacy a doula provides doesn't involve speaking for you, but gently reminding others of your preferences if neccessary. At least, that is how I think about part of the role of the doula during birth. Gosh, it's great to be able to throw ideas around like this in a forum - so useful!

[Clare Bear]

Hi littleberlin,

I am a Doula and I think you are absolutely right to expect not only physical support but also emotional support. I see this as definately one of my roles as a Doula.

I recently attended a birth with similar circumstances to yours. Mum was extremely anxious about induction, her ability to cope, and the safety of her baby. We spent alot of time learning about the process of an induction and I encouraged her to speak with this at length with her OB. During the learning process we also discussed and planned to implement ways that would assist her to cope and as the time drew closer I believe she was in a much better head space. She needed alot of encouragement and emotional support and with our pre-natal visits, regular emails and calls I know she was satisfied.

The result was indeed an induction and one of the most beautiful and empowering births that I have been involved with. Throughout the labour just a simple reminder of the things we had learned and lots of encouragement was all she needed to keep herself together. She was amazing and very proud of herself afterwards quite understandably.

Maybe let your Doula know how you feel and explore this together. As a student and not having been through this herself she may not be aware of how you feel or what your expectations are, but I do not for a second think you are being too needy.

Good luck to you