Communication skills are of the greatest importance to me, as a doula, educator, parent, and person. I fell in love with this piece because it offers easy-to-follow ideas. There really is no place in life where we don't need to use communication skills -- so refining them will help us not only as doulas, but also as members of families, communities, and the world.
As doulas our profession is one that is infused with passion. We are passionate about the families that we serve and the beliefs that we hold, but unfortunately a doula’s passion does not always translate into professional communication. There seems to be a never ending obstacle course for doulas in their struggle to conduct themselves in such a manner that honors the profession that they have chosen. Unprofessional conduct from doulas spans from scope of practice violations to lack of respect towards fellow doulas and other providers such as nurses, midwives, and obstetricians. How many times have you read a doula’s post criticizing a nurse or provider’s actions at a birth she recently attended? Have you met a doula who is quick to speak negatively about another doula behind her back or criticize a doula for doing things differently? Doulas then wonder, “Why isn’t the nurse more accepting of me?” or “Why doesn’t that doula refer clients to me?”
Unprofessional conduct is not only an obstacle to a doula’s personal practice, but it breaks down the level of professionalism within the doula community as a whole. Professional conduct is actually an easy skill to master. At the heart of professionalism lies communication. With the advent of electronic communication, personal communication skills have seen a significant breakdown. If you don’t use it, apparently you lose it. Luckily, by adhering to the following communication 101 principles a doula can maintain a level of professionalism at all times.
1. Think before you speak/act/email. Remember the old adage to count to 10 before speaking? Turns out that this isn’t just a line your parents made up but is a timeless truth. Taking a moment before responding, whether in person or by electronic communication, can easily avoid a knee-jerk response that can cause irreparable harm. When it comes to electronic communication, think about whether you would actually say what you are typing if the person was sitting in front of you.
2. Speak with integrity. Choose your words carefully! Avoid words that intentionally inflame or create gossip. Ask yourself, “Is this how I would like to be spoken of/about?” Keep private subjects private, and avoid flaming or gossiping about other professionals in public forums.
3. Keep your promises. If you say you can back someone up, help with an event, etc., then do it. If you aren’t sure, don’t commit. Be clear when you communicate expectations around working with other professionals so that miscommunication doesn’t cause you to go back on your word. Don’t leave other professionals or clients in the lurch.
4. Don’t Assume. I am sure you know the expression about assuming! If you are ever unsure, clarify with the person directly, and by directly I mean in person as long as it is conceivably possible. While electronic communication can be an effective tool for a quick message, tone and body language are totally lost and these are integral to meaningful conversations. To not take the time to sit down and talk in person might send a negative message about your level of professionalism and respect for clients or colleagues, no matter what profession you are in.
5. Treat others the way you would like them to treat you. Is the provider at your client’s birth less than pleasant? Is a particular doula not giving you a warm fuzzy? You have no idea what that person has gone through that particular day. Maybe that person is struggling. Perhaps their loved one is critically ill. Perhaps they have been up for 24 hours working non-stop. Rather than taking it personally and speaking ill of that person behind their back, try extending that individual some grace and empathy. Ask yourself, “How would I like to be treated?”
By following these communication 101 skills, you can not only improve your own personal practice, but you can also help to further the level of doula professionalism as a whole. Be an advocate for all doulas by starting with your own professional conduct!
Heather Scott is a childbirth educator and a doula through the Childbirth and Postpartum Professional Association. In more recent years Heather has expanded her practice through earning her Bachelor’s in nursing from Regis University and is a registered nurse in the birth center setting where she has worked since 2008. Heather graduated in 2016 from the Frontier Nursing University MSN program and is a Certified Nurse Midwife. Heather and her family live in the foothills southwest of Denver. When not attending a birth or teaching a childbirth class Heather can be found spending as much quality time as possible with her husband, four children and usually a furry friend or two in the background! It is with great enthusiasm that Heather seeks to provide families with quality support through Cocoon Birth whose mission is to nurture, empower and honor your family.
I am a lover of doulas and what they do for families. We need to hear how we are doing, how we are being perceived, if we ever want to improve! When we get those bits of negative feedback, it is an opportunity for us to change and be better, not shrink and get resentful. We are all just people, trying to do the best we can. Communication is an important piece of the doula-client relationship -- the more we can communicate, before and during a birth, the better satisfied we can all be.
I hate to be Debbie Downer, that is not in my heart at all. I hired a doula for what I thought were realistic reasons. Like so many others, I read the statistics: shorter labors, lower uses of epidurals, happier feelings after the birth; those were the ones that stuck in my mind. I just didn't expect things to go the way they did, and when they went, they went fast. I felt like my doula went along with that, while I was left behind feeling alone.
I know one admirable quality of any doula worth her salt is good working relationships with the nurses and doctors at the place of birth. I was impressed by the stories I heard from my doula, the goings out to lunch with nurses, the sittings next to doctors at conferences. I will admit, it made me feel like she integrated well into the hospital process. What I didn't expect was that she might need to maintain that balance. When push came to shove in my situation, I did not feel she was with me, on my side. I felt like she was on their side, and it was her job to get me to feel good about coming to their decisions and preferences.
