DTI’s Response: #21 Doula’s and Don’ts: A Cautionary Tale

We’ve been talking about #21 Doula’s and Don’ts: A Cautionary Tale at DTI today and received many questions from our doulas regarding the issues surrounding this birth.

It is clear to us that this isn’t about debating if this particular doula practiced in or out of her scope. From our perspective, there are many clear indicators that she was practicing outside of her scope by offering medical advice and having (what seemed like) her own agenda. But here’s the shift in the conversation that feels most important to us. DOULAS DON’T SAVE WOMEN FROM THEIR OWN BIRTH. We support women in making their own decisions. We support women in taking ownership of having autonomy over their own body and baby. We have seen many posts on doula list serves saying that, “doulas play a role of authority” for pregnant women. At DTI, we focus on bringing back the conversation to the keeper of birth: the mother herself. In order to do that as a doula, you also need to know and be clear about your professional role.

So here’s what this blog brought up for us.

When a doula is hired, who holds the reigns of responsibility? Is it on the consumer/parent or as this case suggests on the doula? We have to question: what are the larger implications on a birthing mother’s role when a doula practices outside of her scope? As doulas ourselves, we see this predicament over and over again. The client may hire a doula because they do not like, trust, or respect their provider. Maybe they don’t know who their provider is going to be because the hospital or birth center they have chosen has such a large practice of OB’s or midwives. That scenario can feel impersonal and untrustworthy to many women. You see, what we’re dealing with is a systemic problem, not an individual one. The system at large is broken and the doula cannot be expected to fix it. Many doulas are expressing a lot of anxiety around the complexities of practicing in today’s birth climate. There is no doubt that being a doula today can be very challenging. For many seasoned doulas, we have watched the landscape change from bad to worse. We’ve honed in on new skills in order to serve our families and work with care providers with the utmost knowledge and respect. DTI is committed to making a real impact by creating a program that provides a high level of mentorship support and expertise for our doulas because we know doulas need more.

It is likely that these issues come up during the interview process—“We are hiring a doula because we don’t trust our OB or midwife”. This is the doulas opportunity to talk about her own role and what her scope of practice is and is not. Many clients will ask ,”What would you do?” Again, this is a great windo to reflect back more questions about their own values, their own decision making process, and their own choices. This is our opportunity to discuss the woman’s own autonomy and our own. Every family must own their OWN RIGHT to birth!

Being a fierce DTI doula means understanding the difference between being powerful alongside a woman’s OWN power versus a misconstrued concept of empowering another person. It means having integrity for our own profession insofar as staying up to date on current research and data. It means putting down any agenda and providing resources for our clients to make their own informed decisions. It means taking the time in our prenatals with our families to talk about our current climate of birth through a human rights framework. Let’s also be aware that mistakes and questionable conduct take place in every profession. A witch hunt does not have to take place because one doula practiced outside of her scope.  In fact, we need to come together to talk about the wide definition of what is too commonly named, “a doula’s scope of practice”. What we’re seeing in our field concerns us. Yes, it’s frustrating. Yes, it gives doulas a bad reputation. But as women and doulas, let’s be mindful about how we frame these conversations. Let’s not lose sight of the heart of the conversation that every mother has a right to her own birth. Always.

One doula does not define our profession, but this story can be a great opportunity for deeper dialogue for doulas everywhere.

Love, DTI

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