Who is the decision maker?

Last week we had a great zoom call on the topic of professional liability for doulas. The conversation was inspired by my recent legal experiences and brought the expertise of lawyer and birth advocate Hermine Hayes-Klein to our community. There were many great takeaways to be certain, not the least of which included the value of a solid contract and liability insurance, but that is not what I came here to say today.

The more inspiring and meaningful part of the conversation for me had to do with empowering our clients to better understand and claim deeper ownership for their birth choices including their desire to have us present for the birth of their children. Our role as advocates is distinctly one of empowerment, and we can help our clients better communicate this with their care teams by having clarifying conversations with them in advance about how they are entering their birth space, and everyone’s roles. 

As doulas we know we are not there to offer our opinions or advice with regard to their choices. We are not there to make decisions for them nor to absolve them of the burden of that responsibility. We are there to support our clients in advocating for their choices and desires. In a system that is designed to deny or override bodily autonomy and the client’s position of authority vis a vis their own bodies and care, we stand with them to uphold those rights. 

Hermine helped to paint a picture for us in which our clients could take more responsibility for their choices in our presence, not less. We don’t want to be in the position of being another person toward which the client feels they are deferring their personal authority. She helped us see a world in which we are preparing our clients to walk into their birth space proudly introducing us as their doula, informing their providers of the importance of informed consent to their treatment (verbally and in writing). To see them, the client, as the preeminent decision maker in the room, not the doula or doctor or midwife, or partner or grandmother for that matter. That any clinical advice coming from the care provider will be considered in a shared decision making capacity toward which the doula is present to support and advocate for their client in especially vulnerable moments.  

Ultimately what was missing from my case was this very thing. With compassion, my client who lost her baby essentially was unwilling and unable to accept ownership for her decisions in the process. To be clear, not that she is to blame. A tragedy doesn’t always have someone to blame, and that is sometimes the hardest part of accepting, grieving, and making peace with a bad outcome.

Message me if you’d like access to the recording. To learn more and reach out to Hermine directly, visit her website.