Do Doulas Advocate For Their Clients?

• Transcript

  Welcome to doula Tips and Tits. This podcast is a place where we answer one question about doula work, both to support you and to help you support your clients. I'm Kaely Harrod. I've been supporting families in this perinatal space since my oldest was born 12 nearly 13 years ago. I am a birth and postpartum doula childbirth educator, lovely cheerleader and a doula coach. I love guiding and supporting doulas as they work out their doula business. It is a tremendous joy to be trusted in this way. Thank you for joining us on this journey. Hello, and welcome back. Today's episode is the first of a two episode miniseries talking about advocacy as a doula. Now, advocacy is kind of a hot topic in the doula world. And oftentimes, we hear it talked about in a variety of different ways. So we're gonna have two questions, one that we'll answer today and the next that will that'll answer next episode, and then we can kind of break down advocacy from there. So the first question that we're answering today is do doulas advocate? Are we advocates for our clients, especially, and primarily for this conversation in the birth space? So I'm not saying that people aren't advocates in the postpartum space as well, because we absolutely are. But this conversation is coming from a conversation with another doula that I've been coaching. And also, just really honing in on that birth space advocacy, kind of mid labor advocacy, right? Next episode, I'll answer the question, what exactly do we do to advocate Right? Like, what are some things we can say? How can that look? So I'll give you a little bit more like practical steps in that episode. So be sure to stay tuned for that one. If you're not already subscribed to the podcast, that's one way to make sure that you get notifications when that next episode comes out. It's coming out on Friday, these episodes released every Wednesday and Friday at midnight. And so that's when you can expect to hear that next episode. So So to start with, today, we're talking about the question, Do doulas advocate and advocate now? The short answer is yes. But if you've been around at all, you know, that most of my answers are a little bit more nuanced than that, because this space that we work in, has some nuance, right? There is some variety here. And so, yes, doulas advocate for their clients, what that looks like, is different, depending on the scenario. Now, do we also teach our clients to advocate for themselves? Absolutely. Do we help our clients self advocate? Yes. But also, sometimes we are advocating for them. And part of that is based on the fact that we have an inherent understanding of the process and, and what should be happening that our clients don't always have. So let me explain what I mean when I say that. So let's say you know, you are, you're at a birth scenario. And you know, every time a client comes into this hospital, they ask them these four questions, right? But then your client only gets asked two of those questions. And the other two are actually really important for their care. And you're like, Huh, that's interesting. Every other client I've ever had here gets asked all four questions, right? Then in that moment, your client can either never know that there are normally four questions asked, you can ask the staff a separate from your client, like, Hey, why didn't you ask those other two questions that you normally ask? Or you can kind of address it in the moment like, Oh, are we also going to talk about this thing? Because that's what we always do at this hospital, right? No matter which of those things you're doing, aside from doing nothing, aside from the option of like your patient, just your client just never knows that there are two questions that are incredibly important to them. That could have been asked but weren't. That's the only option. That's not some form of advocacy. Okay. So when I talk about advocacy, I don't mean you making decisions for your client. I don't mean you telling the staff or the team when and how they can do something. I mean, that you're providing equity and accountability in a space that is not always historically equitable and accountable right now. I want to add some layers here, because that's what I do. But also because, excuse me, because that's really important in this conversation. So when we're thinking about the layers, what I want you to think about is the US healthcare system. So I know that maybe not everyone listening to this podcast is in the US. But the majority of you are, I've looked at kind of the demographics of folks that listen, which I'm so grateful for all of you who are here listening, and finding this super helpful. So, so in the US healthcare system, we have a history of oppression, and racism. And that's on a level of class, it's on a level of gender, it's on a level of racism, of course, ethnicity, skin color, language issues. So there, there is bias, and a systemic inequity that is built into many of our systems in the US. Okay. So that's the foundation from which I am working in this conversation. So when we think about advocacy, part of what I am thinking is, there are scenarios where I see the difference in treatment of clients based on one of those things, based on their sexual orientation based on their marital status based on their skin tone, based on their English proficiency, right.

