Ever wondered why you’re super stressed when you commit to a birth client?
When I ask the community of Birth Coach Method’s doula students to elaborate on their stress level and its source, they usually begin talking about being on-call. I wholeheartedly agree that being on-call 24/7 when you are a career doula is super stressful. It’s been alsoreported by midwives that the unpredictability of childbirth – when will it begin and how will the process unfold, is one of the biggest hardships of the role. It keeps us on our toes – always having to arrange support for our families, always ready to cancel plans or miss family events. It’s messing up our vacations, and more.
Another source of stress that often emerges in our community meetings, or personal mentorship sessions, is our accountability for clients’ birth experiences. While medical caregivers are held accountable for the outcomes, we are held accountable for the quality of the birth process.
The psychological birth of a mother, similar to adolescence, involves hormonal and identity shifting.
Listen to my interview with Maureen McGrath where we discuss Matrescence
January 24, 2021
Throughout this profound identity transition, an expectant individual undergoes an average of about 13 doctors’ appointments during pregnancy, 3 urine tests, 4-5 blood tests, 4 ultrasound tests, 2-3 vaginal exams/swabs, and 2 monitor exams. That is if they are healthy, give birth before or on their EDD, and do not need further diagnostic or screening exams. Then, they will go through the childbirth experience. An experience in which the transparent fabric of one’s routine is disturbed by pain, fear of death, and temporary loss of control. Their body expels a new human being while they are under the care of medical caregivers – most of them practice from an “expert” position. This abundance of encounters with medical maternal healthcare providers amplifies the neglect of expectant individuals’ emotional state and mindset during this profound transformation. Not even one behavioral assessment is routinely recommended for this individual. Instead of focusing on individuals’ well-being and mental health as they transition to parenthood and prepare for the profound transformation of childbirth, maternal caregivers and researchers tend to focus on how the baby is doing.
Just like prenatal coaching, transformational postpartum coaching shifts the focus from helping or informing to elevating new-parents’ performance level, self-confidence, and well-being.
Most of my writing has been dedicated to pregnancy and childbirth support. During the pandemic, I’ve been thinking a lot about the challenges of new parents or parents who have expanded their family recently. I want to share how transformational coaching during the parents’ postpartum period can enhance their experience.
You can learn to empower expectant individuals to perceive their own mindset and desires as the most valuable ‘data’ their providers should focus on, by doing so yourself! Learn to provide transformational birth support coaching, and you’ll get to see them conducting themselves brilliantly and with confidence throughout their birth experience, and celebrate themselves.
Some of the most heartbreaking news that doulas received along with the outbreak of COVID-19 was that we are banned from hospitals. Many of us were already committed to couples and families that we have come to love and care for, and with the increased level of uncertainty and fear, we knew that our clients needed us even more. As the numbers of COVID-19 cases continue to increase, it becomes clear that this crisis might last as long as a year or even more, raising a growing concern about doulas’ source of income. As upsetting and tormenting as this ban might be, the current crisis bears an opportunity; an opportunity to achieve work-life balance.
I am called to support my colleague and friend. How do I step up for her and make a difference?
I have been practicing as a doula for almost three years. I’ve also certified in the Birth Coach Method as a birth support coach and am extremely grateful for the training I received under Neri Choma. I love this role of supporting families. My main goal is for them to feel supported and loved as they welcome their baby to the world. I was a teacher for over ten years prior to launching my doula career, so planning and organizing was a big part of what I did. I like structure. As a doula, I try to structure my prenatal sessions. It helps me get to know the needs and goals of my clients in a systematic way and to understand how to support them and meet them where they are at. As part of my service, I also fill in any educational gaps as needed. I want to help them understand their options.
But what happens when I have a client who is a doula? How do I inform her? Do I just offer labor support and skip all my sessions with her? I usually offer each client three to four sessions. This client didn’t need to practice the tools of labor support with me since she is a trained doula and prenatal yoga instructor. She also had taken a childbirth class with her partner. So I felt like the bulk of what I usually offer my clients was off the table.
Now what?
I needed to go beyond informing and all the way to coaching.
Twenty years ago, when I was nearing the end of the yearlong doula training program in Jerusalem, my trainer advised us all not to quit our jobs in favor of establishing a doula practice. Regardless of the fact that we enrolled in a yearlong program with a commitment to give 100 hours in hospital shifts, Shoshannah guided us to view the doula role in terms of community service rather than a career path.
A doula for every woman is not just right; it’s a valuable asset
This perspective is reflected in the well-known saying “A doula for every woman”, a motto I trust was carved with noble intentions but prioritizes the welfare and empowerment of only one woman – the birthing woman, at the cost of disempowering another woman – the doula. It should be noted that the topic of doulas’ monetary compensation, just like the other two dilemmas I addressed before it, has also caused some turbulences within the doula community. This can be read in Penny Simkins’ Real Talk from Penny Simkin, in which she responded to the disagreement with this motto as expressed by a ProDoula member.
This is the second blog in a series of three that I began writing in November. I am very passionate about the doula profession. That’s why I feel called to write this series before it is too late. And by “too late” I mean that I think our profession is in danger. Being a doula trainer and at the same time an approved continuing education provider for obstetric nurses, allows me to be connected and empathetic to both sides of the conflict – doula and medical caregivers. On top of listening to nurses’ pain points in their relationships with doulas, I recently have been invited to speak at a few OBGYN and midwives’ practices and heard that they are on the verge of banning doulas
Additionally, recent events confirm what I have been fearing – the current practice of doulas’ who share evidence-based information that supports better obstetric practice (while not being medically trained and bearing no liability for their clients’ health) is going to hurt us.
It puts our relationships with medical caregivers at risk.
It will lead more cities to follow New York in attempts to license doulas.
It will lead our best friends – hospital-based midwives – to ban doulas or have blacklists of unwanted doulas that they don’t trust.
It might also make it harder for us to find paying clients because they hear more and more stories about doulas who break the trust and rapport that couples have established with their medical providers.
In 2005, while I was trained as a transformational life coach (see final subsection below), it became clear to me that prenatal coaching has got to be the foundation of successful leadership in the field of birth support. I am certain that the coaching principles and strategies elevate birth givers’ ability to cope and conduct themselves throughout the journey of pregnancy and birth, and elicit birth givers’ accountability to their desired experience, and as a result of those will increase their satisfaction levels with the whole journey. And so, immediately after graduating, I began integrating coaching strategies into the field of birth support. About a decade after implementing coaching into my birth support practice, I felt ready to publish this method in my book The Art of Coaching for Childbirth.
