By Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE, CLE

Today is the second post in the occasional series “Doula Me This!” Each post in the series provides a common scenario that a birth or postpartum (or both) doula may face. The “correct” answer (if there is one) requires some synthesis of the situation and at times consideration of the DONA International’s Standards of Practice and Code of Ethics.

I got the idea for today’s “Doula Me This!” post after reading a recent blog post “Doulas are Not Magic” by Alice Turner, Doula and Lamaze Certified Childbirth Educator. I thought her post was well-written, spot on and addresses a common conundrum for doulas who are often faced with clients who have unrealistic expectations of what a doula does. I wanted to share a scenario about meeting with potential clients who have a misconception about the role of a birth doula. Read through this scenario here and let me know how you would handle such a situation in the comments below. If you are struggling to find clarity on how you would respond, consider reading Alice’s post for additional support.

Doula Me This!

You are sitting down for an interview with a pregnant person and their partner. They are 32 weeks pregnant with their first baby and interested in hiring you to be their birth doula. They were referred by a co-worker who was a former client of yours, and they are excited to see if you are a good fit for them.

The Details

  • Doula: Sophie
  • Pregnant person: Jamie
  • Partner: Sam

After getting introductions out of the way, Jamie and Sam begin to ask you most of the common questions you typically hear at interviews. After that, you ask the family what interests them about having a doula and how they believe a doula might support them. Jamie excitedly shares that they have heard wonderful things about having a doula and believes it will really help them have the non-medicated, low intervention birth they are planning for.

Jamie: My sister had a very long labor with an OP baby who never rotated, and she needed a cesarean after the baby would not drop and come out. She never dilated past 7cm and hard horrible, painful back labor.

Sam: We think that if we had you with us, you can help us correct the baby’s position if it was facing backward so that the same thing won’t happen to us.

Jamie:  After all, you have all this training and birth experience helping other families. Also, we really wanted to birth at Seneca Hospital which has great outcomes and low cesarean rates, but our insurance only covers our care at Spring Street Hospital. We know there is a high epidural rate there and a lot of policies that don’t always follow the evidence we learned in childbirth classes. Also, they have a high cesarean rate, even for low-risk people. We feel that having you with us will help us to avoid those things. My doctor shared that she feels it is better to have an epidural on board just in case we need a cesarean, but I would prefer not to.

Sam: You can tell the staff and our doctor that we are hoping for no interventions and can help us to cope and progress our labor naturally.

Jamie: I hope you now understand a little more about why we are hoping to have a doula at our birth and we have heard so many good things about you from our co-worker, that we are confident that you can help us have the birth we want. We would like you to be our doula. Do you have any questions for us?

While Jamie is speaking, Sam is taking out his checkbook and inquiring who should they make the check out to?

Your Dilemma

It is clear that this couple is ready and wants to hire you right on the spot. You have felt a real connection with them and love working with clients referred from satisfied past clients. As you sit there with the potential to “seal the deal,” you ponder the appropriate next step.

What Would You Do

Your doula calendar is pretty open, and having these clients on the books will really reduce some financial pressure during a rather lean time. You like this couple and would like to work with them. After what you just heard about why they want to have a doula at their birth, do you have any concerns? Should you agree to work with them?  Does something else need to happen first? Do you tell them you are not the doula for them and end the interview with some referrals to other doulas?  What would you do?