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Remaining Supportive When You Disagree with your Client's Decision

Dear Doula,

I keep running into a very frustrating question at prenatal visits and I'm not sure how to respond to my clients. The question goes something like this: "My doctor is pretty conservative and there are a lot of things he says he does that I don't want, like routinely induce at forty and a half weeks or that I have to deliver on my back. How do I navigate this and get the birth I want?" I suggest they change care providers but they respond by saying something like "I don't feel comfortable doing that this late" or "I really like him other than that" or "He's the only doctor my insurance covers." How do I deal with this knowing they may not get the birth they want? What do I tell them about 'navigating' these things during their birth. How do I remain nonjudgemental and supportive when I feel like they are setting themselves up for failure? Help!! TIA.


Frustrated AF


Dear Frustrated AF,

This is such a terribly difficult scenario to be in and I've been there so many times. It's so hard to witness this go down, knowing your client is potentially setting themselves up for a birth experience they won't be happy with. If all the talking to them in the world doesn't change their mind about switching care providers, then it's up to you to be as compassionate and supportive during and after their birth as possible. If they have feelings about a part of their care they aren't happy with, empathize with their experience and reflect back to them that is it completely legitimate to feel whatever they are feeling. This can help mitigate trauma that can happen when their wants and needs are not shared by their care provider. If they can leave their birth feeling like at least one member of their team was respectful of their choices, it will make the memory of their birth much better. If there is tension during the birth between them and their doctor, remind yourself to not take this energy in. They chose to stay with this provider and you must support that decision - even if you don't agree with it. As you get further into your career, you can choose not to work with certain care providers. I chose to not attend births at a particular hospital that was not friendly towards patient wishes and it was such a relief. And if they are mistreated during the birth, suffer obstetric violence or are not given true informed consent, please encourage them to make a complaint to the hospital or the medical board in your state. Even if they decline to do so, you'll feel like you did all you could. One of the most important parts of doula work is helping parents feel heard, supported and cared for during their birth. Best of luck!


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