Not Any Woman Can

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One of my most hated myths about doula care is the idea that any woman can be a doula.  Just put a person born with a uterus in a labor room and she’ll be able to help effectively – with no preparation.  This is a myth that devalues what doulas do, and gets in the way of us being perceived as professionals. It also devalues the men who offer good doula care.  The myth that “any woman can” is even perpetuated by doulas, who may not realize the damage this idea does.

Effective labor support requires sophisticated emotional skills that rise to the level of a skilled counselor.  A good doula has to be able to correctly read everyone’s behavior in order to positively influence the emotional tone of the room.  She or he needs to know the mother’s need before the mother knows it.  In my published research on emotional support skills [pdf: GillilandMidwifery], it became clear that these skills take many births to master.  The components of emotional intelligence are at the heart of doula work.  Good doula support cannot be accomplished without keen self-knowledge, empathy, emotion management, and relational skills.

In addition, doulas utilize a wide variety of positioning techniques and comfort measures.  In order to establish a position correctly, the subtle placement of a shoulder, foot or ankle can make the difference between comfort and pain for days after the birth.  Having a wide variety of ideas and stamina are essential for the physical demands of labor support.

The key to understanding empowerment is knowing that a doula cannot empower anybody.  A person has to take advantage of an opportunity presented to them to state what they want and to ask questions.  Doulas create these opportunities.  But it only happens smoothly by using complex communication strategies.  Doulas need to be able to relate to everyone’s concerns:  medical care providers, nurses, the mother and her immediate family.  This begins with keen observational skills and compassion for conflicting agendas.  Her choice of words and attitude is deliberate and intentional.

These are not skills possessed by most people!  They are cultivated, practiced, and honed over years of attentive living and attending births.   Doulas go over and over each support experience they have in order to squeeze as much knowledge as possible out of it.  They learn that birth is about what the mother wants and not what the doula wants.  This is central to labor doula effectiveness.

In this post, I’ve only begun to scratch the surface of what birth doulas do.  Its necessary to establish a rapport with strangers and educate without overwhelming at prenatal visits.  Many births involve trauma prevention and navigating the landscape of past abuse.  After the birth, doulas are critical to recovery from a difficult birth or normal postpartum challenges.

We MUST establish our own value in the world.  The work of birth doulas is vitally important in people’s lives!  It cannot be done by just anybody.  When we don’t value the complexity of our carework, no other professional – nurses, doctors, or midwives – can do so either.

 

Upcoming:  How Doulas Undermine Our Own Value (it’s not money)

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