August 29, 2025 • 20 mins
Angie Rosier shares insights on doula guidelines at hospitals, exploring the delicate balance between supporting clients and collaborating with medical staff.
• Hospitals will sometimes provide doula guidelines that outline appropriate roles and boundaries
• Doulas are welcome additions who provide emotional support, comfort measures, and improved communication
• Doulas should not perform clinical tasks like checking vital signs, doing vaginal exams, or administering medications
• Gray areas exist where doulas may assist with monitors or participate in brainstorming strategies
• Hospital policies typically restrict electrical items, open flames, and items requiring heating for safety reasons
• Creating a collaborative team atmosphere is essential for positive birth experiences
• The primary goal shared by everyone is a healthy mother and healthy baby
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Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:48):
Hello and welcome to the Ordinary Doula Podcast.
My name is Angie Rozier, I'myour host and I appreciate you
spending this time with us.
So today I want to share alittle something that I was
given a few weeks ago as I wasat a birth at a hospital.
A hospital I've been to many,many, many times before and this
(01:09):
time they handed me a littledoula guidelines sheet when I
went in and they don't always dothis I think it depends on
who's at the desk and stuff.
But as I've worked at differenthospitals I've kind of seen
policies ebb and flow around howhospitals are going to handle
and manage doulas who come inSome of them.
I've been at some hospitalsthat have you sign something
(01:29):
they might give the patientsthat are going to use a doula
something that the doula needsto look at ahead of time.
They'll promise to do this andpromise not to do that and stuff
.
So today we're going to talkabout doula do's and doula
don'ts.
This particular sheet was kindof cool Overall.
It talks about what a doula isand it says I love it, but it
(01:52):
starts off that your doula iswelcome to join you, which I
absolutely love.
It says let me just I'm goingto read a little bit from it.
Here and there, studies showthat having a trained birth
attendant to provide emotionalsupport and labor coaching can
help you have the birthexperience you desire.
So, first paragraph, they saythat, which is awesome.
They also state that they arekind of taking their guidelines
for practice and scope ofpractice from Donut
(02:15):
International, which is a reallygreat standard for what the
role of doulas is and whatthey're expected to do and what
they're expected not to do, andin bold it says please share
this with your doula and anyother person who intends to
support you during labor anddelivery.
Talks about how important theseguidelines are.
Doulas work for you and is notan employee of the hospital,
(02:38):
which I love that they highlightthat, because the doula does
work just for the patient.
But the guidelines help us allfoster a safe and supportive
environment.
Also, which I agree with, theymake sure everyone works well
together to nurture you and yourbaby and, as a doula joins a
hospital team and her client atthe hospital, they should make a
(02:59):
collaborative team.
It's not great to go in withyour dukes up and, you know, be
ready to pick a fight or anargument with anyone and
everyone, and some doulas dohave that kind of that persona
that they're going to go in andprotect, protect, protect, you
know, like protect your clientfrom the big bad hospital, the
big bad medical system, themedical system does you know?
(03:20):
They're not out there, they'renot there to get everyone right,
they're not the big bad guy.
But there is gaps, right,there's, as we've spoken about
many times on this podcast.
There are those gaps where whatthe hospital wants to do and
the patient wants to do areslightly, a little bit different
.
So they have a list here ofdo-la-do's and do-la-don'ts and
(03:43):
I think it's interesting, Ithink a lot of times where the
lines can be blurred, because Ireally like what they've stated
here.
Overall, I really totally agreewith how they've stated it.
But I think where we get into alittle bit of trouble is where
someone who's not really a doulacomes in saying they're a doula
and they may step outside ofscope of practice and definitely
(04:06):
out of these guidelines thatthis hospital is encouraging,
and sometimes that person who'snot a trained doula might be a
sister or a friend, a cousin, aneighbor, someone who wants to
just go in and offer laborsupport, but maybe they don't
have the nuances, um, how to dothat?
Also, sometimes I think andyou'll kind of see as we go
(04:28):
through this so this might be ahome birth midwife in a transfer
situation, somebody who doesn'tmore clinical skills than
doulas usually do.
So let's start with the do list.
So this is what this particularhospital says.
What doulas do?
They offer guidance, help youwith your comfort during labor
Perfect, that is absolutelyawesome.
It says they may help you withbreathing, relaxation, movement,
(04:50):
positioning and visualizationexercises.
That, in a nutshell, is a lotof what doulas do.
