Every once in a while during a consultation a mom will ask me, “…and you’ll be able to speak to the hospital staff for me, right?” In response, I smile and tell her that I do not speak for her, but rather show her how to advocate for herself and her baby.
Communication is key in everything we do. Sometimes, as women, our voices have been silenced – by our families, society at large and even by our partners. Someone often thinks they know better than we do, and can show us the best way to handle a situation. A lifetime of learned helplessness doesn’t vanish when we become pregnant. If anything, our insecurities are multiplied. We learn to distrust our instincts and our bodies.
What does mom need to speak up about?
I always tell moms to research any information they’re given, even when it’s coming from me. All too often, we listen to “experts” without using our critical minds to question what’s being said. We spend more time researching the kind of car we want to buy than we do research regarding our health and wellbeing. It’s important for moms to question and ask for more information from their care providers, because care providers often turn questions into statements or commands.
For example, “I’m going to break your water now, because this will really help things get going.”
This should be a question: “You’ve been at 7 centimeters for 5 hours now. I think breaking your water will help to speed things up. What do you think about that?”
See how the latter asks mom for her input? She even has a chance to decline. The former, on the other hand, leaves no room for discussion. This is where mom has to feel empowered enough to advocate for herself. She could stop and ask for more information – risks vs. benefits. She could also ask what other interventions, if any, the recommended intervention may lead to. Breaking the sac before mom is 10 centimeters often leads to a fetal scalp monitor, an intrauterine pressure catheter and a foley catheter to channel urination. These interventions are often left out when the care provider walks in with a smile ready to rupture your membranes.
Why can’t the doula ask these questions?
There are some doulas who offer to speak for their clients. I think that’s just as much of an injustice as the rest of the world taking away a woman’s voice. The issue with asking or expecting your doula to speak for you is simply that she isn’t you! You run the risk of turning your experience into someone else’s when you give up your voice. You may be opening the door to allow your doula to relive her own birth experience through you. You create an atmosphere where it’s possible to not have your best birth when you give up your voice. If you relinquish your voice during labor, with what voice do you plan on raising your child?
So what do I do?
During your prenatal visits with your doula, ask her to help you role play different scenarios. Start simple with things like drinking and going to the bathroom, to more complex like negotiating interventions and holding your baby. Create code words with your doula so she knows if you need help making a decision (and by help I don’t mean the, “What would you do?” kind of help – but asking the doula for more information about a topic to help you make your own decision). Write a birth plan so you can see on paper what you’re expecting from your birth. Use your birth plan to ask questions of your care provider during prenatal appointments so you have clarity before you go into labor.
Don’t be passive-aggressive about your desires, discuss them upfront. I’ve seen too many moms simply email their birth plan, or bring it to the hospital while in labor; these types of plans often go unread, and mom is displeased with her birth experience. Your care provider works for you! Have the necessary proactive conversations before you go into labor. You should also register for an out of the hospital childbirth education series to help you resolve communication issues.
“Birth is powerful, let it empower you.” author unknown