Often times, after a birth, a client will say something like “I couldn’t have done it without you”. Which is a lovely sentiment. I absolutely understand what they mean, and wouldn’t contest it. It’s a compliment meant to be accepted graciously. But part of me always needs to resist the urge to drop some Glinda the Good Witch wisdom. ‘You had the power all along, my dear. You just needed to learn it for yourself.’
Here are the facts. The Doula Effect is real. Births with a skilled support attendant tend to, on average, have a lower risk of preterm labour, cesarean birth and unwanted interventions. Conversely, doula attended births have a higher rate of maternal perception of her birth as a positive experience. We know informational, emotional and physical support improves outcomes. We know the mere presence of a person, unrelated to the mother, keeping a continuous presence in the room improves outcomes. All of this is true. Doulas do help. But you don’t need me.
What actions do I take alone, to directly intervene and change the direction of a birth? Very few. What I do is help others do. When something overwhelming has happened and a client needs informational support (“my OB mentioned an episiotomy, what should I do?”), it isn’t me who makes the decisions. I supply information, and hold space for a client to consider it and talk it out. I don’t ask the hard questions, I don’t make the hard decisions. I encourage you to.
When a client is panicking, sure that she’s done and wants this all to end, I don’t supply the will to carry on. I look her in the eye, and I tell her the truth. That she’s a rock star, displaying astounding strength, and she CAN do it because she IS doing it. She’s the one who had the bravery to allow me to reach out to her. She’s the one who displayed the astounding strength I remind her of. She’s the one who takes my words to heart, and she’s the one who finds the will to continue, or the strength to ask for help.
Sure, I do provide physical support with my own two hands. But I provide it to clients who have taken that step to allow physical closeness in their most vulnerable moments. I teach their partner hip squeezes and rubs and counterpressure so they can take comfort care into their own hands. I don’t decide what the magical technique will be. The one that relieves any given pain in any given moment. It’s my client who shows me what she needs.
You might look at the evidence, and want a doula. That’s a great call. But you don’t need us. Hiring a doula is simply ensuring the presence of someone who can remind you of your own incredible power. It’s you who does all the hard work. You can do it without me. You had the power all along.