After all the reading and preparation I've been doing before officially beginning the certification process, I think I've decided what I want my "specialty" to be as a doula.
There are some who are purely postpartum doulas, who support mom and help with baby after birth, dealing with issues such as breastfeeding and the like. Some specialize in loss, and coping with those issues. Some attend only home births. Some attend only hospital births. Some prefer to support solely c-section moms, while others take only vaginal birth clients. There are some who don't want clients who desire pain medication, and still others who push for their clients to get epidurals.
Overall, the vast majority of doulas seem to be natural birth advocates. I, as previously stated, am as well. But I don't want to become biased, because just because that's what I would choose for myself doesn't mean it's the only way to birth, and I don't want to project my views on others. Educate them? Yes. Help them to make the best choices for them and their babies? Yes. Push them to make the same choices I would, if it's not what they're really comfortable with? NO. They should make the choice that they are most comfortable with, and my feelings and opinions, outside of the realm of established medical fact, have no place in that.
So I followed this line of thought, and went back to the beginning of my journey: what made me want to become a doula in the first place? What was my inspiration?
Injustice. Trauma. Mothers feeling bullied. Choices being taken away. Women coming out of their birth experiences in tears, wondering what went wrong, and why they couldn't/didn't get the birth they wanted. First time moms being terrified to give birth. Second/third/fourth time moms being scared to go through another traumatic experience. Doctors who are more interested in getting home in time for dinner than their patients' feelings or what is really best for mom and baby. Unnecessary interventions. Common, wild misconceptions about labor and birth that are still accepted as fact.
I was fed up. I wanted to stop all this from happening, make moms feel strong, and keep the power in their hands.
Then, who are the moms who really need the support of a doula? Not the confident mom who has had a successful natural home birth and is planning another. Not the mom who is happily at peace with her decision to schedule a repeat c-section. Not the mom with the wonderfully supportive OB or midwife, whose judgement she trusts implicitly, and knows that she won't be pushed into anything unnecessary. Yes, these moms could always use the support of a doula to maintain their confidence and support them should anything go wrong, and I'd happily be there for them, but surely that support is needed more elsewhere.
It is.
It's needed by the mom who wants a VBAC and is scared she'll be pushed into a repeat c-section, and needs to be sure she has someone on her side to help her either achieve her goal or accept a c-section calmly if it's needed. It's needed by the mom with pre-eclampsia who has to be induced at 38 weeks to save hers or the baby's life, and still wants to try for a natural labor because she's scared of the "cascade of interventions" leading her to a c-section. It's needed by the mom whose baby is transverse, or who has placenta previa, and there's no other option than a c-section. It's needed by the first-time mom who doesn't want to end up with a primary "unnecessarian," which would make any future vaginal births a battle. It's needed by the mom who had a traumatic first vaginal unmedicated birth, who wants to make sure she gets to the hospital in time to get an epidural and avoid that fear and pain this time. It's needed by any high-risk mom, any frightened mom, and any mom with no choice but to stick with an unsupportive doctor who has to have someone in her corner.
So that's who I'll be giving it to. Those moms who really need it. The VBACs, the medical inductions, the necessary c-sections, the high-risk moms, the frightened moms, the moms with bullies for doctors. The moms who don't have enough confidence within themselves, and need the support of an educated person to hold their hand, rub their back, reassure them, and comfort them if things don't go ideally. the ones who really need a doula.
Will I happily take a client planning a home water birth? Absolutely! I want to support all moms, and all births. But I want to help those moms in difficult situations first. I want to make them my priority. I want that to be the focus of my studies. I want to be the bodyguard, the advocate, the listening ear, the shoulder to cry on, the hand to squeeze, the pool of knowledge, the builder of confidence, the enforcer of rights. I want to make sure that no birth, however difficult and risky, is traumatic. Because it doesn't have to be that way, no matter the emergencies that pop up. No mom should to feel out of control or confused, and if she has someone there to explain everything, assure her that it will be fine and nothing is happening that doesn't absolutely have to, and make sure she consents to everything that happens (and exhausts all other options first), no mom will.
I know I won't be able to do this for every mom, everywhere, but it has to start somewhere. I read a quote once that really stuck with me: "Be the change you want to see in the world." I took it to heart, and I hope that I am able to achieve my goal, because every mom, everywhere, deserves it.
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