They say fosters a positiveenvironment and supports good
communication between you andyour healthcare team.
Absolutely love that too.
They're not using the wordadvocate in there, because
that's kind of a strong word,but that's exactly what doulas
are doing.
For example, your doula may helpyou communicate your wishes for
(05:14):
your medical care and, asrecorded in your birth plan, if
you like, she may also help themedical team explain some of
your care options to you, and Ifind that all the time, a lot of
times, if, like, the care teamcomes in and presents something
or explain something to myclient, so often they look at me
right there like all right,what do you think?
Or you know, as we have ahistory here and we've talked
(05:37):
about this, what you know,explain this more.
And so many times, after thatexplanation or those options are
offered, the team leaves, orthe provider or whoever the
medical professional is, and wehave another talk about it.
Right?
We're like, all right, let'sdiscuss this further.
So I love that they are talkingabout the communication point.
And then it continues to saymost helpfully, your doula can
(05:58):
encourage you to ask questionsand speak for yourself.
You are your own best advocate.
So they did use the wordadvocate, but for you know,
having the patient be their ownadvocate, which is true.
But, however, when you'recontracting, when you're in
labor, when you're in anunfamiliar setting and maybe you
have some extra fears aroundthat, when your partner has a
(06:21):
different expertise in life andchildbirth and all the nuances
around labor and delivery of thestrategy um involved there,
they may not know so, um.
So I think the doulas they'rethey're not using a very strong
advocate role here, but doulasdefinitely are advocates and
very kind of quiet advocates,kind of subtle advocates, um, in
(06:41):
really diplomatic and amicableways.
Of course we want to be anadvocate.
It goes on to say, on the dolist, the doulas do?
They provide physical andemotional support for you and
your partner during labor andbirth.
Very true, love it.
So I think they've highlightedpretty well what doulas do
during labor and delivery.
It can get a lot more complex,of course, as we have, you know.
(07:05):
You bring in the emotions ofthis and the physicality of the
exhaustion for clients and somepeople come into this with a lot
of fears, right, some prepreviously experienced medical
trauma or birth trauma or lifetrauma.
This gets in pretty deep andthe medical staff is usually not
in a place to a be aware ofthat or be be able to cautiously
(07:29):
, compassionately handle that Um.
So doulas wear that hat prettyheavy.
The last thing they say hereand this one's kind of
interesting a doula well, and Iagree with it, a doula protects
your privacy.
Just as a medical team adheresto health insurance, the
portability account, which isHIPAA right Accountability Act,
your doula should also respectpatient confidentiality and
(07:50):
while doulas are not as tied toHIPAA as medical professionals
are, right, the training and theattestations and things aren't
as strong for doulas.
However, doulas do need to bevery respectful and cautious
about their clients' informationand their experiences and how
(08:11):
they choose to share that?
Um, all right, and of courseit's, you know.
Just with no um identifiers,right?
That's uh, and you'd besurprised.
What can be an identifier whenwe're sharing information,
health information.
All right, let's go to the donot list.
Here's what doulas do not doduring labor.
So, as we go through this list,this is where like yeah, this
(08:33):
is, they may be speaking alittle bit to someone else A
supportive and well-traineddoula does not perform clinical
or medical tasks.
Your healthcare team providesthese services.
This means your doula cannot doany or other clinical tasks
such as take blood pressure ortemperature, check fetal heart
tones or adjust monitors, dovaginal exams, rupture membranes
(08:54):
, which is breaking your water,do perennial massage, give or
adjust medicine, includinghomeopathic or herbal remedies.
So all of those things are veryclinical.
I will say that over the yearsI have sort of done some of
those for sure.
As far as adjust monitors, likeI do that quite frequently and
(09:19):
sometimes I'll sit and hold amonitor in a finicky situation,
just if it.
You know, sometimes it needs tobe held just right to pick up,
and I've honestly found thatnurses appreciate that they are
coming in the room less ifsomebody else was like, oh,
let's just, you know, put afinger on that and hold it.
And now I don't put monitorslike on or I'm not taking them
off If somebody's going to thebathroom, um, take blood
(09:39):
pressure.
I don't take blood.
I mean, some nurses, honestly,have asked me to do that, um,
but maybe I'll take a bloodpressure cuff off if somebody's
going to the bathroom orsomething like that, or help it,
put it back on if it's sliddown or something.
(10:00):
Vaginal exams never.
Rupture membranesanes nope.
Perineal massage no.
