Prepare Your Parents To Make Decisions – Doula Series Ep. 8

By: Care Messer Birth Doula, Doulas, Education March 14, 2019

It’s important to demonstrate boundaries and consent to our families so they can gain more confidence and find their voice before their labor even begins. Parents need to understand that they are the consumer in this birth experience and that they can work in partnership with their providers. You can teach parents new skills in prenatal visits that help them slow down the urgency and rush of the birth environment. With just teaching a simple “gut check,” you can help your families feel more confident and empowered to make decisions during their babies birth.

Video Transcript:

– In last week’s video, we talked about and consent with you and your personal life. This week, we’re going to teach you how to teach parents the same stuff. So, when you’re structuring your prenatals, there are a few key things that your parents need to know that probably you’re going to be the one to teach. So, number one, they are the consumer and they’re paying the bill. There’s always a choice with their care and they get to choose in all situations. Number two, know the difference between options and actually emergent situations, because those are very distinct things that they need to know, options versus emergencies. Number three, how to slow things down and take time to consider what information they just gathered and make a decision about that care. One of the things I use as an example to teach consumerism to a parent who thinks that they’re going to be dictated to at a hospital or a doctor’s office or whatever, because they don’t know enough, is that they are the consumer, we are the consumer. You wouldn’t expect to walk into a car dealership and be told you’re going to be getting the red car on Wednesday. What you’re going to do at a car dealership is you’re going to mill around, see what options there are, decide what color you want, what options you want on that car and then go negotiate that. It’s not going to be a dictatorship at a car dealership, or you would walk off the lot. It’s the same in medical care. We can ask, we can get information and then we can decide. We always have a choice. Another piece to that is when you come into hospital environment, letting your parents know that they can request the type of nurse that they want. For example, if they want a natural birth, it’s okay to say, hey, we want the nurse on the floor. Maybe medical Nancy isn’t the one we want, maybe she is, because that’s the kind of birth you want. It’s your choice, but you can request the kind of birth provider, care provider, midwife, doc, that you want to come to your birth. If they know there’s a choice and an option that they could request that, it might make it a little bit different for them, feeling like they’re a little more in control of the situation. It’s important that you go over what a true emergency is versus what options and interventions are being offered to hurry things along. So, a true emergency is 10 people rush that room, we’ve got to get mom and baby to the OR and get that baby out in three minutes. That is a true emergency. We will not stop. We will go. We will not ask questions. Those are the kind of emergencies we don’t want to be asked questions in. We want that baby out so that we’re saving mom and baby. Very rare that those happen, but that’s a true emergency. When we’re offered interventions, water breaking, starting pit, like that to speed things along, or hurry up, they always have time to slow things down, ask questions, get information. That’s not an emergency situation. That’s an intervention being offered to speed things up, hurry things along, etc. That’s not an emergency. They just need to know that. And then the next thing they need to know for sure, is how to slow things down. Take time to ask questions, listen for the answers, decide what sounds good, and then make the decision. Slowing things down is going to make the parents feel more in control of the situation and actually not have regrets because they took the time to make a decision for themselves and their baby. That’s what can create a very empowered birth situation even if it didn’t go the way they wanted it to go. Another thing you can do that makes it simpler for you to teach is encourage your families to be in out of hospital birth classes. That way, their educator’s going to be saying some of the same stuff that you would suggest and it’s much easier to reinforce what’s already been said than to come up with it on your own and have them be hearing it from you for the very first time. It’s a lot simpler to say, what did your educator say about XYZ, and them say, oh yeah, we’re supposed to dim the hospital lights, we’re supposed to ask this kind of stuff, remember to be there, we’re supposed to, supposed to, supposed to, and you can say, awesome, I can help you do that. How do you see me supporting you when you do that at the hospital? Much easier because you’re encouraging them to take further action that they’re already on their way to do. Next, really prepare them for the hospital environment they’re going into. You’re literally going into a business, a business building to give birth to a baby. Because, it’s somebody’s regular work place. It’s fast paced, it’s noisy, there’s people talking, there’s chatter going on at the water cooler, there’s beeping, there’s things being dropped. It’s a work environment. They need to understand it’s not going to be blissful with spa like qualities and candles lit and that stuff, unless they bring that environment in. So, then you can switch into this is a work environment, it’s going to be loud, this and this, how do we set that boundary in your room, for that to be a sanctuary for this woman? How are we going to dim the lights? What kind of scents do you want in the room? What kind of music do you want playing? This is her boundary. This will make her feel safe. What other cozy things can you add? Cozy slippers, big fluffy robes. I’ve had moms bring those before. Think outside that box to make that boundary yummy and delicious because you’re in a work environment. They need to know those sounds are going to be happening, how to get back to their zen sanctuary that they’re looking forward to. Next is teaching your parents the language of consent. Consent is different out of hospital than it is in the hospital. Remember that hospitals have mandated policies and procedures to protect the patients from certain situations as well as to protect themselves from litigation that can occur obviously in medical care. There is a safety level for your parents going into a hospital environment to birth. That safety level is a mandated policy, right? Because we have policies at a hospital so that things don’t get missed. It is there for our protection as well as theirs. However, it is also there for the masses, not for individual situations. That’s the wiggle room that the parents can come into asking questions, getting more information and then making decisions. But, consent on the inside of a hospital is presented differently than on the outside and