Considerations Before Inviting Someone Into Your Birth Space

By far one of the MOST frequently asked questions in my childbirth education classes, Hypnobirthing classes and as a birth doula is: Who shall I have at my birth? I want my mother, but not my mother in law (or the other way around).

How can I say no without hurting their feelings? My partner's feelings? How do we navigate this?

Firstly, let's be brutally honest here…. The birth of a baby is a miracle. Who wouldn't want to witness the birth of a baby? Giving birth however, is not a spectator sport. The way our bodies work best when we are in labour and birthing our baby is WHEN we feel SAFE AND UNOBSERVED. You are able to FOCUS on what is going on inside of you, rather than entertaining or worrying about those around you - no matter who they are.

SOME IMPORTANT CONSIDERATIONS FOR YOU TO THINK OVER……

How vulnerable have you been with this particular person lately and in the past? Are you the sort of person that keeps their mouth closed when they have upset you? Can you fully and 100% tell them to piss off? Well, unless there is a deep level of trust in ANY relationship, it is likely that you will find it difficult to be vulnerable during your labour and your birth. As a doula, I can tell you now, you WILL feel vulnerable at times, so ask yourself: how do you feel being physically exposed (naked), in awkward positions, making internal grunting, primal birth noises in front of them? Because if you cannot envisage yourself fully in the zone and growling and groaning with ease, then they won’t be the best person to have in your birth space. NO Inhibitions here please!!

Following on from first point: Ask yourself does this person make you FEEL GOOD ABOUT YOURSELF? WELL, ummmm, If you don't absolutely love this individual and enjoy their company when you're not in labour, then please explain how are you going to feel when you ARE?! Gulp! Re-read first point again if you need even more clarification.

Are they/have they been supportive of your choices thus far in life, overall? It is really unfortunate (and yes, has happened more than once) where I have attended a birth where a family member of the birthing mum is in her face pressuring her to make decisions (based out of their own opinion or the worst….. their own birth experiences and their fears). PLEASE…… If you going to invite anyone to your birth (family member or friend), please make your personal birth preferences known (give them a copy of your birth plan!). If they do not support you wholeheartedly, then it is probably a BIG NO from me! If they can’t support your preferences, what can they offer you?

I am an individual that has no regrets - Please understand this is one event in your life that you do not want to have any regrets. Are you inviting someone just ‘so you don’t upset them? Or so you don’t upset your partner? Will you regret this ? If you are really unsure (and you are allowed to be), perhaps you can ask them to wait in the family room. IF you decide that you would actually really like their presence, then you can invite them in. If you want them to leave, ask for privacy. None of these decisions are required to be final. If you OR your partner feel that there is potential for regret when inviting someone, it is highly likely you will feel the same after.

In my role as a doula I have seen frantic, panicky mothers marching off to get someone to help their daughter when they were coping amazingly through strong contractions, but yet mother was distraught at the suffering she was seeing her daughter go through. I have seen mother in laws intervene by insisting they do/do not have pain relief, to undermining them, killing their confidence to even making shocking remarks about their anatomy (cringe).

Your birth space and your birth journey is sacred - please where you can, eliminate any potential regrets when it comes to your support team.

Remember the quote “you may forget what they have said, but you will always remember how they made you feel”.

My Birth Doula Contract - What it is, Why we have it & What to expect

You may have had a friend recommend you invest in a Birth Doula, you may have read about what a Birth Doula can offer while browsing online, you may have even come across the role of a Birth Doula in a pregnancy or parenting magazine. Do you jump on google to find out more?

Perhaps the next step for you is to browse and see who is available in your area, or maybe you just have lingering questions and you are not quite ready to reach out just yet. One of these questions I am sure you keep tucked away while you ponder is ‘How do I know they are the right fit for me?”. I encourage you to pick up the phone and call the Birth Doula, or to email them if you prefer. Part of my service (and most other Birth Doula’s too) is to chat first and then arrange a ‘meet and greet’.

A meet and greet is offered at no charge (for myself & again most other Birth Doula’s) and is usually around an hour’s duration. We meet at a cafe or it can be in your own home, depending on what makes you feel the most comfortable. This is the opportunity to ask your Birth Doula all your questions, their philosophy around birth, where they trained, how many births they have attended, do they have a back up person they work with and if so, will you get to meet them?, what is their scope of practice? do they offer you a copy?, how many births they will attend per month, if they will attend births in hospitals, birthing centres or home births, or all of these options?

You may like to obtain references or testimonials. At the initial meet up, the Birth Doula is also considering herself whether she feels that she will be the right fit for you too - it is a mutual decision, and often both parties come to the same conclusion at the end of the meeting.

At the meeting my potential client/s receives a folder with a copy of my Birth Doula service contracts (I offer two), information about my other support services, a copy of my scope of practice and a handout on The Benefits of Birth Doula’s. Couples or individuals will then take this information away which gives them the time to talk over their thoughts and feelings before making a final decision.