However, um have several times,with client permission
obviously, um, and providerawareness, held warm compresses,
right, like, anyone can do that, like a provider, sometimes
they'll do that, dads can dothat, the partners can do that,
um, I've done that several times, so it's not anything clinical,
but just holding that warmcompress, the warm wash cloths
on the perineum, give and adjustmedicine yeah, never.
(10:21):
Sometimes I'll turn off, likeif the blood pressure alarm or
maybe different alarms are goingoff.
I might like hit a silence andlet the nurse know that that's
going off, because that'simportant for them to know.
Other things they do not do isinterfere with medical treatment
or disrupt the birthingenvironment, and I think that's
a kind of a shout out to thosewho are going in for a fight,
(10:42):
right, the doulas who are goinginto protect, protect, protect,
um, thinking that we're in enemyterritory, which we're not, so
disrupt positive birthingenvironment.
I, I love that because, um, Imean sometimes, uh, you know,
doulas are watchdogs I call themdiplomatic watchdogs, and so
sometimes there is a little bitof guard dog.
You might do, but should bedone, in a diplomatic way, um,
(11:05):
but we do not want to interfereif we want to keep a positive
birthing environment.
In fact, it's the doula's jobto create and maintain a
positive birthing environmentand she does that by um, using
teamwork with the entire medicalteam.
Doulas do not diagnose medicalconditions or present options
for medical care.
Instead, she supports thecommunication of the medical
staff.
So this is a tricky spotDiagnose, no, they do not
(11:29):
diagnose Present options.
That, I think, happens quite alot, because sometimes we're
brainstorming options, honestly,like we will work as a team
with the nurse, the provider.
Sometimes I'll have nurses anddoctors and midwives ask me like
hey, what do you think?
What should we do now?
This could be have to do withpositioning, you know,
(11:50):
positioning of baby and mom.
This could have to do withgetting labor going, moving
things along, searching forprogress.
So again, a collaborativeenvironment.
So I think sometimes doulas dopresent options for medical not
even medical, but strategy andthe what we're going to do
(12:10):
during this process.
So that one's kind ofinteresting.
And there's definitely some grayarea there, but no, not
diagnosing medical conditions,right.
There's definitely some grayarea there, but no, not
diagnosing medical conditions,right.
And then a doula should notspeak for you or make decisions
for you.
Rather, she should encourageyou to ask questions about your
care and treatment.
True statement.
But some people like, if youthink about the physical, mental
(12:34):
, emotional capacity of peopledeep into the labor process,
it's a lot to come out of thatand advocate for yourself or ask
questions about your care andtreatment.
Sometimes you're just hangingon.
So the doula again fills insome of those gaps in a real
nuanced way, so that she isalways pulling the her clients'
opinions and desires and notimposing her own Um.
(12:56):
So I you know, and again,another little gray area, um,
but I think each team is alittle bit different and as the
team spends time together theykind of gel and become their own
um, kind of their own entity.
Each time it'll look a littlebit different.
The last thing do is do not dois object to the following to,
I'm sorry, object to followingpolicies of the hospital and the
(13:16):
direction of your healthcareteam.
As she supports you in labor,she works at the discretion of
the doctor and nurses andcooperates with their requests.
I think that's true and evenmore than cooperate, I think
collaborate, because so, so, so,so many times it is a
collaboration among the team.
As the doula, it's interestingevery single situation you walk
into, and there's hospitals I'vebeen to dozens and dozens of
(13:38):
times and so I know them.
I know nurses, I know providerswho we've worked numerous times
together.
We work well together.
A little bit different there,but a lot of times you go in and
you have to prove yourselfright away.
Right, you have a big job as adoula.
Help that team to trust you.
Your client goes in trustingyou, ideally, obviously, and
(13:59):
that team to trust you.
Your client goes in trustingyou, ideally, obviously and so
it takes a little bit of time tokind of gel as a team.
So interesting there.
I like that.
It does get to some stickystuff a little bit and honestly,
like I have had nurses ask meto, and this is maybe we've
spent several hours together orI've worked with them many, many
times over the years and theywill ask me to do clinical stuff
.
That's way outside my scope, sothat's kind of interesting.
I've like helped place bladdercatheters and some things that
(14:24):
doulas typically for sure don'tdo, but again, you kind of earn
that with the team.
The rest of what this there's alittle other section on this and
it talks about comfort aids,which I think is great, and it,
you know, says here's somethings you can do, but it also
gives some things they don'twant you doing.