this is what they’re going to hear when they go into a hospital situation. Consent to the hospital is kind of here’s what we’re going to be doing and here’s how we’re going to proceed, instead of, is it okay if? And would you be okay with, if? It’s just not like that at a hospital. So, they need to understand what they’re going to hear and not be reactive to it, but actually take a step back and be responsive to it, because we’re making friends with our hospital environment. We do not want to teach our parents to go in with their dukes up and be firm and angry and this is how it’s going to be, because that’s what’s going to make labor go backwards if mom gets in that fight or flight. We work with our care providers and they really need to understand that that’s where you’re at and how we can create a beautiful environment if we’re on that same page. That being said, it doesn’t mean that birth partner and mom have to comply with every single thing that’s coming out of the care provider’s mouth, if it doesn’t feel right, or if they don’t agree with it, but it does mean that we have normal, healthy conversations with providers instead of reactive, angry conversations with providers. Because, nobody wants that in their work place and we’re trying to get this baby out, not keep this baby in. So, what consent is is asking for permission before we do something. I don’t really care what environment your parents are planning on birthing in whether it’s a hospital birth center or home, consent is not just doing without asking, and it’s not phrased, I’m going to do XYZ, I will be doing, that’s not consent. Consent is would you be okay if I checked your cervix after this next contraction? Listening for the answer and then going forward. Right? That’s consent. It’s not always presented that way, because in a work environment, we have things to do. It’s fast paced, this is what our usual plan is of action and this is where we go. Now, we’re going to dial it back a little bit and teach parents how to feel what feels right in that moment and then ask a question, slow things down. Parents can say yes or no to anything at any moment. When they’re checking in with their feelings and what feels right in that moment, they will be able to stop, slow things down, ask a question, get some information and then move forward. They will feel more in control and they’ve feel more empowered, they’ll also feel heard. Being heard is crucial for a mother in her birth. So, if your parents don’t already know the brain acronym, this is something you need to teach them. We’ve already made a video on it, you can direct them to that or you can teach it. B stands for benefits to that suggestion. R, what are the risks to that suggestion? A, what are the alternatives to that suggestion? I, intuitively, what do I feel about it? And N has a few meanings. No, not right now or what would happen if we just wait? Not at this time. When they use the brain acronym, they’re going to be asking what the pros and the cons are to that. Then, they’re going to take some time, think about it, you may be in the room when they’re looking at that decision, maybe interpreting some of that medical information for them. You can actually be asked to leave and be totally okay with that and they need to know that it’s okay to ask me to leave at any point, for you guys to make that decision. Your parents need to understand that all their medical choices are their decision. It shouldn’t be influenced by what the doula thinks, the doctor thinks or the nurse thinks. It’s their choice. Checking in with their gut to see how it feels and letting everybody leave the room so they can check in with each other, is sometimes the best way to do it. Once they make that decision, yes, we’re going to accept that, no, we’re not going to accept that, we think we’re going to wait a little bit, we need more time, they’re going to feel confident and comfortable with talking to their care provider about that, because you’ve role played with them and given them the choice and the power ahead of time to make those gut check choices. Checking with your gut is the only thing in that moment that you can really teach them. For example, checking with your gut is, we’re going to break your waters in four centimeters. How do you feel about that? What does your gut say? Turning it back to them and if they’ve already heard that from you, they can go, I don’t know, we need some time. Perfect. Right? Turn it back over to them. How can you teach them what’s your gut say? It’s a really simple phrase to use. You’ve already worked with them in prenatals. They’re going to hear it from you and go, “Oh, this is my time to slow things down.” Especially the birth partner that’s not in labor, that’s his or her cue to go, “Oh, wait, we talked about this.” it’s really important that you role play at your prenatals so parents get used to using their voice, slowing things down and taking time to make decisions. Remember, it’s fast paced at a hospital. You know that, you’ve been there before. Slow things down. That is your job to slow things down. Teaching that in a prenatal will give them confidence. So, here’s some scenarios that you could use. After this contraction, I’m going to check your cervix. How does that feel? Once you reach four centimeters, we’re going to break your bag of waters. How does that feel? Your labor’s really slowed down, so we’re going to start pit in a few minutes. How does that feel? At your next appointment, we’re going to see how dilated you are and we’re going to do a membrane sweep. How does that feel? I’m sure you can come up with your own. There are more than I can count that you could role play with. Things that can be talked about at prenatal appointments, induction dates, here’s what we’re going to do, here’s how I do this with all my parents, whatever. Those are the kind of things that you want to role play ahead of time before they even get to those doctors appointments. They really need to understand and a lot of this is going to come from you, that they shouldn’t be in fight or flight with their care provider. If that’s not the right care provider for them, it’s okay to change. They shouldn’t be in fight or flight during their labor and birth. So, if we can dial it back and slow things down ahead of time, and they feel confident in doing that, you’re going to be way ahead of the game with them. So, the most important things to teach, parents are the consumers, they always have choice with their care, it’s okay to gather information, ask questions, take time, to decide what feels right to them. So, if you can teach that in a prenatal, and get confident in doing the gut check during their labor and birth, these parents are going to have a more empowered birth experience.

About the author:
Care is the founder of the Birth Education Center, San Diego HypnoBirthing and Cuddle Sanctuary San Diego. She is a Birth Educator, Hypnotherapist, Birth and Postpartum Doula, INNATE Care Provider, Erotic Blueprint Coach and also professional Cuddler. She specializes in connection work between people and increasing self boundaries for a more balanced life together.