  06:41

  And in that moment, I believe

  Kaely Harrod 06:44

  it's my responsibility to help their experience be safer, and more equitable for them, it is not my responsibility to make the environment more comfortable for the providers, or the staff members who are bringing inequity into the birth space for my client. So that's my foundational belief, you're allowed to disagree with me. But then these two episodes aren't maybe going to resonate with you, because this is where I come from, when I speak about this, right? So when we talk about advocacy, it needs to be in the bigger context of the inequity that exists in the system. So I'll be honest with you, and and you know, that I don't shy away from having strong opinions about things, right. But I'm going to be really honest, that what I see, and I'm speaking this as a middle class, white woman, that is heteronormative, like so I fit in so many different things, right? Like I do live in a bigger body, I do have a multi ethnic family. So I have a few layers of slightly less privilege, but actually live a very privileged life. Right. And most of the folks that I hear in the birth world talking about doulas are not advocates are people who live in a privileged place, because most of their clients also look like them and live in a privileged place. And I don't mean that obstetric violence or inequity in the health care system only happens to folks who lack privilege, that's not the case. But also, if you're primarily serving clients who the system was made for, then you're going to see less of a need to advocate advocate kind of inherently right. So if you're primarily serving clients that are in the majority culture of what the healthcare system was set up for, which is wealthy white folks, middle class white folks, right, like a, a, like small bodied, pretty well off, well educated white woman, right? Like not trans, not queer, not like that the system was set up for that patient in labor and delivery, then you probably haven't had a ton of situations where you needed to advocate or where you witnessed injustice. I'm going to also be honest, this is just a this is just an episode of all the things. My firm stance is if you have seen inequity if you serve as a doula with clients, who have been recipients of inequity and violence in the birth space, and you did not advocate for them at all. That's problematic And I think you then in turn, continued to further that trauma. And that doesn't mean there isn't space to grow and learn from that. But I think continuing in that vein, continues to make birth dangerous, and that's not okay. And I'm honestly not going to apologize about that very strong stance that I have on it. Because I think birth is is something that we like to talk about as being beautiful. But the reality is that in our inequitable, completely biased, totally racist health care system, it is a dangerous thing for some people. And we have to know that and live in that space, if we're going to protect birthing people in the US system, we have to, and if you don't believe that, and you don't live in that space, please, for the love of goodness, don't ever have a person of color, or a trans person or a queer family or any of those folks who are victims of that system so frequently, as your clients because they need someone who can advocate for them. They need someone who will advocate for them. They need someone who yes will help them advocate, but also someone who will speak up if the system is sweeping them aside. Okay, so I'm gonna just step down from that soapbox for a minute. Next episode, I will talk some about actual phrases that I use that I have used that I recommend using, how I kind of talk about this with clients and how we sort of set this up in the process. So I do really recommend that you tune into that next episode, I realized that this is a very heavy conversation to have. If you're new to this conversation, even when you're not new to it, it's heavy, right? So I would be more than happy to have a conversation with you about this over on Instagram. Find me at Herat doula, send me a message. I'm more than happy to connect about this and hear your thoughts your feedback, your you know grumblings about this episode, but also to answer questions that you have because I think this is an incredibly important space. All right. I'll talk to you guys soon. Thanks for joining us for this episode of the doula Tips and Tips podcast. If you learned something today, or had an aha moment, we'd love for you to share that on Instagram and tag us at Herat doula, so we can celebrate alongside you. If you found this podcast helpful. We would so appreciate you taking a second to leave a rating and review on your favorite podcast app that helps other doulas find us as we do this work together. This podcast is intended as educational and entertainment it is not medical advice or business advice. Please consult your own medical or legal team for your own

  13:08

  needs around

Doulas are advocates. I will stand firm on this. If you do not see your role as ever advocating for your client then you are probably coming from a very privileged place. If you ever work with clients who are marginalized in our healthcare system you have to be ready and willing to advocate and amplify their voice. You center them, absolutely, you don’t speak for them or decide things for them, but you DO absolutely need to know how to advocate for and with them when needed.

Now, I realize this may ruffle some feathers. People have strong feelings about this. But I stand very firmly on my stand. Doula must know how to advocate if our future is going to involve safer birth for all birthing people. 

“Do we also teach our clients to advocate for themselves? Absolutely. Do we help our clients self advocate? Yes. But also, sometimes we are advocating for them. And part of that is based on the fact that we have an inherent understanding of the process and, and what should be happening that our clients don't always have. So let me explain what I mean when I say that. So let's say you know, you are, you're at a birth scenario. And you know, every time a client comes into this hospital, they ask them these four questions, right? But then your client only gets asked two of those questions. And the other two are actually really important for their care. And you're like, Huh, that's interesting. Every other client I've ever had here gets asked all four questions, right? Then in that moment, your client can either never know that there are normally four questions asked, you can ask the staff separate from your client, like, Hey, why didn't you ask those other two questions that you normally ask? Or you can kind of address it in the moment like, Oh, are we also going to talk about this thing? Because that's what we always do at this hospital, right? No matter which of those things you're doing, aside from doing nothing, aside from the option of like your patient, just your client just never knows that there are two questions that are incredibly important to them. That could have been asked but weren't. That's the only option. That's not some form of advocacy.”

Now, today’s episode is not digging into the how, just the reality that we must. Friday’s episode is the how, so stay tuned for that one. 

CONNECT with Kaely on TikTok or  Instagram

https://www.tiktok.com/@doulacoach

https://www.instagram.com/Harroddoula/

If you like this episode, don't forget to share it to your Instagram stories and tag me @harroddoula

Kaely Daily is produced by Kaely Harrod of Harrod Doula Services

It is sponsored by The Birth Prep Blueprint Childbirth Class

Music by Madirfan: Hidden Place on Pixabay