It says to help manage theintensity of labor, women and
(14:46):
their doulas often bring comfortaids to the hospital True story
, things like birthing balls,framed photos, massage tools.
You are welcome to do this too.
So they kind of touch on somethings, some ideas like three,
four little things there thatpeople can bring.
It says, however, as you packyour bag in preparation for
labor in the hospital, keep inmind, due to safety rules, the
following are not allowed at ourhospitals, and this is just
(15:10):
this system of hospitals.
It said anything that needs tobe plugged in, such as blenders,
heating pads or crockpots.
So there's some funky stories,right?
Every policy has a story behindit.
Can't take essential oildiffusers, it says, because
that's a plug-in Candles oranything with an open flame,
obviously in a hospital, andthen sacks or packs that need to
(15:30):
be microwaved.
The healthcare team is notallowed to heat them for you.
So I happen to know of a storywith this hospital years ago
where someone took a blender.
It says blenders.
I'm like why would you need ablender at a birth?
Right?
And this particular story thatI heard about years ago.
Someone had a baby and theywanted a piece of the placenta
(15:53):
which had to be cut off.
Um, like, the healthcare teamhad to cut it off and they put
it into a smoothie right therein the room.
So I blended it so that theyhad a bit of placenta that they
ingested right after delivery.
Interesting, um, that's a topicfor another day, but something
like that happens and that'swhere this policy came from.
(16:16):
Right, and, of course, likeheating pads, I like I don't
know like the hospital willprovide heating pads.
I don't know like the hospitalwill provide heating pads.
I've never known them to bevery hot, but I have had lots of
clients.
I'm trying to think if, at thisparticular hospital systems
take heating pads, but a lot ofclients will bring a heating pad
.
Essential oil diffusers that'skind of a bummer but I hardly
use them anyway because they,you know, acutely in one corner
(16:39):
of the room are pretty good.
But those hospital rooms can bekind of big and very drafty and
so a lot of times I'll, ifwe're using essential oils, I'll
use them more acutely on atissue or a washcloth or
something.
So not a big deal for me.
Candles, obviously not.
Heat packs that need to bewarmed, and a lot of that is
with the rate of people gettingepidurals in hospitals.
They aren't able to feel thatheat and the amount of heat that
(17:02):
that might be on their back,and so that's, you know, kind of
a blanket statement, if youwill, blanket policy to prevent
any burns on people who cannottotally feel what's going on on
their skin because of epidurals.
So that's the do's and don'tsof this particular hospital
system.
It says this hospital in myarea has several hospitals, they
don't have this out.
All the do's and don'ts of thisparticular hospital system.
(17:22):
It says, um, this hospital inmy area has several hospitals,
um, they don't have this out allthe time, they don't have it
out at every hospital, um, butkind of interesting to see.
You know someone got togetherevery sheet that's put out this
is called a fact sheet forpatients and families.
Um has a team behind it, right,a team of people who go over
and review it and they bring youknow policy as they create
(17:43):
policy.
They somebody met about thisand so they are doing their best
to work with doulas.
Overall, I like it a lot, butthere's a few little gray areas
of nuances that are kind ofinteresting.
So if you see these in yourarea, make sure you know just
kind of interesting to take noteof them.
And always, whether you have adoula coming to join you or you
(18:03):
are the doula joining someone,make a collaborative team.
Like we are all on the sameteam.
We all have a little bit of adifferent role, but respect each
other's roles, right?
We're going to respect the roleof every single person on this
birth team.
They all have a little bit of adifferent expertise and
everyone is.
We're striving for the bestexperience for the birthing
(18:24):
person and her baby.
Right, the premier goal ofevery single birth team is
healthy mom, healthy baby.
There's a lot of other goals wecan get along the way and
hopefully we can all strive toget those which are empowering
birth experiences, positivebirth experiences, collaborative
birth experiences where peopleare made to feel good, uh, even
in a hard situation, they'remade to feel better, they're
(18:45):
made to feel supported, um, andthat they can feel people really
, truly do care about them.
I love having that role on thebirth team Actually, I'm headed
out to a birth in just a fewminutes.
I wanted to squeeze this inbefore I headed out Um and
hopefully it will be an awesome,positive and empowering birth
experience for the client I'llbe joining today.
Thank you so much for beingwith us and hope you have a
(19:06):
great day, night, week, weekend,wherever you are, and, as
always, please reach out tosomeone near or far and make a
human connection today.
