Communication in Birth Work

We’re back up and running! My computer isn’t entirely fixed yet, but it’s functioning well enough to type a post. 🙂

The last doula class that I took was one on the topic of communication. I thought I would summarize what I learned during class since how we communicate is so important in all areas, but especially in something so sensitive as birth work.

Here’s an opening quote for you:

“Some people are very good at talking, but not so good at communicating.”

Gulp. I don’t want to be the bumbling doula who only blabs at her clients. Our teacher discussed the 3 main types of communication that we generally use throughout our days.

1) Automatic. This is what we use when we are on auto-pilot and not truly listening. At the drive thru, we don’t really hear the phrase, “Hi, may I take your order?”- we merely go up thinking of what we want to eat. When we hear the voice come out of the order box, we don’t process the question- we merely proceed to tell the worker what we are craving. Automatic communication is good for conversations about the weather, answering routine questions, and various unimportant matters.

2) Analytical. This is when we are conversing with someone, processing their words, and contributing our own view. This can be a very good means of communication, but the danger comes in when we are really only looking to insert our own opinion. A great example of this in birth work is when I hear someone say that they went into labor, got their epidural because they were screaming for pain meds at 3 cm, then got stuck at 4 cm. I could feel tempted to insert, “Oh yes, epidurals are notorious for slowing down labor. Without one, maybe you would have progressed.”

But is that what the person really needs to hear? Can I change the past by inserting my opinion? No, I cannot, and I in fact probably just make them feel judged for using an epidural. Analytical communication has it’s place- problem solving, coming to compromises, debating, planning events, etc. However, it may not be the best means to employ when someone is sharing their own intimate story.

3) Reflective. Reflective communication is when we listen with an open mind, confirming what we are hearing from another person and striving to understand their point of view, not our own. If someone is telling a birth story, maybe they don’t need to hear exactly when and where things went wrong. Perhaps what they need is to hear their own feelings validated and confirmed. They need to know they aren’t crazy for feeling happy or sad or distressed over the way the birth went.

For example, perhaps a mom might say that she felt scared when everyone rushed into the room with the NICU ready during her second stage labor. When we listen reflectively, we don’t merely insert our opinion or try to make her feel better by saying, “Oh, but you were so in control. You had nothing to be afraid of. That’s just normal procedures.” In doing so, we just blow her off and make her feel like how she feels about it doesn’t matter. Perhaps we should say, “Yes, that would be scary to see all the hospital staff rushing in for pushing! Tell me more about it. Did they make it worse or better for you? How did it turn out?”

While automatic and analytical communication styles certainly have their places, birth work (and other sensitive fields) call for us to listen reflectively. We should hear things from the mom’s point of view and let her tell her story without taking away the process of sorting her thoughts from her. She needs to work through what happened to come to terms with the experience, whether it was good or bad.

When using reflective communication, there is a place for helping the mom to reframe her experience. For instance, in the above scenario, instead of telling the mom that she had no reason to be scared when extra staff ran in for the delivery, we can tell her that she showed much courage during pushing despite all of the nerve-wracking activity around her.  Helping mom to see her own strength can be beneficial to her mental picture of the birth.

Birth is an incredible life transforming event! Conversations about birth do not call for trite responses, belittling, or the blunt insertion of our opinions. It calls for careful listening, validation of mom’s experience, sensitive and truthful affirmations, and gentle guidance to see the birth with clarity when needed. Remember that women often recall what others said to them regarding their birth, sometimes long after the affair is over. Guard your words well, and remember most of all to listen.