There is a movement that has been taking over the doula community, and that is the idea that doulas provide unbiased support. Maybe some do. Maybe some doulas have completely purged themselves of every ounce of bias they’ve ever possessed. However, I am not there yet, nor will I claim to be 100% bias-free. I believe that most people are unable to be completely, 100% bias-free, and so does Brené Brown. And because Brené Brown said it, it must be true.
“Most credentialed professionals do indeed receive some type of training regarding objectivity, but there is ongoing debate about what is truly achievable. Some are taught that objectivity is possible, and they are trained to try to replace their personal lenses with professional lenses when they are with clients or patients.
Others, including me, are taught that pure objectivity does not exist and that people can’t ever completely put away their personal lenses. We are trained, instead, to understand the biases and power of our experiences so we understand how they might affect our interactions with clients. We believe this is the most ethical way to work with clients.”
-Brené Brown. I Thought it Was Just Me (But It Wasn’t). 119.
I can’t promise that I will ever be 100% bias-free, but what I can promise is that I will do my best to not let my biases affect my work in a negative way. And just to be completely transparent, here are some of the biases I am working on.
1. I think natural childbirth is the bomb dot com.
I will choose that route for any children I ever have as long as it is safe for me to do so. And lest I tempt the universe to bless me with more children, I won’t say anything about whether or not I am planning to have any future children.
I feel like my niche as a doula is working with those who are at least planning to have a natural childbirth. This is not to say that I won’t work with people who are planning other types of births, but rather, most people who hire me are at least preparing to have a natural childbirth.
2. I think labor should start on its own.
This is a biggie, and I am still working on this one. I’ve just seen way too many clients who were induced struggle much more to achieve their birth goals than those who went into labor on their own. Induction of labor is truly a game-changer. Is it possible to beat the odds and have an amazing induction without even thinking about an epidural? Absolutely! I’ve supported plenty of clients as they did it. They beat the odds.
Odds are, a first time mom whose labor is induced will have an epidural. And if her body really just was not ready for labor, she will have a Cesarean birth. This is not to say that I think inductions and pitocin are the devil (because we all know there is a time and a place for interventions), but that inductions are a whole different ball game.
Because of what I have seen and read, I still believe that going into labor on your own increases your odds of having the birth you want.
3. I like some care providers more than others.
This one is pretty simple. If a care provider treats my clients like crap, uses fear-mongering, and doesn’t practice evidence-based care, I really don’t like them very much.
If they support my clients’ wishes, I like them.
Very Important Note: Personality has NOTHING to do with whether or not a care provider is supportive.
Let me repeat that another way.
Amazing personality DOES NOT EQUAL supportive care provider
I’ve known some really cool care providers who have sweetly coerced clients into interventions they didn’t want, all while telling the best jokes and just plain charming the pants off of everyone in the room. I’ve known some real stinkers who behaved as if they hated their lives (or at least that moment of their lives), but provided some of the most supportive care in Houston.
If you find a truly supportive care provider who also has an amazing personality, that is just icing on the cake.
4. I think home birth is super spectacular.
I have chosen to have two of my babies at home, and I can’t imagine doing it any other way. I believe women give birth the best where they feel the safest, and I feel safest at home. I gave birth to my first baby in the hospital, and I couldn’t have felt safer in any other place for that birth. I loved my home births, but I also loved my hospital birth. That birth was amazing and inspired this doula journey of mine.
However, I can’t help but wonder sometimes how some births would have gone if they would have started at home. Home births are just different. The only way that anyone can really tell how they are different is to attend several. Doulas have a unique viewpoint because they attend births everywhere. I’ve attended births in hospitals, birth centers, and homes. They all have their own flavor, so to speak.
I think it would be really awesome if home birth midwives could spend some time attending hospital births as part of their education and OBs and hospital midwives could spend some time attending birth center and home births as part of theirs. I still have this crazy idea that hospital and out-of-hospital care providers could help each other out. It could really benefit families. And it’s not like hospitals would be losing much money. Most people still prefer to give birth in the hospital setting.
5. I don’t judge your choices, but I do kinda hope you make certain choices over others.
If you have a notoriously crappy care provider, I really hope you switch to a better one. Because I know you will have a better birth with a better care provider. It isn’t because I think I know better than you how your birth should go. It’s really just a simple matter of numbers and past experience.
