You are responsible TO your clients, not FOR your clients

As a doula, your primary responsibility is to your clients. Your job is to uphold their wishes, advocate for their choices and ensure they feel heard, held and respected. 

However, you cannot be held responsible for your clients. You cannot save them from the choices they make or the outcomes of those choices. 

And whilst many of us find it really hard, and frustrating, to have to sometimes witness what we know will be a difficult situation unfold, our job is to uphold their agency and bodily autonomy, and walk this path with them, offering them the support and reassurance they may need. 

Being responsible to your clients means showing up, and being there beside them as they navigate their birth and postnatal experience. 

So whether they choose to do what you’d really like them to do (and yes most of us who really understand birth and are super comfortable with all that birth throws our way will want people to opt out of as much medical intervention as possible). Or whether they choose to do the exact opposite of what you’d choose to do in a situation; whether they choose to follow a medical professional’s opinion or not; your job is to ensure they can do so. This is true informed, well supported consent. 

Whether this is following their instinct or taking a position backed up by all the evidence in the world, they must retain the ability to make those decisions and feel comfortable and supported in those decisions. 

Every doula in the world will have at some point been asked “Well what would you do?”, and the answer must always be the same. “These are your choices, your body and your baby. I will support you to do whatever you feel is right for you”. 

And I know this is a far cry from what many healthcare professionals believe doulas are doing: which is whispering “home birth/ freebirth at all costs, just say NO”, into the ears of every woman and birthing person who refuses an intervention, but this is simply not the case. 

A good doula is helping clients to make autonomous choices, enabling women and birthing people to lean into what they feel is right for them … and very often, surprise, surprise this isn’t all the medical stuff you can throw at me! A good doula is empathetic, but has the self awareness to compartmentalise how they feel about a situation to create space and then hold that space so that their clients can step into the power of a decision they make for themselves and their baby. 

And yes we all have confirmation bias - and we tend to be hired by people who want that confirmation bias - but a good doula has an ongoing practice of self reflection, and knows how to give themselves time and space to sit with how they feel about a situation and then put this to one side and hold space for another. 

This isn’t to say that you can’t be a doula who only supports free birth or home birth or Caesarean birth and that if you do so that makes you ‘less than’ as a doula. But you must have the self awareness to know that your confirmation bias will mean that you will absolutely only work with people who think about birth the way you do and want the same things you want to a large extent. There’s nothing wrong with this if this is the path you choose.

However, I still believe everyone deserves a doula who will walk the path through birth with them no matter what that path looks like. 

I have come these views, quite strongly, after 13 years in birth work. During which time I too have had moments of “I can’t support births in the system”, “I can’t believe they chose that” etc etc. This work can be hard, it goes deep. I believe to be a good doula you have to be able to dig deep when, as my doula colleague likes to say “shit gets real”, and you have to be able to have time and space to self reflect. Whilst we strongly advocate for doulas running their birth work as businesses, this may mean that sometimes you pause, take a step back and reflect. You take time to heal and figure out how you do this work in a way that supports you and your clients. But personally, I keep coming back to I’m here to walk beside those who choose to work with me because I offer them something they need, strong, compassionate care and support, without judgement, no matter the choices they make.