The Informed Decision, The doula and the Birth Plan

7/11/2013

The process for making a truly informed decision takes new information and marries it to old information and must consider personal circumstances. It is for this reason that different people facing similar decisions will make different choices.

It is essential that options are known and people are given the time and the freedom to choose. Being asked to make an on-the-spot decision under stressful conditions with limited information is not an informed decision.

The doula facilitates the Informed Decision by providing informational support by guiding people through their current understanding and experiences, helping them gather the new evidence-based information and interpreting it into context with personal circumstances,

A doula should approach preparation support (as with other aspects of doula work) with empathy, unconditional positive regard and congruence. Her role as a paraprofessional is not to provide advice, but to support understanding and provide a space for decision making and support birth planning.

The birth plan document is the result of much research and preparation, many questions between care provider and client, and contains a summary of informed decisions for all possibilities. It is the “if this, then that” working document prepared in conjunction with care providers.

When it comes to informed birth preparation, a doula bridges the gap in care provision as a continuous and impartial third party by facilitating a thorough and workable birth plan.

2 Comments

Karin Leonhardt link

25/3/2021 05:04:55 am

I have a question: We don't answer the parent's questions, we just give them questions and they are responsible to ask their caregiver?

Catherine Bell

6/4/2021 11:20:47 am

Hi Karin,
As a doula, If you are asked a question, by all means provide information, which may prompt other questions to ask. We facilitate a discussion, giving them a chance to explore their options, without directing them, so that they can draw their own conclusions. This approach allows us to step away from our own bias, and make space for our client to come to a conclusion that makes sense to them.

The client is the decision maker.

The care provider has a responsibility to provide risks, benefits and alternatives for care options. Knowing the questions to ask can help draw out more information, and increase understanding. Our client needs the confidence to be able to fully discuss their options with a care provider. Questions can be the key to building this discussion. The care provider needs to be able to record 'informed' consent (or refusal) to 'recommended' care. The client needs to be able to make a decision, feeling confident they understand their options.

When our client feels settled in a decision, they are likely to no longer feel the need to ask questions for that aspect of their care. Asking questions helps them to be sure they fully understand their pathways. As new information comes to light, they may adjust decisions or reassess pathways, the better they understand the different pathways, they better they are able to assess the best way forward based on that moment.

Our role as a doula does involve answering questions, by providing information...but helping them to place that information into a context that makes sense with their values, circumstances and goals. so in answering questions, we provide space for discussion because ultimately the answer is their decision.

The Informed Decision, The doula and the Birth Plan

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