Today someone asked me to make a confession. “What’s one thing you felt unprepared for when you became a doula,” they asked. So many ideas jumped in my head, some felt appropriate to share, others didn’t. I looked at the theme of the ideas and word kept sticking out to me: “judgement.” I definitely wasn’t prepared for the feeling of judgement coming at me, but I grew and knew how to deal with it, so that’s not a big deal. But the idea of “being non-judgmental”- now that’s something that I wasn’t prepared for. And, honestly, as a teacher and a mentor to doulas, most doulas coming into this work aren’t truly at that point yet. So, I’m learning to start that conversation early in the hopes to really help that growth happen sooner and easier.
You see, we’re taught that our doula scope of practice is to offer “non-judgmental” support to the families we serve; that we support all of their choices; that we guide them in using their voice to make decisions based on their values. And, that’s great. I DO see doulas support client choice and offering support. Yet, so many times this is only surface support- not a truly ingrained support of the actual ownership our clients have over their decisions.
You see, even our trainings have underlying bias in them- that birth is a natural process and we should trust the body, and our job, as doulas, is to provide “informational” support to clients so they know they have options. See how this immediately sets a subtle undertone of bias and judgement? If a client says “oh, I just want to walk in and get an epidural,” new doulas often feel compelled to offer information about the risks of that. I see this all the time in doula forums and discussions, where a doula describes the scenario above but feels guilty for not educating the client of the risks, or really taking into account that that choice is the client’s. We don’t need to double check that they have all the information and go through a checklist to ensure ourselves that they’re making the “right” choice. Instead, we only say “great, tell me about your decision and how I can support you. Do you feel you have all the information you want about your plans?”
Let me give you the example of one of the first times I really realized how subtle judgement could damage the support relationship of a family. I was doing postpartum work for a family that had older children as well. The mother had expressed the breastfeeding was a challenge for the older children and wasn’t sure how the relationship was going to go this time around, but wanted to try for as long as possible. She knew she had limited milk supply for physiological reasons, but also expressed guilt for having supplemented with her older children. I arrived at there house one night to provide overnight support and found her looking exhausted and obviously distraught due to a long day of challenging breastfeeding, lack of sleep and extra stress because she felt she was “going down the same road” as she had with the older children.
I listened as she shared her story, got a feel for what was going on, but pretty quickly jumped in and said- “so, do you want to skip a feeding tonight? I’ll give baby a bottle and you can catch up on sleep.” She stopped, broke out in tears, and hugged me because that’s exactly what she wanted but was so scared I was going to judge her or push her to breastfeed that she didn’t want to ask.
That moment would have been so much different if I let my own thoughts and feelings on breastfeeding be stronger than my support for her own agency over her choices.
If I had spent time talking to her about how wonderful breastfeeding is or how she can just get through this one feed, or if my bio and prenatal support had been subtly pushed a “breast is best” agenda, I would have undermined her experience and her needs with my own.
In my own Doula Trainer training for CAPPA we discussed this topic and how we all have to find ways to notice when we have a bias. The safest, best thing that we can do is take time to notice our internal reactions- do we feel a “snag” or a “glitch” when clients make certain choices? If so- politely, professionally offer support to someone that can support this client to the very fullest, while we work through the topic for ourselves. If we don’t, we risk undermining the care, and we truly aren’t giving the fullest respect to the client.
Now, I am not perfect. I am always growing. I am always trying to do my best. But I have learned to listen, to feel my own reactions, to dig for what the client is really hoping for, and to do my best to start with affirming all choices from the beginning. I will stumble. You will stumble. But we will all do better as we learn. My hope is that opening this discussion allows all of us to safely say “yeah, I have some judgement that may affect my clients” and allow for easier growth and transition to the point of whole-heartedly supporting a client with “That’s cool, I support you!”