Collaborating with

Medical Care Teams

Doulas are part of a care team that may include midwives, OBs, other clinical specialists, nurses, partners, and family members. Collaboratively engaging various members of this team can be key to nurturing a positive environment for the birthing family.

In the US, 98% of births take place in hospitals, so working with hospital and medical staff will most likely be part of your professional experience. Here are some ideas and approaches to consider as you begin to imagine how such collaborations might work.

• Collaboration with medical care professionals is closely connected with issues of advocacy. Please read our document on advocacy, and keep those ideas in mind as you think about collaborative practices.

• Having a “good relationship” with your client’s medical care team is sometimes a prerogative of privilege. Too, there may be times when you will have to choose between having that good relationship and properly supporting your client. It is also generally true, however, that maintaining some sense of harmony and joint purpose with medical care staff can be key to a positive birth experience. You will need to activate all of your sensitivity, intuition, and discernment to evaluate when and how it is possible and safe to work collaboratively with a given medical care provider or team.

• Be aware of how you speak to your clients about their specific medical care provider, or medical care providers in general. You should of course be honest, and answer any of your client’s questions truthfully, but always work within the framework of trying to offer what is authentically helpful to your client in that moment. Shocking their system with negative information that they are not prepared to process is probably not helpful, either to the client themself or to the strength of the relationships within the birth team (including your relationship with your client).

• Remember that while you may have a lot of information about your client’s medical care provider/hospital, you have no knowledge of what the outcome of this particular birth will be, or how your client will feel about it. Seek a balance between allowing your previous knowledge to guide you and maintaining an open sense of beginner’s mind as the labor and birth unfolds.

• Maintain clarity with your client, with the medical care team, and within yourself as to your role as a doula. Broadly speaking, doulas do not engage in medical care, give their clients medical recommendations, or make medical decisions on their clients’ behalf. Clear understanding of everyone’s role can help foster mutual respect and a sense of cooperative effort among members of the birth team.

• When possible, approach the medical care team with respectful collegiality.

• Introduce yourself (or have your client introduce you, whichever you feel to be more appropriate).
• Write your name and cell number on the whiteboard in the room.
• Remember and use the names of all staff members.
• If you are stepping out for any reason, let a nurse know, and tell them approximately when you will be returning. You can also note this on the whiteboard.        

• When possible, show yourself to be a helpful team member. It’s great if the staff feels that your client is well taken care of and that your presence is lightening their workload.

• Familiarize yourself with how to control the bed and the lights in the room; the location of things like linens, emesis basins, tissues, etc.; the pantry (a room on the floor that often has things like hot water, ice, a microwave, coffee and tea, etc.); how to get specialized equipment like a birth ball, peanut ball, birth stool, squat bar, etc. Use this knowledge to take care of simple things yourself, rather than asking the nursing staff to do it. (Do NOT tend to medical matters yourself.)
• Be aware of the space in the room. Do not physically get in the way of the medical care staff, particularly in moments of medical urgency. Do not stand between your client and a medical care provider unless there is a specific reason for your doing so.
• Try to maintain a tidy environment. Keep your possessions and the client’s possessions organized. Throw out trash, put dirty linens in the hamper, and so on.

• As you continue to work within your community, you will become more familiar with various care providers and hospitals. You may find, too, that you begin to develop ongoing professional relationships that will be helpful to your clients’ experiences and your practice.