Make a difference in someoneelse's life you never know what
a difference that can make and Iwill hope to see you next time.
Thanks so much for being here,and this is Angie Rosier signing
off with the Ordinary DoulaPodcast.
Speaker 1 (19:39):
Thank you for listening to the Ordinary Doula
podcast with Angie Rosier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth.
Thank you.
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:48):
Hello and welcome to the Ordinary Doula Podcast.
My name is Angie Rozier, I'myour host and I appreciate you
spending this time with us.
So today I want to share alittle something that I was
given a few weeks ago as I wasat a birth at a hospital.
A hospital I've been to many,many, many times before and this
(01:09):
time they handed me a littledoula guidelines sheet when I
went in and they don't always dothis I think it depends on
who's at the desk and stuff.
But as I've worked at differenthospitals I've kind of seen
policies ebb and flow around howhospitals are going to handle
and manage doulas who come inSome of them.
I've been at some hospitalsthat have you sign something
(01:29):
they might give the patientsthat are going to use a doula
something that the doula needsto look at ahead of time.
They'll promise to do this andpromise not to do that and stuff
.
So today we're going to talkabout doula do's and doula
don'ts.
This particular sheet was kindof cool Overall.
It talks about what a doula isand it says I love it, but it
(01:52):
starts off that your doula iswelcome to join you, which I
absolutely love.
It says let me just I'm goingto read a little bit from it.
Here and there, studies showthat having a trained birth
attendant to provide emotionalsupport and labor coaching can
help you have the birthexperience you desire.
So, first paragraph, they saythat, which is awesome.
They also state that they arekind of taking their guidelines
for practice and scope ofpractice from Donut
(02:15):
International, which is a reallygreat standard for what the
role of doulas is and whatthey're expected to do and what
they're expected not to do, andin bold it says please share
this with your doula and anyother person who intends to
support you during labor anddelivery.
Talks about how important theseguidelines are.
Doulas work for you and is notan employee of the hospital,
(02:38):
which I love that they highlightthat, because the doula does
work just for the patient.
But the guidelines help us allfoster a safe and supportive
environment.
Also, which I agree with, theymake sure everyone works well
together to nurture you and yourbaby and, as a doula joins a
hospital team and her client atthe hospital, they should make a
(02:59):
collaborative team.
It's not great to go in withyour dukes up and, you know, be
ready to pick a fight or anargument with anyone and
everyone, and some doulas dohave that kind of that persona
that they're going to go in andprotect, protect, protect, you
know, like protect your clientfrom the big bad hospital, the
big bad medical system, themedical system does you know?
(03:20):
They're not out there, they'renot there to get everyone right,
they're not the big bad guy.
But there is gaps, right,there's, as we've spoken about
many times on this podcast.
There are those gaps where whatthe hospital wants to do and
the patient wants to do areslightly, a little bit different
.
So they have a list here ofdo-la-do's and do-la-don'ts and
(03:43):
I think it's interesting, Ithink a lot of times where the
lines can be blurred, because Ireally like what they've stated
here.
Overall, I really totally agreewith how they've stated it.
But I think where we get into alittle bit of trouble is where
someone who's not really a doulacomes in saying they're a doula
and they may step outside ofscope of practice and definitely
(04:06):
out of these guidelines thatthis hospital is encouraging,
and sometimes that person who'snot a trained doula might be a
sister or a friend, a cousin, aneighbor, someone who wants to
just go in and offer laborsupport, but maybe they don't
have the nuances, um, how to dothat?
Also, sometimes I think andyou'll kind of see as we go
(04:28):
through this so this might be ahome birth midwife in a transfer
situation, somebody who doesn'tmore clinical skills than
doulas usually do.
So let's start with the do list.
So this is what this particularhospital says.
What doulas do?
They offer guidance, help youwith your comfort during labor
Perfect, that is absolutelyawesome.
It says they may help you withbreathing, relaxation, movement,
(04:50):
positioning and visualizationexercises.
That, in a nutshell, is a lotof what doulas do.
They say fosters a positiveenvironment and supports good
communication between you andyour healthcare team.
Absolutely love that too.
They're not using the wordadvocate in there, because
that's kind of a strong word,but that's exactly what doulas
are doing.
For example, your doula may helpyou communicate your wishes for
(05:14):
your medical care and, asrecorded in your birth plan, if
you like, she may also help themedical team explain some of
your care options to you, and Ifind that all the time, a lot of
times, if, like, the care teamcomes in and presents something
or explain something to myclient, so often they look at me
right there like all right,what do you think?