In a way, this was the beginning of the isolation. I had heard hospital doulas who are provided by the hospital or volunteer/work for the hospital sometimes have a hard time being neutral. I did not worry about this, because my doula was independent and nonaffiliated with the hospital. She did have a family member who was high ranking on the infrastructure of the hospital board, but again I saw this as a bonus, not a deficit. In reality, I think it aligned her with the hospital's way of doing things. It made it seem like her job was to help me buckle to that agenda in a less threatening way than if it came from a staff member.
I had a complication when it came time to push. Suddenly I was being rolled over, yelled at urgently, and told to push, even without a contraction. Extra people came rushing into the room. I was hearing all kinds of instructions at once. I closed my eyes and tried to do what they told me. My husband was no where to be seen or felt. My doula was also lost in the haze. I had no clue what was happening. I needed the tiniest bit of an explanation. The one person I would have expected this from was not there. My doula.
After the baby came out there was an audible sigh of relief. She was taken to a flat table to be given air and make sure she was breathing like she should. I felt the smallest touch from my husband's hand, and I wanted to gobble it up and have it take me away. He was scared too. We watched as our baby was being poked and prodded, mask on her face, lights flashing and alarms beeping. I looked for my doula and she was talking to the nurse about how frightening that was, and how she was sorry the nurse had to get up on the stool to help move me because the nurse was pregnant.
I could have used the emotional support my doula was giving my nurse.
It took a while before anyone explained what happened. It took even longer before our baby was brought to us. I felt pretty insignificant. I felt alone and afraid. Soon after the bustle in my room went down and I was considered recovered, my doula announced she needed to go move her car before her meter ran out. She said she would be right back.
"That's ok. I think we are ok now." She looked at me with a puzzled expression. "But the baby isn't back from the nursery. Do you want me to wait and see if we can get you nursing?" I let her know I was really tired, and I would ask for help from the staff if we needed it. She came over, gave me a hug, and said, "Thanks for having me as your doula."
Really I just felt sad. I felt let down. I wanted more mothering, and I got what seemed like a bubble gum teenager who was only with me until the cooler kids came (her friends at the hospital). I am not writing off doulas forever. I still can't deny those statistics. But next time, I am going to ask different questions, and remember to be impressed by different answers.
Lindsey is a high school math teacher and new resident to Harrisburg, Pennsylvania. Her husband, daughter, and Shar-Pei, Bluto, are expecting the arrival of a new baby around Thanksgiving. She is just starting to reach out to potential doulas.
I cannot say how much I enjoyed Bryna's contribution. Isn't there enough of a language gap in the birth world? Dilation when we could say open, and effacement for thinning? What about other terms, such as advanced maternal age (which perhaps is a step up from geriatric pregnancy!)? Or fragile pregnancy? Often these terms serve to make the distinction between doctor and patient. What about words that make the distinction between doula and parent? I hope this gets us thinking!
I’ve worked in the birth world for 10 years, this year. At first, I had what I thought was “burnout” or getting tired of being so emotionally and physically available for clients -- which causes a sort of cynicism and laissez-faire attitude toward one’s responsibilities. I went to work for a couple of weeks thinking this -- visiting clients and being as helpful and present as ever, I realized how happy this work continues to make me, and how capable I feel -- without cynicism. So, if I’m not burnt out, what am I?
I can’t figure it out -- and I’m still sorting through my feelings on this, but let me lay out for you what I’ve discovered so far:
Our language as birth workers, as a general whole, sucks. I’m sick of it. I am so tired of “trust the process” and “it’s not stronger than you, it IS you,” and a thousand other cliches we fall back on as birth workers. As doulas, lactation consultants, midwives, and other affiliates in this world...if I hear about one more person “re-centering” I might scream!
Is there a place for self-care and energy work? Sure. Is it imperative we learn the language and speak circles around our clients? No. No. No. When you tell a client that their “energetic blockages might hold back their labor” you are not giving them information. You are disempowering them, at best, alienating them at worst.
Maybe your particular client needs to move past a fear, a worry, or whatever the heck before they can go forward -- we have all seen this happen. Once, I had a parent hang out at 6cm for HOURS until we FaceTimed their blissfully sleeping kid at Gramma’s house. Baby came within the hour. Was it their “energetic blockage?” Maybe. Or maybe they just needed to know their kid was ok. Or maybe those are the same thing -- but which one uses the flowery language?
Why do we feel called (even saying “feel called” makes me twitchy) to use this flowery prosaic speech when we discuss birth? Some of us use it our whole lives! What difference does it make? What harm could it possibly cause?
I’m working on that part.
I suspect it does make a difference and it can cause harm. I’ve made an active shift away from the “birthspeak” this past year or so. Working to actively remove the embroidery from my words, I am seeing more and more that it’s elitist, exclusive, and I think, harming our communities.
