The Professional Doula: L & D Etiquette

hands labor

Calling all doulas- aspiring and experienced alike! Welcome to Part 2 of a short series on developing professionally as a birth doula. The goal of this series is to help you learn how to better serve the mother, work with care providers, and develop a good rapport while you’re at it. Be sure to visit the other parts of the series:

Part 1: Dress the Part

Far too often I have overheard hospital staff talking about “the nerve” of other doulas, or listened to doctors talking about doulas getting in the way. Don’t be that doula! It’s still possible to serve the mother well while also cooperating with the staff. Here are some quick tips to having good etiquette in L& D.

1) Introduce Yourself. You are aiming to form pleasant relationships with the staff for the duration of the mother’s labor. Be friendly. Act professionally. Don’t be a standoff.

2) Ask questions. Show genuine interest in the staff & their activities. Make conversation as appropriate- obviously remembering that the mother is your first priority. Ask them how long they’ve been at this hospital. Ask if they have children. Ask if the day was busy for them. You’d be surprised how earnest and pleasant small talk can soften staff members that have a poor preconception of doulas.

3) Ask permission. Yes, ultimately, the mother should be able to get what she needs to labor comfortably. But the best way to do this is not by recklessly raiding the cupboards. The supplies are still the hospital’s, not yours. Just pop your head out to the nurses’ station and say, “Hey, do you mind if I grab a washcloth out of the cabinet?” or, “I know you’re busy right now, but when you get a chance could you point me in the direction of the extra blankets?”

Better yet, ask the nurses when you first arrive if they mind if you grab what you need as you need itDoing so ensures that you won’t be stuck in a hard place when the mother is in transition and needs you there almost constantly.

4) Think ahead. For that matter, try to ask a little bit ahead of time about as much as possible. It helps keep stress levels down and leaves everyone feeling prepared. For example, try to gently remind the staff about the couple’s desire for delayed cord clamping in between pushes, rather than right as the baby is being born.

5) Keep your cool. If you are faced with opposition, be polite. Don’t be mean-spirited in your replies. I understand that many of us are very passionate about birth issues. However, starting a fight in the labor room doesn’t help the mother or yourself. If there is disagreement over a procedure or policy, you need to stand behind the couple’s desires while still upholding respect for the staff. I would suggest the following format for your conversations with staff when a conflict arises:

  • I understand there is a disagreement over [such and such a procedure].
  • When the couple and I spoke prenatally, I know they were hoping for [such and such an alternative].
  • Would you be willing to present your concerns with the couple and discuss possible options with them? (Provided this is not an emergency, of course.) Perhaps a compromise can be reached.
  • Thank you for your understanding. I know this may not be your standard protocol, but as long as mom and baby are both healthy, I know they would really appreciate your flexibility in this matter.

Maintaining your professionalism will help your client’s case, not hurt it. And it will help you to develop rapport at the hospital while you’re at it.

6) Let the staff do their job. There are certain times in which you need to allow the hospital staff to take center stage. You should not have a problem allowing them to do what they need to do in these situations. Here are three examples:

  • They won’t want you near the doctor’s instrument table during pushing. Make sure you are not in the way.
  • If the baby needs resuscitation, you will not be allowed to hover over the baby until he or she is stable. Respect this.
  • If there is a true emergency, staff may need to move quickly. Step back and allow them to do so.

7) Say thank you. The hospital staff works very hard for a lot of women. They are usually on 12 hour shifts, on their feet for much of it, and are often being snapped at by stressed families. Many times they are left un-thanked for their work. Even if you weren’t particularly fond of a particular nurse or doctor, make sure you tell them thank you for their hard work! They deserve it!

Okay, experienced doulas… what have you learned over your time working in hospitals? Share your wisdom in the comments section!

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