Or you know, as we have ahistory here and we've talked
(05:37):
about this, what you know,explain this more.
And so many times, after thatexplanation or those options are
offered, the team leaves, orthe provider or whoever the
medical professional is, and wehave another talk about it.
Right?
We're like, all right, let'sdiscuss this further.
So I love that they are talkingabout the communication point.
And then it continues to saymost helpfully, your doula can
(05:58):
encourage you to ask questionsand speak for yourself.
You are your own best advocate.
So they did use the wordadvocate, but for you know,
having the patient be their ownadvocate, which is true.
But, however, when you'recontracting, when you're in
labor, when you're in anunfamiliar setting and maybe you
have some extra fears aroundthat, when your partner has a
(06:21):
different expertise in life andchildbirth and all the nuances
around labor and delivery of thestrategy um involved there,
they may not know so, um.
So I think the doulas they'rethey're not using a very strong
advocate role here, but doulasdefinitely are advocates and
very kind of quiet advocates,kind of subtle advocates, um, in
(06:41):
really diplomatic and amicableways.
Of course we want to be anadvocate.
It goes on to say, on the dolist, the doulas do?
They provide physical andemotional support for you and
your partner during labor andbirth.
Very true, love it.
So I think they've highlightedpretty well what doulas do
during labor and delivery.
It can get a lot more complex,of course, as we have, you know.
(07:05):
You bring in the emotions ofthis and the physicality of the
exhaustion for clients and somepeople come into this with a lot
of fears, right, some prepreviously experienced medical
trauma or birth trauma or lifetrauma.
This gets in pretty deep andthe medical staff is usually not
in a place to a be aware ofthat or be be able to cautiously
(07:29):
, compassionately handle that Um.
So doulas wear that hat prettyheavy.
The last thing they say hereand this one's kind of
interesting a doula well, and Iagree with it, a doula protects
your privacy.
Just as a medical team adheresto health insurance, the
portability account, which isHIPAA right Accountability Act,
your doula should also respectpatient confidentiality and
(07:50):
while doulas are not as tied toHIPAA as medical professionals
are, right, the training and theattestations and things aren't
as strong for doulas.
However, doulas do need to bevery respectful and cautious
about their clients' informationand their experiences and how
(08:11):
they choose to share that?
Um, all right, and of courseit's, you know.
Just with no um identifiers,right?
That's uh, and you'd besurprised.
What can be an identifier whenwe're sharing information,
health information.
All right, let's go to the donot list.
Here's what doulas do not doduring labor.
So, as we go through this list,this is where like yeah, this
(08:33):
is, they may be speaking alittle bit to someone else A
supportive and well-traineddoula does not perform clinical
or medical tasks.
Your healthcare team providesthese services.
This means your doula cannot doany or other clinical tasks
such as take blood pressure ortemperature, check fetal heart
tones or adjust monitors, dovaginal exams, rupture membranes
(08:54):
, which is breaking your water,do perennial massage, give or
adjust medicine, includinghomeopathic or herbal remedies.
So all of those things are veryclinical.
I will say that over the yearsI have sort of done some of
those for sure.
As far as adjust monitors, likeI do that quite frequently and
(09:19):
sometimes I'll sit and hold amonitor in a finicky situation,
just if it.
You know, sometimes it needs tobe held just right to pick up,
and I've honestly found thatnurses appreciate that they are
coming in the room less ifsomebody else was like, oh,
let's just, you know, put afinger on that and hold it.
And now I don't put monitorslike on or I'm not taking them
off If somebody's going to thebathroom, um, take blood
(09:39):
pressure.
I don't take blood.
I mean, some nurses, honestly,have asked me to do that, um,
but maybe I'll take a bloodpressure cuff off if somebody's
going to the bathroom orsomething like that, or help it,
put it back on if it's sliddown or something.
(10:00):
Vaginal exams never.
Rupture membranesanes nope.
Perineal massage no.
However, um have several times,with client permission
obviously, um, and providerawareness, held warm compresses,
right, like, anyone can do that, like a provider, sometimes
they'll do that, dads can dothat, the partners can do that,
um, I've done that several times, so it's not anything clinical,
but just holding that warmcompress, the warm wash cloths
on the perineum, give and adjustmedicine yeah, never.
