Birthing Without a Doula: Advocating For Yourself

More and more, conversations have shifted to spotlighting how essential a doula’s support can be during a woman’s pregnancy and subsequent birth. Whether they are advocating for a woman or a couple during pregnancy, labor or the fourth trimester, their work is rooted in being a guide for new parents. 

“As a doula, I work closely with my clients throughout pregnancy to provide information on healthy pregnancy practices, nutrition, birth choices, breastfeeding and postpartum care,” explains Carson Meyer, birth doula and founder of C & The Moon. “I get to know each client’s unique individual needs and preferences to best assist them through their journey.” 

Doulas help build the bridge that helps support a family’s transition into parenthood—but doula services can be expensive, and may not be covered by insurance. It’s not an option for every family, which is why it’s especially important to be your own advocate in pregnancy, labor and birth.

Related: My husband won’t be my birth coach—and we’re both okay with that

Making doula services more accessible

Meyer is also an advisor for Little Honey Money, a cash fund baby registry that enables new families to register for wellness or pregnancy support gifts, like a doula, prenatal massages or breastfeeding support, spreading out the cost of these helpful services among family and friends.

According to Lori Bregman, doula, co-founder of Seedlife and advisor to Little Honey Money, having a doula or understanding how to advocate for yourself like one is essential, particularly given the reality of doctors appointments. 

“These days doctors appointments are limited to 10 to 20 minutes,” explains Bregman. “In those 10 minutes, it’s hard to establish a real connection and have all your questions and concerns answered.” 

While platforms like Little Honey Money and Poppy Seed Health (which offers on-demand support from a doula, midwife or nurse) are making doula services more accessible, it’s still powerful to understand how and when to advocate for your rights. 

Set yourself up for success

Even without a doula, it’s possible for both you and your birthing team to create an honest, positive foundation for your birthing experience. 

As you start meeting with your medical experts, one way to begin advocating for yourself and encouraging openness is to share any past trauma that may resurface during your pregnancy or labor. 

“Share your family history if you feel it is relevant to helping them understand a bit more about you,” encourages TaNefer L Camara, MS-HCA, IBCLC Mom, Lactation Consultant, Doula, and Maternal Health Strategist. “Share your learning style and how best to communicate or how you prefer to receive information.” 

Other ways to help set the stage for success is to put your birthing plan and desires on paper, so that anyone who needs to reference it has it available to them. 

Your birthing team, plus friends and family can also take it upon themselves to help you advocate for yourself by being privy to your birthing plan or reading books like The Birth Partner by Penny Simkin.

Know what red flags to look for in your medical care

“Your care provider for pregnancy, labor and beyond should partner with you,” explains Tesiah Coleman, MSN, WHNP-BC, AGPCNP-BC, CLC, the director of virtual care at Tia, and a doula and health equity advocate. “Steer clear of providers who dominate the conversation or decision-making. If they can’t listen to you during your prenatal visits, then they certainly won’t while you’re in labor.” 

Coleman adds: “If a provider insists on a treatment or plan you don’t agree with, ask for a record. You can say things like ‘can you please put in my chart that I do not agree with this plan and am asking for an alternative.’ Make sure you ask to see the clinical note after it’s written. Typically they would rather work with you than risk writing that disclaimer and having something go wrong.” 

Other red flags to look out for include doctors dissuading you from seeking additional support (like doula support), mention of a big baby, encouraging inducing labor for non-medical reasons, disregarding your fears or concerns around birth, or anything that makes you feel personally uncomfortable. 

Practice self-advocacy

Hardly anyone is an expert at advocating for themselves, particularly in tense or medical situations. Everyone has to practice and reaffirm their right to do so. 

“It can be intimidating to advocate for yourself in medical situations because your medical provider is supposed to be the expert,” explains Josephine Atluri, mindfulness coach & author of 5 Minute Mindfulness for Pregnancy.  “However, it’s your body and you know best how you are feeling. It is in your right to ask all the questions that are weighing on your mind and to advocate for things that you want to pursue in your medical treatment.”

Atluri encourages starting by asking yourself why you’re having a hard time asking for help or advocating for yourself, as shining a light on what may be stopping you can help you figure out where to go next. 

Leaning on different breathing and meditation techniques either before or during the moments you’ll need to advocate for yourself can also be helpful. 

Clarissa Edmondson, CBE, doula, pregnancy & infant loss advocate and advocate at Poppy Seed Health, shares a template that can be useful when practicing advocating for yourself in real time: 

  • I am _____ weeks pregnant, and I would like information on better preparation for my upcoming birth. My expectant due date is ___________. 
  • I would love information on the birth process, I am planning a ________ (hospital/home birth). I would prefer a ___________ (medicated or unmedicated birth). 
  • Lastly, I would like information on navigating postpartum. 

Related: 4 simple things you can do to have a better hospital birth

You deserve a safe and healthy pregnancy and birth

Knowing your medical rights and reminding yourself that you are always in your right to refuse or delay care or get a second opinion also helps build your confidence ahead of having to speak up for yourself in a medical situation. 

Most importantly, it’s key to remember why you’re advocating for yourself. 

“You are advocating for a healthy pregnancy, birth and postpartum,” explains Edmondson. “[You’re] protecting yourself and your baby, and making sure that you have all your options readily available to you.” 

No doula? No problem—experts share how to advocate for yourself during pregnancy