I was reading an article on new collaborative efforts between doctors/medical staff and chaplains/spiritual leaders in the healthcare space
to improve overall health outcomes and experiences. One distinction the author identified between the different care approaches of these two groups is that medical staff are often focused on answering the question, “what is the matter?” whereas chaplains help folks answer “what matters?”
What a beautiful description of what a doula does! We help folks navigate
the space where they are asking both of these questions at the same time, and we help folks find the answers in a manner that is integrative to the client.
For example, I bring two primary birth pans to my 36 week prenatal visit
with clients. The first plan goes down a whole list of questions or options
that may come up at their birth. If hypertension is the “matter,”
what options might they have for treating that? Or, clients may text me with
symptoms, and I can offer them questions to ask their provider to help them figure out “what is the matter.” The second plan I go over is an
emotional birth plan. It is completely focused on learning what matters in the birth space for that person, and guides a creative discussion for how to honor that in a way that supports any physical matters (or birth location policies). And over the course of this visit, and throughout all prenatal, birth, and postpartum care, I am constantly balancing these two questions, and integrating their answers.
I do find that most medical providers and staff are, necessarily, more
focused on what is the matter. We really want them to do this! If there is a
concern, we deeply want and need providers who can help us identify and treat it. And then my job is to also serve as a gentle reminder to these staff that we must also hold “what matters” as an equivalent priority.
This is often where my job gets tricky. There truly is a power dynamic in
the birth space between the medical “authority” and the patient, and
the doula. As a human myself, I also don’t like being reminded of priorities,
or “questioned,” or corrected. Inviting in the question of what matters, reminding a provider of what a client clearly said they wanted, or questioning if there might possibly be a different course of action that could
produce a better outcome, must be done so gently. In my role, this power
dynamic challenge is “what is the matter,” and “what matters” overall is that there is as much birth team collaboration as possible for the sake of the
client. My goal as the doula is not to force a provider to make a change, but to still hold both of these things together and keep the relationships center.
There are so many unique situations that arise at births. Every birth I attend is so unique, and there is learning to be found at every one. That is a huge part of why I love my job! Learning about what matters to my clients on a deep level, and creatively helping them bring that learning into the birth space, is so rewarding and so important.
If you’ve birthed before, did you have someone holding that space (gently
and sometimes with firm boundaries) for what mattered to you? How did you, or how would you know what matters to you? My last tidbit of advice is that often, once we find out what deeply matters, there really are multiple paths in every birth to connect to that deep need. We can worry slightly less about specific tools to use or not use, and find ways that any tool can meet that underlying need. No matter what is the matter, we can support what really matters.