Your Doula is Not Your Bestie

I've heard a lot of talk about a doula being a "girl's best friend" to a mom in labor. Besides not agreeing with the implication of this statement, I have concerns for how perpetuating this perspective can really limit a pregnant person's options and the quality of support that they need and deserve from their doula.

What should doulas do?

When you work with a doula, you are working with a certified and trained professional in the perinatal field. Not your bestie. That's not to say that you shouldn't hit it off with your doula, because personal connection is important in any professional relationship, just like your doctor, midwife, nurse, lactation consultant, or anyone part of your support team for birth.

However, would you not hire a doctor if s/he doesn't feel like a friend? Would you find another midwife if she isn't someone you can imagine yourself hanging out with on the weekend, or are you more interested in their credentialing, skill level, education, experience when it comes to their involvement in your birth?

A doula cannot be both your friend and your doula at the same time. This could create a relational imbalance that can lead to a mother feeling emotionally violated either during or after she reflects on her experience with her doula. We want to safeguard that at all costs!

Healthy boundaries are what creates calm and openness and trust in a professional relationship. Working with a doula should feel like the professional relationship that it needs to be. Your doula is not your bestie. You are hiring a doula to do a job for you. If your bestie becomes your doula, that's a different story, but aside from any personal history with your doula, personal boundaries are of utmost importance.

We know that The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) made a joint statement: in the 2017 Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery and says this about the effect of labor support:

“Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”

“…the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery.”

“Given that there are no associated measurable harms, this resource is probably underutilized.”

Being that doulas are "one of the most effective tools to improve labor and delivery outcomes," physically / mentally / emotionally which should be the focus of any professional relationship.

What about that doula bond?

There is a concern about professional boundaries being crossed when doulas and clients get too" friendly." You do not need to feel concerned about whether or not you are bonding with your doula. Instead, you should feel confident that you the deserve warmth, compassion, and individualized support a doula can bring to all her clients.

Your doula is hired by you to meet your needs, and that agreement can be clearly spelled out in a contract that you both sign. The contract is there to verbalize and safeguard your agreement. (You also have a contract with your doctor or midwife for the same reasons, although you may not have realized it, but it is under "Patient rights and responsibilities.")

Your doula should be clear about her scope of practice, what's included in her fees, who her back-ups are in the event she cannot attend your birth and how often she uses them. She should provide information about her education and certification, how many births she has attended, what is required for recertification and what kind of continuing education credits she is required to have to meet the changing needs and trends in obstetrics and professionalism in the perinatal field.

Your doula is there to listen. It is her job to be kind, compassionate, and have good professional boundaries. So that whatever decision you make, whether that be natural or epidural, homebirth or hospital, your doula will be there to provide the informational, emotional, and physical support that you need when it comes to making good, informed decisions about your birth.

Finally, your doula should have a good working relationship with midwives, doctors, and other medical professionals. She is not there to save you or save the day but rather is there to support you to empower yourself to make informed decisions. You will not let her down if you change your mind about something. You are not responsible to give her a good referral.

Here’s what our doulas do:

CAPPA doulas are trained and certified by an international certifying organization that has been educating and training perinatal professionals since 1998. The CAPPA mission is to provide dynamic training and continuing education opportunities for doulas and educators around the world. CAPPA professionals approach their work with expectant families during the perinatal year with a desire to educate, support, and to see all families succeed. TheCAPPA Approach is built on the CAPPA Vision, which supports the four cornerstones. These cornerstones are:

• Using evidence-based information in practice

• Embracing positive mental attitudes

• Approaching all situations with a loving, non-judgmental mindset

• Building bridges amongst support and healthcare professionals

Want more?

We have a list of questions to ask a doula when you are in the process of interviewing doulas for your birth. Send us a message and we will happily send that to you or answer any other questions you may have. Happy doula searching! Remember - you DESERVE to be treated with kindness, respect, and support for your birthing choices.