Breaking the Fear-Tension-Pain Cycle

Regardless of whatever your birth choices are, I am with you for your benefit alone. Using my education, experience, and my ability to help others remain grounded, I will see to it that you and your partner are well informed by using evidence-based methods and practices.

My personal methodology sits on four pillars of labor support; Physical, emotional, informational, and advocacy.


Physical support is important because it helps the birthing person maintain a sense of control, comfort, and confidence. Aspects of physical support provided may include:

  • Soothing with touch through the use of massage, counter pressure, or a rebozo

  • Helping to create a calm environment

  • Assisting with water therapy

  • Applying warmth or cold

  • Assisting with walking to and from the bathroom

  • Giving ice chips, food, and drinks


Emotional support helps the birthing person feel cared for and feel a sense of pride and empowerment after birth. One of my primary goals is to care for the mother’s emotional health and enhance her ability to have positive birth memories. Some of the following types of emotional support to the birthing person and their partner are:

  • Continuous presence

  • Reassurance

  • Encouragement

  • Praise

  • Helping the birthing person see themselves or their situation more positively

  • Mirroring—calmly describing what the birthing person is experiencing and echoing back the same feelings and intensity

  • Helping the birthing person and partner work through fears and self-doubt

  • Debriefing after the birth—listening to the mother with empathy


Informational support helps keep the birthing person and their partner informed about what’s going on with the course of labor, as well as provides them with access to evidence-based information about birth options. Aspects of informational support include:

  • Guiding the birthing person and their partner through labor

  • Suggesting techniques in labor, such as breathing, relaxation techniques, movement, and positioning (positioning is important both with and without epidurals)

  • Helping them find evidence-based information about different options in pregnancy and childbirth

  • Helping explain medical procedures before or as they occur

  • Helping the partner understand what’s going on with their loved one’s labor (for example, interpreting the different sounds the birthing person makes)


Advocacy can take many forms—most of which do not include speaking on behalf of the client. Some examples of advocacy that doulas have described include:

  • Encouraging the birthing person or their partner to ask questions and verbalize their preferences

  • Asking the birthing person what they want

  • Supporting the birthing person’s decision

  • Amplifying the mother’s voice if she is being dismissed, ignored, or not heard

  • Creating space and time for the birthing family so that they can ask questions, gather information, and make decisions without feeling pressured

  • Facilitating communication between the parents and care providers

  • Teaching the birthing person and partner positive communication techniques

Taking into account the past definitions of advocacy for nurses, and the desire of many doulas to support the birthing person but not speak in place of them, I’d like to propose a new definition of advocacy in the context of doula care:

"Advocacy is defined as supporting the birthing person in their right to make decisions about their own body and baby."


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