Will a Doula Advocate for Me?

You may have already heard or read about the many benefits hiring a birth doula offers. Not only are they knowledgeable about birth, they are also 100% focused upon you and your partner, from the time they join you in labor until an hour or two after baby is born. A doula will meet with you and your partner in advance to make sure that you’re fully prepared for labor and childbirth, directing you to evidence-based information that will help guide you to make the best decisions for yourself and your baby. Once you’re in labor they will you provide physical comfort measures, verbal encouragement and emotional support and ensure that you feel safe and supported throughout the journey. But something you may not be aware of is how a doula can assist you with advocacy once at the hospital if the occasion warrants it.

You may be wondering when you would ever need to advocate for yourself, so let me give you an example. Let’s say that you arrive at the hospital in active labor accompanied by your partner and doula. The care provider that’s been assigned to you isn’t the OB you’ve been seeing throughout your pregnancy; in fact, you’ve never met them before. This OB has just examined you and recommends you start an IV drip of Pitocin to get your contractions stronger and more frequent. You’re unsure this is something you want, but the OB warns you if you don’t start Pitocin then you’ll likely be in labor for hours and hours with no progress. You feel pressured to go along with their recommendation but really don’t want to, based on the research you’ve done.

While they will never speak to care providers on your behalf, your doula will remind you and your partner at crucial moments like this that you have a choice when it comes to procedures and can always opt to decline the recommended treatment when it’s a non-emergent situation (i.e., most of the time). She will have taught you strategies at your prenatal meetings of how to slow down what’s going on in the birth room in order to make unrushed, informed choices instead of feeling unnecessarily pressured. Ideally you will have role played this sort of scenario with her, so if it happens in the birth room you and your partner feel confident and prepared to navigate the situation. In extreme cases if a doula witnesses something take place that is truly unjust or unethical, she will report it to hospital administration; fortunately however, these incidents are rare. More commonly she will make sure you and your partner have all the facts before making any decisions and are given time the time you need to decide.

Other examples of her advocacy may arise in other ways. A doula is an observer who won’t allow your questions and concerns to be unanswered or overlooked by your care providers. The best doulas recognize that you may have asked a question earlier that never got answered, or perhaps expressed a concern before the care provider’s visit and then forgot to ask it when they’re in the room with you. A doula will remind you to ask it again before the care provider leaves the room, or say to you, “Hey Amy, did you ever get your question answered about how IV fluids affect the baby?” Her techniques are diplomatic but effective. She will keep the energy in the room positive and team-oriented, while ensuring you are making fully informed choices. Ultimately everyone is on the same time and is working toward a baby being born safely. There are ways to advocate without creating an atmosphere of ‘Us vs. Them’ that feels adversarial; no one wants that energy in the birth room. And if there is a care provider that you’re simply not vibing with for whatever reason, a doula will remind you that you can always request someone else. Just the mere presence of doula in the room observing things with an understanding of what’s going on can increase the chances that your care providers will be on their best behavior and less likely to take any shortcuts with consent or fully explaining procedures. As if you needed another reason to hire a doula, advocacy is an important one!

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