Depending on the Birth Doula (and like a Midwife) you will need to make your decision fairly quickly as they may no longer be available if you leave it too long. Some of my Birth Doula friends will only attend one birth a month and another will attend up to 5 - so it does vary.

Once you have made the decision to go ahead - great. You will be asked to pay a deposit (that varies from Doula to Doula), read, sign and date the contract and then begins the wonderful journey of having them work with you for the duration of your pregnancy, birth and for some of your post-partum period.

What is in a Service Contract?

This can vary but typically you would expect to be offered:

• Up to two antenatal visits

• Devise and write up a birth plan (or two) together

• Comfort measures for birth and labour

• Support via phone or email for the duration of your pregnancy and birth (and some post-partum)

• On call 24/7 from 37-38weeks through to 42 weeks of your EDD (so this on-call period can be 5 weeks to a month)

• Stays with you from the moment you need their support when in labour, to approx. 2 hours post birth

• Can take photographs if requested and keep family/friends updated via text/email if requested

• Offer further services & this is individual to each Birth Doula (e.g pregnancy massage, aromatherapy oils)

• Visit once or twice in the post-partum period to see how you are managing and whether you made need any additional support (light housework, cooking, help with baby)

What about the cost factor?

Each Birth Doula’s service fees vary, the majority asking for a deposit up front (approx. 50%) of total service fee once the service contract has been signed, with the final payment made at 37-38 weeks - this is so your Birth Doula can be on call for you 24/7, from this time on. Again, this may vary, but the usual expectation is that the last payment is made at the time (mentioned above), and some Birth Doula’s will enforce that they will not be on call until this final payment has been received.

Antenatal visits vary, I offer two which are a few hours in duration each, and this is where we discuss their concerns, thoughts, doubts, fears and expectations. We discuss comfort measures for labour and birth, offer our resource/referral list, what it will look like for them as I attend their birth, the roles of all those attending your birth (medical staff included) to name a few. A part of my service with my holistic health background is to discuss the use of Bach Flower Essences or Homeopathic remedies if this is something that interests them and, more often than not, the additional services (add-ons to my service contract) are taken up as they can see the benefits of non-medical pain relief options once these have been explored. However, I do have clients that are very aware of my training and background and tell me from the day we meet that they are not interested in my potions and lotions - they will be having an epidural and that is that! That’s all good! So, is it my role to ‘try to change their mind?”. No it isn’t. I will of course want to explore what led them to their firm decision, offer research and a discussion (the same which I offer in a Childbirth Education class) and if they are still firm with their decision, great. As long as I know they have made a fully informed decision, I am going to honour that.

When not visiting face to face I like to check in every few weeks to see how they are getting on and if the need any assistance in their decision making. This is where it is crucial to be careful - we cannot give our personal opinions about what we think they should do or “what I would do if I were you” scenarios, rather, we offer evidence based information (with up to date research) and allow them to make their own decisions - IF of course this is something they wish to pursue. Which leads me to the Standards of Practice/Scope of practice, and why it is so vitally important. It is in place so that you, as my client, understand services rendered, limits to practice, advocacy, referral process, continuity of care, training and experience.

A Code of Ethics outlays our rules of conduct, ethical responsibility to clients, ethical responsibility to colleagues, ethical responsibility to the birth doula profession and ethical responsibility to society.

I like to send an email to the Lead Maternity Carer to introduce myself, and I am happy to meet with them at one of the client’s antenatal appointments if this is something the client and/or the LMC requests.

Birth Plans?! Yes, plans. One for a normal physiological vaginal birth and one for a caesarean birth - consider both carefully and document your wishes as you don’t know for sure how your birth experience will unfold. There are differing opinions on birth plans e.g. they never go to plan, it just goes out the window anyway… some of it can, for sure. But…. just because some things don’t go quite as you had hoped - doesn’t mean the whole entire experience has been ‘wasted’. And, this is just what we go through - different scenarios & what is likely to unfold.

Birth - The time has arrived for you to birth your baby. You may go into spontaneous labour or perhaps a decision has been made for an induction - either way your Birth Doula is there for you with a toolkit of support measures. She will see you through side by side, hour by hour, minute by minute to ensure you can have the best birthing experience possible. When you feel ready, you will want to be alone with your new baby and your birthing partner - this is the time your Birth Doula says farewell and makes her way home feeling exhilarated, but tired!

Post-Partum - A visit or two to see you and baby will include (if offered & varies between Birth Doula’s) - a home-cooked meal, baking, picking up any items you may need, light house-work, helping with baby (settling & soothing techniques) and offer a listening, supportive ear.

Please know your birth experience is an experience the Birth Doula will cherish also. The connection and bond created lasts long after the birth of your baby so much so, that not only do our clients keep our number on their phone (‘for just in case’) we feels so privileged that you’ve invested the trust in us to be a part of your next birth experience!