To use “birthspeak” (which I’m shortening to BS for brevity) you need to be trained in BS. Which means you need the disposable income and the funds, as well as the childcare (potentially) and the time to be taking these workshops in which BS is heavily featured. I am acutely aware of the time, money, and support it requires to attend these things -- and the privilege afforded me as a cisgender white woman with an employed partner, higher education, and middle-class income.
This doesn’t make me bad, nor does it make me better -- but it does give me an unfair advantage over someone who doesn’t have the same opportunities due to circumstances beyond their control. Using BS means having learned BS. If you were able to learn and are able to use BS, check your privilege.
To understand BS, you need to have an education which requires introduction to concepts well beyond Reading, Writing, & Arithmetic. For example, you’d need to know what “energy” means outside the status quo definition -- which means you need exposure somewhere in your experience and education. In the same way that you’d likely have had to attend a yoga class to know how to “yoga breathe.” These concepts are not something you run across in everyday life!
Even if you say “let’s do some yoga breaths” and go on to explain the concept and action in an easy-to-grasp way, you’re reminding your client (who needed to ask you for an explanation) of somewhere they don’t have access -- whether by financial or social exclusion. You have also brought forward a lack of knowledge in a way that isn’t necessary. This can cause more feelings of exclusion. Perceived or real, exclusion is exclusion. You have already lost a little bit of common ground with your client. This is harmful. I won’t go into microaggressions here, because they’re much better explained here and you can see the impact on those who have experienced them here. These things can add up, and diminish your client’s self-efficacy, or pride and feelings of capability.
Perhaps the internal dialogue of your client then goes like this: “How can I be a good parent if I don’t even know what a yoga breath is?! Once she explained it, it was so simple -- just breathing in my nose and out my mouth! There’s too much to learn, I’m too overwhelmed…”
Was this your intention? Of course not! Is it sometimes the unintended consequence of BS? You betcha. That sentence above is taken directly from the experience of a former client of mine, describing their experience with one of their childbirth educators. BS can impact us all.
Something else to consider as potentially harmful -- a lot of the language is appropriated from other cultures without thought or permission. Co-opting other cultures’ sacred rites & rituals because it feels “more spiritual” is not okay -- especially if you don’t know the significance of the words you are using. Think about it. Think about the things that you do every day as a birth worker -- do you really need that “Namaste” email signature?
How to remove BS from your vernacular:
Real-life example time! One of the things I do as a doula is “holding space.” Holding space is a concept, and doesn’t quite fall into BS territory, in my mind. It can be explained easily and doesn’t draw unfairly from any specific cultures who do not benefit from its use, and can be explained without presumption or condescension to clients.
In practice, it can look like an awful lot of doing nothing, but it can be a really powerful tool in an emotionally fraught time. To “hold space” you simply remain focused on your client while they process something difficult. In most folks’ vocabulary, it’s called “being there for someone.”
Do you have to call it “holding space” even though the concept itself is called that and is taught with that title? NOPE. If your client doesn’t have a working knowledge of BS and it would not benefit them in any way to know what the technique is called, do they really need to know? Especially when they know exactly what you mean when you say “I’ll be there for you if it gets tough, emotionally -- and here is what that looks like…”
Does this mean you can’t describe your client’s birth to another birth worker as a “totally transcendent experience!”? Not at all! Does it mean rethinking how you describe your work to the general public? I hope so. We all want to “find our tribe” but we don’t often stop to think where those words came from or what they really mean. You don’t need to use BS to be a good birth worker. You can use plain language and continue to witness miracles on the daily.
Obviously, this is not a commandment, nor is it a one-size-fits all manifesto. It’s just a personal exploration of thoughts and feelings on a subject that turns out to be quite sticky. All I know is that the BS is grating on my nerves. Totally anecdotally, I have noticed a significant uptick in my client diversity since I’ve dropped it in both speaking and marketing. I have clients and friends thank me for being more “genuine” and “straightforward.” I had no idea I was being confusing and not coming across as genuine. I’m glad I dropped it.
What has your experience been with BS?
Bryna has 3 kiddos, a seafaring husband, and a sweet pup named Amelia Earhart. She loves to climb rocks, play in the surf, and camp in Big Sur.
She has been working with families since 2006, and became an IBCLC in 2010. She owns Doula My Soul, llc -- a private practice in the Portland, Oregon metro area. She works as a doula specializing in high-risk and surgical birth, a lactation consultant offering home, office, and online consults, and teaches classes through both Doula My Soul and OHSU Center for Women's Health.
Bryna has mentored many students through their IBCLC hours, and loves to share the joy of helping families meet their individual definitions of success!
Are you a doula who likes to write? Join us for the "31 Days of Doulas, 2017," as we enter our 4th year of guest blog posts for, about, and by DOULAS! Not an experienced blogger? That's ok! I will help walk you through your idea to get a great result. Don't even have an idea? That's also ok! I have a penchant for helping early writers find that seed of an idea to nurture, grow, and share as a blossoming story of interest and heart, to others. There are still spaces left for 2017 -- contact me today!
♥ four young boys and a boy dog (offspring)