Saturday, June 13, 2015

Five Tips for Birthworkers Dealing with Challenging Client Choices

It happens to every one of us in our careers where we will feel challenged and triggered by some of the choices a client makes for themselves.  How can we continue to serve in the best way possible?

1) Receive
Sit with what your client is saying in a receptive way.  It is important you are not attached to having their choices resonate with what you would do in any given situation. Respond in a way that demonstrates you are receiving them.  The question "Could you tell me more about that?," invites your client to express their concerns and feelings, giving you an insight into their experience. Many clients will consider choices that feel radically different from the ones you feel are healthy and empowering.  Breathe, and listen.  Get out of your head, and drop down into your heart, that place from which the deepest listening space is held.  It is only by listening and giving space for their stories to unfold that you can begin to truly understand their needs, responding appropriately and effectively.  We have two ears and one mouth for a reason: listen at least twice as much as you speak.

2) Don't React...RESEARCH!
Imagine what might happen to the conversation if you met your client with a reaction to their potential choices with words such as, "But epidurals can lead to Cesareans or perineal tearing!", or "Formula feeding isn't good for your baby!", or "That is mutilation!"

 Doulas understand that fear can impact the birthing/postpartum experience.  We must be careful not to contribute to fear with our own reactions.  For one, it doesn't honour our clients.  For another, people tend to dig in their heels and stick to their guns in defensiveness if they feel attacked.  This shuts down the opportunity to have the good information you have to share received.

Once your client has talked out their decision making process with your support, you can, if they have felt safe enough in your presence to ask for more information, provide evidence based knowledge.  A clear understanding of the benefits and risks of any given choice can be helpful in supporting a client in a decision making process, but be careful how you give it.  Check in to see if you are being "persuasive" by emphasizing certain benefits or risks according to your own bias.  We criticize "the system" for doing this all the time, and must be mindful about  not participating in this game ourselves.  Direct clients to further resources (evidence based ones) so they can do their own research too. You can refresh your own knowledge as well on the subject, in case any new evidence has come to light you haven't yet heard.

3) Respect
It is not true that "if people just knew the right information they'd make "healthier" choices".  Health encompasses more than just the body.  Sometimes choices are made based upon what clients know is right for them mentally, emotionally, spiritually, and socially.  Only they can decide what is best for their and their family's well-being.  Your job is not to "make" them choose the things you think are "right".  It is simply and truly to inform and to support choice.

4) Reflect
If your client's choice irks you so much that you are challenged in your attempts to give them your respect, honouring the reign of their sovereignty over decision making, it is time to take a look at what is making you take this so personally.  Is it possible you identify yourself as successful only if you've "made" everyone feel empowered according to your own standards?  Are you identifying with and taking on the vulnerability of your client or their baby and want to "save" them, getting caught up in some counter-transference?  Is their decision striking a painful chord in your moral/emotional landscape?  Is your ego challenged by their not choosing what you've outlined? Do you feel "in competition" with their choices? Ask yourself these things gently and lovingly.

There are many examples of why it may be too hard for you to happily and effectively serve a client every once in a while. It happens!  You're human. Don't be too hard on yourself.  All people judge.  We can't help it.  Judgement doesn't make us "bad".  It is what we do with our judgment that demonstrates our character.

5) Renew or Release
If you witness your judgment, identify your triggers (you can talk to your mentor, a counselor, or a doula colleague about this), and find that after some reflection you are indeed able to support your clients' choices with respect even though it feels tough to you, carry on!  Renew your commitment to serve in an unbiased way.  If you cannot, that is okay too.  We all have areas within that are raw and unyielding.  We are all works in progress.  Every single one of us.

It is a gift to everyone to be able to own to yourself that you cannot serve these particular clients with the open heart they need to be met with.  In this case, release them from your care gently (you don't have to share with them it's because you aren't sympatico with their choices), with referrals to other doulas you trust, and wish them a most beautiful birth experience.  You have not failed, you have succeeded in ensuring someone has the best care possible.  That in and of itself is good doula-ing.