Did you know that in most hospitals you are allowed two support people? Presumably one will be your partner and the second can be...your friend, a family member, or a hired professional called a doula.  Having an extra set of hands to assist you and your partner can be very beneficial.  In the case of a doula, The assistance comes without judgement and with an expertise in modern birth and a knowledge of the workings of the hospital.

But what if you were told by your doctor that they didn't allow you to have a doula?  Do you think your doctor has the right to dictate who your support people are? One such incident was highlighted to me earlier this week and it got me thinking. 

Consider this, what are the chances your doctor will actually be at your birth? Having a doula offers you continuity of care.  Your own doctor can't offer you that.  The vast majority only work at their hospital once a week or less.  And as most hospital policies do not dictate the precise "who" you can have, where is it coming from that your doctor can say precisely who will be there to support you?

One reason could be that the doctor has had a past bad experience with a doula and has written off the entire profession.  A situation of one bad apple spoiling the bunch.  But like with all things, there is good and bad.  There are good doulas, and bad doulas.  Just like there are good doctors and bad doctors, good nurses and bad nurses.  But you might agree, that one bad experience shouldn't ruin the experience of all mothers and shouldn't take away a woman's choice for her own birth.  If we did that, then most of us wouldn't be seeing doctors at all, or going to hospitals. 

A second reason might be control.  Some doctors, not all, like to micro manage birth.  They like to control the process and don't like to answer questions.  Some feel the questions you ask are actually you questioning them as a doctor and as a professional.  Some think the doula is whispering in your ear and getting you to make decisions that go against medical advice, or that the doula is bad mouthing them behind their back. 

Nothing could be further from the truth.  A doula is there to support your decisions.  To help you in physical comfort and evidenced based information.  To remind you of your birth plan, that you and your doctor agreed to.  To help you cope when things don't go as planned and to be with you even when everyone's shift has ended.  They are not there to make decisions for you, but to help make sure you have all the information to make an informed consent decision.  And informed consent is your right as a patient. 

So what is a parent to do when confronted with having to choose between the birth team she wants and not upsetting their care provider? The easy answer is nothing.  It shouldn't be a choice.  Your birth should be what you want it to be.  With a care provider you like, who is supportive of your choices, in a place where you feel comfortable, either at home or a hospital or a birth center.  With a team of supporter of your choosing who will care for you, listen to you, and be with you every step of the way. 

But how do you do that? Research.  Interview, yes even doctors.  Go on tours of different facilities, ask questions, ask your friends, family, co-workers, prenatal teacher.  Research on-line, read books beyond What to Expect When Your Expecting.  Pregnancy and birth are all about choice.  Don't have that choice taken away from you because of fear and ignorance. 

Partners.....

What is the role of the partner in the birthing room? For so many generations partners either didn't want to be in the birth room or were barred from being there.  Women were surrounded by their female family members and women in their community.  They were supported with love and compassion and the skill of women who had birth before them.

These days the skill comes from doctors and nurses and midwives.  And the love and compassion comes from their partners.  This can put many partners in an awkward position.  To see the woman you love, in perceived pain, and unable to sympathize or make it go away.  Desperately trying to remember what was said in the prenatal classes, kicking yourself for not reading those pages she had flagged for you and scrambling to find the birth plan she printed off to bring to the hospital.  What is a partner to do when suddenly faced with labour day and being overwhelmed and under prepared?

Step One:  Remain Calm
Even if you are freaking out on the inside, stay strong and in control on the outside.  All that comedic drama we see birthing mothers and their partners pull in the movies is FICTION! She needs your strength even when you aren't feeling it yourself.

Step Two:  Be There
That may seem obvious but I don't mean just physically.  You must be there mentally as well.  So that means no iphone, no blackberry.  Watch her, not the monitors.  Hold her hand, rub her back, listen to her wants and needs and respond to them.  Don't be distracted by the buzzing of your phone with texts and calls from anxious family members.  They can wait.  She needs you now.

Step Three: You are Papa Bear
You are there to protect your family and make sure they are safe.  How do you do that? Ask lots of questions, follow your gut and don't assume every suggestion is right for your family.  Most protocols are based on averages.  And your woman is not average.  She is an individual and her birth is as unique as she is.  She should be treated as such.  Protect her and her space so she can feel safe enough to let go and work at her labour.

Step Four: Plan Ahead
You can't show up for the birth and expect awesome.  No one wakes up one day and decides to run a marathon and win. You have to train or your twitter feed from the finish line will end with #fail.  Listen in prenatal class and practice the comfort measures you are taught.  Most importantly create the birth plan together.  This way you will know what she wants and why and how important each item is to her.  Know what you are fighting for when you are Papa Bear. 

Step Five: Know Your Limitations
Know what you are capable of.  What are your strengths and weaknesses? If you cannot do steps one to four with 100% of your abilities, get help.  Preferably a Doula who will assist you in all your steps and do it so you end up looking like a rock star.  Take all the credit, she won't mind.  Being honest about your ability to assist momma and asking for help is what she needs.  Being macho is not a welcome trait in the labour room, but honesty is.

Answer these questions: Can you be all she needs? Can you handle everything you may face? Do you have the stamina to run this marathon with her? If a voice in your head said no at any point, ask for help.  She'll love you for it in the end.