Although a common misconception is that doulas are only for those planning a birth without pain medication, the truth is that doulas have skills to support all the ways in which families give birth. And while most people who decide to hire a birth doula do plan unmedicated vaginal birth, some of those people will give birth by Cesarean, whether planned or unplanned.

Doulas provide emotional support, physical support, informational support, and advocate for the patient’s right to make their own medical decisions, so doula skills translate to all different childbirth scenarios. Here are some of the ways I provide doula support to my Cesarean families.

• Prenatally, with all families, I discuss what to expect in a Cesarean birth, and what the family would like to preserve from their birth plan if they birth by Cesarean. The majority of my clients are birthing in hospitals in the United States, so on average, 31.9% of them will birth by Cesarean, and they all need to be prepared for that scenario.

• Hospital policy varies widely in regard to doula support in the operating room, so I inform my clients of the policies of their chosen birth place.

• When a client plans a scheduled Cesarean birth, I discuss again prenatally what is important to them in their birth experience, and prompt the birthing person to self-advocate for their wishes that are not routine, for example requesting a clear drape to witness the moment of birth.

• For scheduled Cesarean births, I often meet the family at the hospital during their preparation time. During this time I help the birthing person to stay calm, remind them of their birth plans, help them to stay comfortable, help them gather any additional information, provide emotional support, and take photos as desired.

• When hospital policy allows my presence in the OR, I often take photographs, reassure the birthing person that the pressure and pulling sensations are normal and expected, and help facilitate whatever will help my client feel more relaxed.

• When hospital policy does not allow my presence in the OR, I coach the birth partner on what to do to support the birthing person. I remind them of the birth plan. I remind them to take photos, or as a nurse to take photos, of the baby’s first moments after birth, especially the moments the birthing person cannot witness personally.

• Often, even if OR support is restricted to one person, I am allowed to provide OR support to the birthing person when the birth partner needs to accompany the baby to the NICU. When baby and birthing person are healthy and can stay together, then I am able to provide support in recovery upon my client’s request. This immediate postpartum support is very reassuring to the birthing family, the partner can stay with the baby knowing the birth giver is receiving support, and is with someone familiar.

• For unplanned Cesarean births, I facilitate more conversation between my client and the medical team as the situation allows, making sure my client asks all their questions and is well-informed.

• For all Cesarean births (OK, for all births!), I remind the clients that they need to prioritize recovery, taking physical activity seriously, and slowly, caring for themselves and one another physically and emotionally. I encourage all my clients to consider their needs during the intense first weeks of postpartum, and how they plan to meet those needs while recovering and caring for a newborn 24/7

Doula support is beneficial for all methods of birth, and my own focus as a doula remains unchanged no matter how my client gives birth. I remain focused on providing emotional support for their situation and their decisions. I remain focused on providing physical support to increase comfort. I remain focused on informational support by either providing resources and information or directing the client to appropriate sources. And I remain focused on advocacy, supporting and upholding my client’s right to make their own medical decisions and decisions for their baby.