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Doulas and Advocacy

Can I be real about something? Something sort of weird happened this past week that has had me thinking. I posted a picture on my business Facebook page that said something like this..."Doulas do not advocate. Doulas teach and empower you to advocate for yourself...". Within a couple minutes of me posting this I felt really odd about having posted it. Looking at that photo on my wall made me feel almost slightly nauseated. I deleted this photo and promised myself I would work through my thoughts and feelings and get to the bottom of why I was feeling conflicted.

The first question I asked myself is, "What drew me in and made me feel connected with this picture initially?" Well, I know what it was. I had been thinking about a handful of mamas whose purpose of hiring me was to protect them from the unsupportive practice and hospital they had chosen for the birth of their child. I felt frustrated. One of my goals as a doula is to stress to moms the importance of provider and hospital choice. I have always urged clients to find a provider who "specializes" in the type of birth they want to ask questions and to look for red flags...and that it is NEVER too late to change providers if they feel unsupported. I have seen first hand the toll it takes on a mom when she is bullied into a birth she never wanted nor did she need and I know how hard it can be to advocate for yourself while you are laboring. When a mom's number one reason of hiring a doula is to have her advocate on your behalf, it really limits the doula from doing all the wonderful things she is gifted in doing to make your birth beautiful. She is using a great deal of energy and time to navigate and protect her client from being pressured into unnecessary interventions and/or not treated the way she should be treated.

As a doula, I seek to educate and keep my clients super informed so that they feel confident in advocating for themselves. My hope is that the majority of this self advocacy will take place prior to labor/birth so that they are free to enjoy the birth they have fought for throughout their pregnancy. It's important that moms learn to have a voice. It can be very empowering to realize your desires and needs and then voice these priorities...since after all, this is your birth.

Does that mean that a doula should only teach her clients to advocate for themselves and not play the role of an advocate herself? Does it cross boundaries or threaten her scope of practice to advocate for a mama? I started thinking back on all the births I've had the opportunity of being a part of over the years. Have I at times needed to advocate for my clients? The answer is YES! There have been times I have seen a mom mistreated...or a mom extremely exhausted and unable to speak for herself...and at these times I have carefully and respectfully spoken out on her behalf. In getting to know my clients, they have expressed wishes and desires to me prior to labor. So if I see a mom being treated disrespectfully, or I see her wishes not being taken into consideration, and she and her partner are unable to speak on her behalf, then I will speak. I can't not speak. It's important that providers and staff know that I am there to be a helpful part of the birth team and that I don't desire adversarial conflict. However I'm also there for my client. I'm there to help her experience a birth that will make her feel validated and happy about.

So, here's the least where it concerns me. A doula both advocates and a doula teaches to advocate. A doula knows that the best births happen when she has helped empower her client to advocate for herself prior to birth. And a doula knows that occasionally she may need to play an advocate role in order to help protect and validate the desires and needs of her client.

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