"What's your rate of natural birth?"

[happyartmama]

I work as a doula and I'm sometimes asked by prospective clients what my "rate" of natural birth is. What percentage of the clients I work with "end up" going unmedicated. How do other people answer this? The thing is, I think it's a fairly "good" rate, but I don't really attribute that to me! (at least not solely--the mama's the one doing the work, often with remendous support from many sources.)

So many factors play a part in whether or not a mom ends up with the birth she wanted/anticipated/planned for, including an unmedicated one. But I feel like if I try to explain that to couples, they get the sense that I'm trying not to answer truthfully, or like "my" rate must be bad so that's why I'm not giving a figure. Anyone else encounter this, and how did you handle it?

[Rockies5]

I've never gotten that question but I always say that the couples I have worked with and taught get exactly the birth they wanted and planned for.

Don't they understand that hiring or inviting a doula to their birth isn't a guarantee of anything but support. You can't promise people that their birth will be X, Y or Z any more then anyone could.

How clear are your advertisments on above point? maybe there is some sort of miscommunication or something they're gleaning that you don't intend?


or next time you could just start off the first conversation with how having a doula isn't a guarantee? Its more a guarantee then anything else one can do, but still....

[stayinghome]

I say that my job is to make each individual woman work towards the kind of birth she wants- whether medicated or not. I've never had it pressed beyond that.

[happyartmama]

In my brochure and info. packet that I hand out for them to look over (before signing a contract), it specifically states, "I can not guarantee the outcome of your birth." I think most people are clear that I can't "make" them achieve a natural birth if that's what they want, but there's still perhaps an unconscious belief that if a doula attends almost all unmedicated births, then it MUST be somehow connected to her specific techniques.

It comes more from couples uncertain to begin with...."We really want an unmedicated birth, we're taking a class, etc., but we're just not SURE we can do it." So then I talk about how there are many things you can perpare for prior to birth, and then there are other X factors beyond your control (what time you go into labor, baby's specific position, how quickly your labor progresses, etc.).

Maybe it's because in this area, most couples hiring a doula interview several (we pretty much all know each other or of each other); all other things being equal (personality, fee, etc.), maybe they go by the "rate?" I don't know. I'm hapopy with this work, and it doesn't come up all the time, which is probably why it still throws me when it does. :

[tlcdoula]

If someone asks me that I tell them that I honestly cannot answer that question for them because I have some moms who plan on having medicated births who hire me, some moms who plan on having cesareans who hire me, so I would have to sit down and calculate out those who planned on going unmedicated to figure out what my statistics are. I also explain to them that there are several determining factors on whether a woman has a "natural" birth that are completely out of my control such as the healthcare provider that she chooses or the birth place that she chooses and I go into great detail on how those things can impact her birth even more so than how a doula can impact whether the mom is natural or not.

I think in this day it is also very important to first understand what someone is asking when they ask about "natural" birth because many moms I come in contact think "natural" means vaginal and they are not even asking about medicated versus nonmedicated.

[wumanh]

Maybe you can turn it around and ask them the questions: What rate do you think is a good one? or What percentage of women do you think can birth naturally overall regardless of whether they have a doula or not? What makes you ask that? Do you think a doula has that much effect or control over that? How do you think a doula might influence the likelihood that a woman will birth naturally? What other factors or influences are you aware of?
You get the idea. You can also answer honestly with your rate but also educate them that there are a lot of variables.
You might be able to break it out by caregiver- Well, the moms who have so and so as caregiver seem to have more natural births or who go to XX hospital or birth center.
or Moms who have natural births seem to be the ones who______ (eat well, are comfortable with their bodies, have good support, etc.) whatever you notice making a difference.
Let us know what you come up with.

[happyartmama]

Those are good suggestions. Maybe I can refer back to how I answer another question I'm often asked ("What do you think makes the most difference in women who suceed in having an unmedicated birth?"). I usually respond that all other things being equal (no unusual complications or risk factors), it seems to be the moms who are committed and confident in their body's ability, coupled with the ability to truly relax and work with--not against--what their body needs to do in labor.

Thanks for the help!