If there really is no medical reason indicating you need to be induced, I really hope that you choose to go into labor on your own. Because I know you are more likely to have the birth you want if you choose to wait for labor to begin on its own. I’ve seen lots of inductions, and it really does make a difference.
And when my clients are expecting a boy, I always hope they choose to leave him intact. Because there really isn’t a medical reason to do it. (Unless there is, but that is such a super small proportion of people.)
But with those biases out in the open, here is what I won’t do:
I won’t tell you that you need a new care provider. I won’t tell you that your care provider is awful. I will never say a bad word about them, and I won’t fight with them in labor (I’m not that kind of doula). I will be kind and respectful to everyone on your birth team.
Instead, I will:
Ask you how your appointments are going. I will ask you how you feel when you are with your care provider and what concerns you might have. I will let you know what supportive care looks like so that you can decide for yourself if that is what you are getting. If you feel happy and confident with where you are, I will trust that you know something I don’t and try not to cause you to second-guess yourself. If you mention to me that you aren’t feeling great with your care provider, I will ask questions and share options with you if you want them.
I also won’t:
Tell you not to get induced (or insert other medical intervention here). Because I don’t know your full medical history, and I am not your care provider. It is not my place to steer you one way or another.
Instead, I will:
Trust that you know something that I don’t. You know your body, your baby, and your care provider better than I do. I will do my best to help you have the best induction possible. I will ask you questions about how you are feeling, and if you are happy, I won’t try to cause you to second-guess yourself. If you are not happy, I will ask questions, share options, and act as your sounding board. I will always encourage you to trust your gut.
And finally, I won’t:
Even bring up the circumcision thing unless you ask me for my opinion on it. In which case, I’ll tell you. But at first, I’ll be all doula-like about it, until you say, “No, really. I want to know your opinion.”
Because it really boils down to the fact that my opinions don’t matter when it comes to your choices regarding your birth. My job isn’t to have opinions. My job is to help YOU feel supported in YOURS.
6. I have the best clients.
No, seriously. I really do. When I was a newer doula, I had different opinions about birth than I do now. Back then, I thought C-sections were the worst thing that could happen during someone’s birth.
- Until I saw how C-sections can make the difference between a tragic outcome and a joyous outcome.
- Until I saw my fierce, warrior, highly-educated clients do “everything right” and Baby still decided it needed to be born that way.
- Until I saw amazing care providers do everything they could to help my clients achieve the birth of their dreams, but hard decisions had to be made.
I used to think that epidural births couldn’t possibly be as cool or satisfying.
- Until I saw the most beautiful cases of giggles and tears all wrapped into one, over and over and over, reminding me why I keep doing this job despite all the hard parts, when mamas and papas finally have their babies in their arms and time stands still and you forget about the fact that your client even has an epidural because they are just so happy.
- Until I saw too many times that sometimes an epidural really is the humane thing to do. When birth has been relentless and sleep hasn’t happened for days or when pitocin is just TOO much and the hard work of labor has turned to suffering. And the epidural helped that mama finally ENJOY her birth.
And I used to think that inductions meant an automatic epidural and more-than-likely Cesarean birth.
- Until I saw so many of my clients kick major pitocin butt and do it without any pain relief whatsoever.
- Until I saw warrior women defeat the odds and push babies out of their bodies with pitocin, epidurals, and threats of Cesareans looming over their heads.
I have seen fierce, amazing, warrior mamas and papas. I have seen joy and heartbreak, tears and laughter. I’ve seen grief and hard decisions and “easy” butter births. I have seen things that made me swear I was never going to attend another birth again, followed by a glorious, “redeeming” birth precisely when I needed it.
And it may not be clear which of the clients were amazing. The answer is, “All of them.” They all have inspired me. They all continue to inspire me. No matter where their birth journeys took them, no matter what happened, they never quit. They kept going, they dug deep, they made hard decisions, and they put their desires aside for their babies. Because they had no other choice. Because quitting is not an option in birth. My clients inspire me. They are amazing and truly the best!
So, as you can see, I am not an unbiased doula. I am totally biased. I am biased toward amazing care providers and evidence-based and compassionate care, and most of all, my amazing, super-fantastic, the bomb dot com, awe-inspiring clients.
3 Replies to “Everyone is biased. Yes, even doulas.”
EXCELLENT work here, Kristi!
Thank you so much! Thank you for reading.