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The Downside of Doula-ing

The Downside of Doula-ing by Jodi the Doula


When I first felt called to become a doula, I imagined the joy of witnessing the happiest and most memorable day of a mother’s life again and again. I knew that it would be a blessing and an honor to hold the sacred space for the passage of a new life into the world. That was absolutely right, and remains true to this day, hundreds of babies later


I hadn’t imagined this amazing work having a downside. It’s mothers and fathers and babies! It’s Happy Birthdays and awe and wonder! How can there be any shadow to that? I have learned, over the years, that there is an incredibly high burnout rate among labor support professionals. 


If you are starting out as a birth professional, or are considering becoming one, I want you to know that these things happen. It’s healthy to be prepared for them,  and it’s important that we talk about them with one another. Holding in our tension, our grief, our stress and our own processes is exactly where burnout comes from. In fourteen years and 400 births, I have learned that we’ve all experienced some of the same rough spots.


1) We’re human, and we’re not superheroes.  A full-time doula’s schedule can be brutal. It’s intense.  Any day, any time, we are ready to lift right out of whatever we may be doing. When someone gives the “come now”, it’s time to drop what you’re doing and show up. Births can be long. We need rest and food – two things that aren’t always easily afforded when supporting a laboring woman. She is allowed to be grumpy and tired. You are not. She’s irritable and demanding. She’s due-any-day and a basket case. It is not acceptable for you to be so. You had a rough day? Trouble in paradise? Doesn’t matter. Hang your personal life on a hook outside the door when you walk in, and show up fully present.


2) We get attached. The skill of non-attachment is required, and it’s not easy.  You will experience the “bump” and the resulting swirling feelings that happen the first time (or first several hundred times, depending on how much time your learning takes) that a mother doesn’t take your advice, or disagrees with something that may be personally important to you. You might feel frustrated, or be tempted to take something personally. Your buttons are going to get pushed, sometimes very hard. You cannot decide what she will do – you may only decide what you will do. You may have to remind yourself repeatedly “This is not my birth. This is not my birth. This is NOT MY BIRTH.”  It really isn’t. It’s hers, completely, and it’s your responsibility to let her have her own experience. It’s our job to present the information as objectively as we can, and allow her to make her own best decision.  Regardless of her birth story or outcome, if she knows what choices she has available and understands that she has the power to speak up, we’ve done our job. The end.


3) Our clients are human, too.  We get the honor of being present for one of a woman’s most raw and vulnerable life experiences. This is a privilege, and it is huge to be in that place of trust. Most of the time, this means that we get to play an integral role in someone’s most precious memories. Though every time birth is profoundly beautiful, the truth is, it’s not always pretty.  Every woman has an entire life story that has taken place prior to meeting you, and as her doula, you often won’t know more than the tip of the iceberg. She has her own core beliefs – about birth, about her own strength, about power and control –  that will play out during her birth time. One in four women has experienced abuse in her lifetime. Marriages aren’t always functional. Friends and relations present in the birth space aren’t always supportive. Sometimes, if it is her personal habit, a mother will be looking for someone to resist or to blame, and doulas are easy targets. There is sometimes a spoken or unspoken expectation that a doula will be able to control people, emotions, or events that she simply cannot. Sometimes there is a surrendering of a woman’s power to other people,  even to her doula.


4) Doctors, Midwives, and Nurses? Also human.   Some practitioners are bullies. Some practitioners have had negative experiences with other doulas, or with a laboring woman’s sisters or friends who call themselves “doulas”, and have negative feelings about doulas being present for their patients at all.  Some may not have great communication skills. They might be busy, or snarky, or having an off day. They get bumped and triggered, too.  As doulas, we’re the lowest folks on the totem pole in the birthing room. We have a responsibility for acting with politeness and respect toward every other professional in the room, regardless of our personal opinions, previous experiences, or  inner reactions. We don’t tell them what to do, or how to do it – NOT OUR JOB. We get good at biting our tongues, or better yet, we can be a model for taking a deep breath, letting it go, and providing compassionate support for our mothers. That’s what we’re there for.


5) Sometimes, things just go wrong.  We may want, with every fiber of our being, for every birth to go peacefully, happily, and well. We may do everything in our power to help this happen. Often, it does, and that joy is the best part of this doula gig. There are other times when the unthinkable happens. Medically necessary inductions aren’t always successful. A longed-for unmedicated birth becomes an unexpected cesarean birth.  Husbands are caught in affairs or leave the marriage with no reason and no warning. Dire medical emergencies occur. We witness abuse in relationships. We witness birth rape.  Babies are diagnosed with conditions “not compatible with life”, and births are a time of grieving.  We come prepared to support women through the physical pain of birth, but the tools we carry in our birth bags are useless for the breathtaking emotional pain that sometimes happens. Sometimes, a doula’s most powerful skill is to simply be the one who witnesses that, yes,  something went very wrong.  We hold space for a lot of grieving, and pain, and loss. This unanticipated aspect of the doula role is why many quit after the first undesired birth outcome.


In time, it becomes clear that when we give our YES to walking the doula path, we are giving a bigger YES than we expected to our own learning and growing more deeply than we may have ever thought possible.  These challenges hold the potential to become the valuable life lessons that doula work has to offer. “I could get called away any minute” can also become “Be fully present and enjoy this moment, right now.” As we learn to make observations instead of placing judgements, we learn that our feelings and reactions have nothing to do with the mama who is in labor, or her partner, or her doctor.  Feelings belong to the person experiencing them, not the person who triggered them, and are indicators of what your lesson will be with this birth.  Learning to accept ourselves as “good enough” in the face of the desire to defend ourselves  is our own work to do. The same is true for discovering our own core beliefs, and recognizing where they differ from the stories of others. We’ve been given an opportunity, in experiencing these bumps, these hard moments, and these feelings, to work on our own growth. That’s the gift that doula work gives us, again and again. These skills take time, sometimes a lot of it. It takes patience, and a willingness to work deeply with our inner selves.  Reach out to your own support people. Do your own work – your own learning and growing – in whatever way you know how. You’ll begin to see where these lessons – honoring boundaries, taking nothing personally, owning our own experiences – pop up in other places in your life, too.


It gets easier with practice. We learn to hold space with love and compassion for someone else’s process, without making it our own. We witness the breaking points, and we learn to stretch without becoming broken. We grow stronger and become the rock our clients need to lean on and reach out to, without their needing to worry (as they may with friends and family) that seeing their fear, their struggle, their vulnerability, their grief and their anger will tear us down or push us away. We support them in the process of learning so that they, too, can stretch without breaking.


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