Role of a Doula – Helping Families Find Their Voice and Use It

In labor and birth, it is so important for families to express their preferences and get their questions out and answered.  This can be very difficult.  Some people completely forget their questions when a nurse or doctor walks into the room.  Others feel intimated by medical personnel.  Still others don’t want to cause any problems and therefore, keep quiet when they really want to speak.  One of the roles of a doula is to support a birthing family so that they can find their voice and use it.

4 Ways in which a doula can help their clients find their voice and use it

1) Prenatal Preparation – Finding their Voice

Most doulas meet with their clients before labor one of more times to really determine how best they can help mom and her partner during labor and birth.  During these prenatal appointments, the topics that are often discussed include birthing preferences, fears and strategies for the big day.  This is a great time for mom and her partner to define their voice.  They can determine their top priorities and figure out how they can best communicate this information to their providers.  This is a great time to identify questions and topics that should really be discussed prior to labor.  During prenatal appointments, doulas can help point out questions that should be asked in the office prior to labor.  Mom and her partner can practice finding their voice during office visits with their care providers.

2) Prenatal Preparation – Role Play Scenarios

I believe the most effective way to prepare for communication during labor and birth is to use role play.  A doula can use her experience with supporting families in labor to set up a very realistic scenario for a communication challenge role play.  Mom and partner can talk through how they would use their voice in each situation and decide what would work best.  There might be some situations where the partner is better at leading the conversation and others where mom should take the lead.  Using role play is a wonderful way to work through possible uncomfortable and difficult situations and also help couples develop a nice working relationship with their doula.

3) Prompt a Conversation During Labor and Birth – the ‘Play Dumb’ technique

As a doula there are times when I need to remind my clients about their preferences or about a question that they want to ask.  The role of a doula is not to speak for their clients, but they can prompt their clients and assist them in starting a conversation.  I call this “playing dumb” and I find that it works very well. 

For example, my client might want to have a conversation with the OB on call during labor about their preferences for delayed cord clamping.  The OB might walk into the room and ask if they had any questions to which they reply “No”.  I know that they want to discuss the clamping issue so I could say “They want delayed cord clamping!” or I could use the ‘play dumb’ technique and say to my clients “What were you saying about delaying clamping?”  This question gently reminds them about the conversation that they wanted to have without actually speaking for them.  They could also choose to ignore the question if they change their mind or this will actually help them get that conversation started.   The ‘play dumb’ technique must be explained during the doula prenatal appointments so that they understand how it works.  It is important that clients know that the doula isn’t actually forgetting their preferences, but just reminding them.  From my experience, most partners love this technique.

4) Ask For Time

Many people ‘lose their voice’ when care providers are in the room.  They might actually forget what they want to say (or ask) or they might be uncomfortable expressing themselves.  A great technique to help in this situation is to ask for time alone.  Unless it is an emergency, care providers can usually spare 3-5 minutes for mom and her partner to speak alone.  During this alone time, mom and her partner can regroup and plan the questions they need to ask or develop a strategy for how they will communicate their preferences.  While a doula can help during this extra time, it is important that the birthing couple also knows that they can ask for the doula to leave as well.