(10:21):
Sometimes I'll turn off, likeif the blood pressure alarm or
maybe different alarms are goingoff.
I might like hit a silence andlet the nurse know that that's
going off, because that'simportant for them to know.
Other things they do not do isinterfere with medical treatment
or disrupt the birthingenvironment, and I think that's
a kind of a shout out to thosewho are going in for a fight,
(10:42):
right, the doulas who are goinginto protect, protect, protect,
um, thinking that we're in enemyterritory, which we're not, so
disrupt positive birthingenvironment.
I, I love that because, um, Imean sometimes, uh, you know,
doulas are watchdogs I call themdiplomatic watchdogs, and so
sometimes there is a little bitof guard dog.
You might do, but should bedone, in a diplomatic way, um,
(11:05):
but we do not want to interfereif we want to keep a positive
birthing environment.
In fact, it's the doula's jobto create and maintain a
positive birthing environmentand she does that by um, using
teamwork with the entire medicalteam.
Doulas do not diagnose medicalconditions or present options
for medical care.
Instead, she supports thecommunication of the medical
staff.
So this is a tricky spotDiagnose, no, they do not
(11:29):
diagnose Present options.
That, I think, happens quite alot, because sometimes we're
brainstorming options, honestly,like we will work as a team
with the nurse, the provider.
Sometimes I'll have nurses anddoctors and midwives ask me like
hey, what do you think?
What should we do now?
This could be have to do withpositioning, you know,
(11:50):
positioning of baby and mom.
This could have to do withgetting labor going, moving
things along, searching forprogress.
So again, a collaborativeenvironment.
So I think sometimes doulas dopresent options for medical not
even medical, but strategy andthe what we're going to do
(12:10):
during this process.
So that one's kind ofinteresting.
And there's definitely some grayarea there, but no, not
diagnosing medical conditions,right.
There's definitely some grayarea there, but no, not
diagnosing medical conditions,right.
And then a doula should notspeak for you or make decisions
for you.
Rather, she should encourageyou to ask questions about your
care and treatment.
True statement.
But some people like, if youthink about the physical, mental
(12:34):
, emotional capacity of peopledeep into the labor process,
it's a lot to come out of thatand advocate for yourself or ask
questions about your care andtreatment.
Sometimes you're just hangingon.
So the doula again fills insome of those gaps in a real
nuanced way, so that she isalways pulling the her clients'
opinions and desires and notimposing her own Um.
(12:56):
So I you know, and again,another little gray area, um,
but I think each team is alittle bit different and as the
team spends time together theykind of gel and become their own
um, kind of their own entity.
Each time it'll look a littlebit different.
The last thing do is do not dois object to the following to,
I'm sorry, object to followingpolicies of the hospital and the
(13:16):
direction of your healthcareteam.
As she supports you in labor,she works at the discretion of
the doctor and nurses andcooperates with their requests.
I think that's true and evenmore than cooperate, I think
collaborate, because so, so, so,so many times it is a
collaboration among the team.
As the doula, it's interestingevery single situation you walk
into, and there's hospitals I'vebeen to dozens and dozens of
(13:38):
times and so I know them.
I know nurses, I know providerswho we've worked numerous times
together.
We work well together.
A little bit different there,but a lot of times you go in and
you have to prove yourselfright away.
Right, you have a big job as adoula.
Help that team to trust you.
Your client goes in trustingyou, ideally, obviously, and
(13:59):
that team to trust you.
Your client goes in trustingyou, ideally, obviously and so
it takes a little bit of time tokind of gel as a team.
So interesting there.
I like that.
It does get to some stickystuff a little bit and honestly,
like I have had nurses ask meto, and this is maybe we've
spent several hours together orI've worked with them many, many
times over the years and theywill ask me to do clinical stuff
.
That's way outside my scope, sothat's kind of interesting.
I've like helped place bladdercatheters and some things that
(14:24):
doulas typically for sure don'tdo, but again, you kind of earn
that with the team.
The rest of what this there's alittle other section on this and
it talks about comfort aids,which I think is great, and it,
you know, says here's somethings you can do, but it also
gives some things they don'twant you doing.
It says to help manage theintensity of labor, women and
(14:46):
their doulas often bring comfortaids to the hospital True story
, things like birthing balls,framed photos, massage tools.
You are welcome to do this too.
So they kind of touch on somethings, some ideas like three,
four little things there thatpeople can bring.
