How do you as a doula approach a laboring client to communicate with you?

Tashina Marker · 02-09-2006, 12:18 AM

Hello Ladies,
Yes it's me again with another question,LOL.I have had probelm so I feel ,with both my clients ,not sharing or communicating with me during the birth.I felt as though they were not telling me what was going inside of them with there thoughts.With my 1st birth I wasn't sure how to go about it.& with my second I waited till everyone was out of the room & then asked,but she seemed short & not honest like she was holding something back,but I didn't know how to well.... get her to tell me.

With the 1st birth Peter was a very involved & supportive guy to Amy,but Amy would not trully communicate with me & some how I always got the feeling it was him.He seemed very much in charge of things,but not you know extreme or anything.Does that make sense?Maybe she was scared to speak up? Maybe she was afraid she would disappoint him? I don't know even in our prenatals she would ask & communicate,but I never got to a place where she placed full trust or confidence.Which disappointed me because it is sooo vital as a birth team to work together in all ways.I had an honest & gentle approach towards them both,so I don't know where I went wrong.I paid close attention to her expressions during the prenatals & the birth,but that only got me as far as knowing she wasn't telling me something.It did not get me the info I needed.

With the second birth mom was very much in charge a RN,her husband was very supportive & there was nothing I could sense that it was him.I somehow thought her long drawnen out birth was due to something in her pass.Of course I have no valid facts to prove it I did deeply feel it to be the reason. Granted it was an all around difficult birth I feel it was more than needed & maybe could have been shortened if things were confronted emotionally.I tryed I asked her severval times when alone,but again like the 1st birth I didn't get anywhere.During the birth she had 2 panic attacks she blames it on the oxygen mask they put on her for a couple of minutes 2 times,but I think it was something else.When in our postpartum visit she said quote" I would sooner have taken a beating from my ex-husband than to have had the painc attacks".Do any of you have an idea of what I did wrong or could have done or differently? Would I be reaching to say maybe abuse wether physically or mentaly had something to do with this? I really want a relationship with mom to where she will share with me what is a blockage for her.

Any help in this is much appreciated, sorry it was a long post.

Need2read · 02-09-2006, 12:38 AM

I think that it is your job to show that you are holding that place for mom. You are showing her that she is allowed to be open and honest with you. I am sure that you are doing everything you can in your mannerisms and personality (just being yourself!) to show that this is a place mom can be honest. Ultimately the only thing you can really do is be up front during the prenatals. In my training I was told by my teachers that they usually say something like, "Sometimes during birth our past struggles can come up and these things may add to the stress or emotionally trying time that birth already is. If there is anything you would like to tell me or talk to me about please feel open enough to do so. Anything you do share with me would be in confidence." You can't really get mom to share some deep struggles she has had unless she wants to and maybe unless she feels it will help her in the long run.

It might be helpful to put yourself into the shoes of mom. If your ex-husband beat you and I said, "Is there anything you want to tell me?" I certainly wouldn't say, "well, you know my previous husband did emotionally and physically abuse me. He did xyz and that is how that ended" I just don't think it is something that anyone really wants to mentally go through again willingly unless they can see that labor will bring up a lot emotionally beyond just "oh shit this hurts" and it could benefit them to be open with their birth team to express these very hrad to deal with issues.

I was also advised that you shouldn't open a can of worms if you can't handle what comes out. I am not at all challenging your ability, so don't think that, but I think that you should be prepared when asking this question that reading a story in the news about a rape is one thing, and it is heartbreaking, but having a woman sitting in front of you telling you about someone who did this to her, your beautiful soon to be a momma client...how are you going to handle that?

I definitely think that taking a counseling class or practicing active listening, even taking a cultural awareness class. Things of that nature would be helpful. There are also really great workshops about attending the birth of a survivor I believe penny simkin does. That way you are not only confident that you are a great Doula, and holding that special place for mom to be completely real, you are able to respond and validate in a respectful and positive manner.

Goodluck to you.

1stimestar · 02-09-2006, 02:19 AM

Also, were you trying to get them to communicate while they were in labor? That's really hard to do. Women should feel comfortable just letting go and allowing themself to hang out in labor land while in labor and not have to think or even form coherant thoughts. So maybe easing up on the communication and just letting them know you are there, they are safe, listen to their body's. Good luck. Hopefully your next birth will be a comfortable one. Then again, we rarely learn as much from those comfortable one. ;0)

tlcdoula · 02-09-2006, 10:05 AM

I totally agree with what the other ladies have already said. I would also like to add that communication before mom is in labor is ideal. It is a chance for you to get to know her and her desires. I know with my prenatals we go over labor scenarios and practice positioning, etc. I also ask mom's prenatally lots of questions so that we really do get to know one another before her birth. Typically if a mom has been abused I will find that information out during a prenatal. If the husband is dominating that too comes out in the prenatals.

I think the majority of the communicating should come during the prenatals and when you are getting to know mom - during labor a mom should be allowed to just labor and do what she needs to do in order to progress and get through her labor and birth and during that time the doula should work on instincts more than questioning.

Stacie · 02-09-2006, 11:32 AM

It helps to stick with the phrase, "What was going through your mind during that contraction?" Then give her a chance to answer, and then you follow-up with, "Anything else?"

gemasita · 02-10-2006, 04:48 PM

Stacie - that is a GREAT suggestion. I have had a hard time with this too.

This is a little bit of a different situation but I have had a mom that didn't seem to want to communicate during labor, or be able to, and I left mom and dad alone and she told dad her frustrations and he told me. So sometimes, a very well-timed trip to the bathroom can be helpful. I always try to give my clients alone time in case there's anything they are holding back on with me in the room. Often, it comes out when I leave and then they communicate it to me when I get back.