Hi, there, I’m Lesley Everest. As a doula with MotherWit Doula Care and Birth Essentials childbirth educator for 23 years, I have been approached many times with the questions: “Will you make sure the doctors and nurses don’t do anything I don’t want them to do when I’m in labour?” or “Will you speak up for me if I’m not in a position to speak for myself?”
These are very valid questions. Giving birth is one of those situations in which you are at once your most powerful AND you’re most vulnerable. Your faculty of logic isn’t always as strong as usual when you are in pain. Worries about what someone may do to your body or your baby while you are deeply focused upon the hard work of bringing forth life are normal.
MotherWit Doulas are your birth champions, there to give you unbiased information to the best of their ability about your labour and what your options are. They are there to uplift your spirits and let you know what a rock star you are being through such a demanding journey. They listen to your needs (the verbal and non-verbal expressions), keep your partner fed and calm, and use their techniques and skills to bring you comfort. What they cannot to, however, is tell care providers what to do or not do. That has to come from you and your partner.
What a doula actually does is support you and your partner (if you have a partner) in speaking up for yourselves in labour. A MotherWit doula upholds your choices in any given situation, but will never force a choice on your behalf. They will, however, help you in figuring out what questions to ask in the moment if you’re not sure. Then, fully trusting that you are the sovereign of your own birth experience, your doula will work around your situation and choices to make you feel as relaxed, comfortable, and cared for as possible.
BRAIN is a great little acronym by which many doulas will help you gather information so you can make as informed decisions as possible about your care. Your team of care providers are there to answer your questions and hear out your preferences, so don’t be shy. It is important for you to know that you have the RIGHT to informed consent and informed refusal to anything that is offered to you and/or your baby.
Here is an example of how this could work. Let’s say you really don’t want an episiotomy. Your doula cannot tell your doctor, if she sees the scissors coming, to refrain from giving you an episiotomy. We are not medically trained, so we don’t know if they’re doing it for an emergency or preference. It is not our role to second guess that. To tell them not to could potentially endanger you or your baby. Your doula can, however, speak into your ear, “it looks like you’re about to get an episiotomy.” This is our cue, discussed prenatally, to engage your BRAIN process. Most women, even in the most intense moments of birthing, will understand that cue and say, “I don’t consent to an episiotomy!” if that’s what their preference is. This gives the care provider pause, if it’s not an emergency, to explain why they want to do it. Once they’ve explained to your satisfaction, then you can either give informed consent to the episiotomy or not.
A MotherWit doula isn’t attached to what it is you actually choose at the end of the day. What we want is for you to feel like you’ve made empowered choices about your care wherever possible. Why? Because studies have show that this leads to a higher chance of you’re reporting a satisfying birth experience.
Let’s look at the B in BRAIN. This stands for BENEFITS. When offered something in childbirth by a care provider, such as medications, procedures, or suggestions, you can ask, “What are the benefits?” This gives your care provider the opportunity to fill you in on how what’s offered can help you.
R stands for RISKS. What are the risks of what’s being offered? Are there any risks at this time of NOT taking the care provider up on what they’re offering?
A is for ALTERNATIVES. It can be helpful to know there may be other options besides what you’re initially being offered to potentially create the same result. For example, if a care provider suggests medication to strengthen your contractions and you ask for alternatives, they may suggest walking up and down stairs for a while, or using a breast pump to stimulate your body’s own natural hormones.
The I in BRAIN stands for INTUITION. As with anything, trust your gut. If you are being offered something that really doesn’t sit well with you, you have the right to say “no thanks”. If you are NOT being offered something and you have a strong sense it is what you need, ask about it. Most experienced doulas will have many stories to share about the uncanny intuition of birthing parents.
Finally, N stands for NOW? or NO THANKS. Very often something is suggested and it can feel urgent. But if you want to keep doing what you’re doing for a while, asking if it’s appropriate to wait can give you the opportunity try alternatives to get desired results. If what’s being offered to you is truly not okay with you, you can just say no.
It is true, sometimes things happen very quickly. Birth is unpredictable, and can sometimes make you feel like things are beyond your control, either because of the birth process itself or because of care providers making split decisions. Sometimes it’s not possible to engage your BRAIN in every 
situation. If you know your preferences in advance, however, you’ll know which things you want to make strong cases for, and this will galvanise your self-advocacy prowess where it matters most to you. Being fierce AND flexible can help you move through birth as smoothly as possible.
If you can look back at your birth and feel that wherever possible YOU were the main decision maker in your birth, heard and supported by those around you, you will hopefully feel all that more powerful. And that’s a great thing to feel as a new parent. As doulas and childbirth educators when a family in our care feels amazing about their birth experience, we are happy!
Be well and have a beautiful birth!
Lesley Everest, mother of four, has been a doula for over two decades. She is the founder of MotherWit Doula Care Agencies in Ottawa and Montreal, MotherWit Doula Training (Holistic Birth and Postpartum Doula Certifications), and Birth Essentials Prenatal Classes. Lesley’s mission is to connect families, doulas, and care providers to their motherwit, encouraging the modern birth/parenting culture to become one that honors the true meaning of “family-centred” care.
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