It says, however, as you packyour bag in preparation for
labor in the hospital, keep inmind, due to safety rules, the
following are not allowed at ourhospitals, and this is just
(15:10):
this system of hospitals.
It said anything that needs tobe plugged in, such as blenders,
heating pads or crockpots.
So there's some funky stories,right?
Every policy has a story behindit.
Can't take essential oildiffusers, it says, because
that's a plug-in Candles oranything with an open flame,
obviously in a hospital, andthen sacks or packs that need to
(15:30):
be microwaved.
The healthcare team is notallowed to heat them for you.
So I happen to know of a storywith this hospital years ago
where someone took a blender.
It says blenders.
I'm like why would you need ablender at a birth?
Right?
And this particular story thatI heard about years ago.
Someone had a baby and theywanted a piece of the placenta
(15:53):
which had to be cut off.
Um, like, the healthcare teamhad to cut it off and they put
it into a smoothie right therein the room.
So I blended it so that theyhad a bit of placenta that they
ingested right after delivery.
Interesting, um, that's a topicfor another day, but something
like that happens and that'swhere this policy came from.
(16:16):
Right, and, of course, likeheating pads, I like I don't
know like the hospital willprovide heating pads.
I don't know like the hospitalwill provide heating pads.
I've never known them to bevery hot, but I have had lots of
clients.
I'm trying to think if, at thisparticular hospital systems
take heating pads, but a lot ofclients will bring a heating pad
.
Essential oil diffusers that'skind of a bummer but I hardly
use them anyway because they,you know, acutely in one corner
(16:39):
of the room are pretty good.
But those hospital rooms can bekind of big and very drafty and
so a lot of times I'll, ifwe're using essential oils, I'll
use them more acutely on atissue or a washcloth or
something.
So not a big deal for me.
Candles, obviously not.
Heat packs that need to bewarmed, and a lot of that is
with the rate of people gettingepidurals in hospitals.
They aren't able to feel thatheat and the amount of heat that
(17:02):
that might be on their back,and so that's, you know, kind of
a blanket statement, if youwill, blanket policy to prevent
any burns on people who cannottotally feel what's going on on
their skin because of epidurals.
So that's the do's and don'tsof this particular hospital
system.
It says this hospital in myarea has several hospitals, they
don't have this out.
All the do's and don'ts of thisparticular hospital system.
(17:22):
It says, um, this hospital inmy area has several hospitals,
um, they don't have this out allthe time, they don't have it
out at every hospital, um, butkind of interesting to see.
You know someone got togetherevery sheet that's put out this
is called a fact sheet forpatients and families.
Um has a team behind it, right,a team of people who go over
and review it and they bring youknow policy as they create
(17:43):
policy.
They somebody met about thisand so they are doing their best
to work with doulas.
Overall, I like it a lot, butthere's a few little gray areas
of nuances that are kind ofinteresting.
So if you see these in yourarea, make sure you know just
kind of interesting to take noteof them.
And always, whether you have adoula coming to join you or you
(18:03):
are the doula joining someone,make a collaborative team.
Like we are all on the sameteam.
We all have a little bit of adifferent role, but respect each
other's roles, right?
We're going to respect the roleof every single person on this
birth team.
They all have a little bit of adifferent expertise and
everyone is.
We're striving for the bestexperience for the birthing
(18:24):
person and her baby.
Right, the premier goal ofevery single birth team is
healthy mom, healthy baby.
There's a lot of other goals wecan get along the way and
hopefully we can all strive toget those which are empowering
birth experiences, positivebirth experiences, collaborative
birth experiences where peopleare made to feel good, uh, even
in a hard situation, they'remade to feel better, they're
(18:45):
made to feel supported, um, andthat they can feel people really
, truly do care about them.
I love having that role on thebirth team Actually, I'm headed
out to a birth in just a fewminutes.
I wanted to squeeze this inbefore I headed out Um and
hopefully it will be an awesome,positive and empowering birth
experience for the client I'llbe joining today.
Thank you so much for beingwith us and hope you have a
(19:06):
great day, night, week, weekend,wherever you are, and, as
always, please reach out tosomeone near or far and make a
human connection today.
Make a difference in someoneelse's life you never know what
a difference that can make and Iwill hope to see you next time.
Thanks so much for being here,and this is Angie Rosier signing
off with the Ordinary DoulaPodcast.
Speaker 1 (19:39):
Thank you for listening to the Ordinary Doula
podcast with Angie Rosier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth.
Thank you.
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