Questions to Ask as a Doula in Tricky Situations

Being a doula means stepping into all kinds of births, each unique in its own right. Some flow smoothly, while others can take unexpected turns, putting you in challenging positions. Knowing what to ask your clients when you're in the thick of things can help keep the process moving in a way that honours them, their choices, and the sacredness of their birth experience.

But let’s face it, tricky situations will come up. You may find yourself in the middle of a tense moment where your client isn’t sure what to do, or the medical staff are presenting interventions that need decisions fast. In times like these, how you handle the situation could make all the difference. And, most importantly, it all starts with asking the right questions.

Clarify and Confirm with Your Doula Client

When the waters start to get murky, your first step as a doula is to seek clarity. This is not about what you think should happen, but about understanding what your client truly wants. As soon as things feel off-track or uncertain, turn to them and ask, "What do you want to do?" or "How are you feeling about this?"

It may seem simple, but these questions can open up space for a deeper conversation about their needs, fears, and hopes. Often, people in stressful situations don’t have a clear idea of what they want right away—they just know they feel pressured or confused. Giving them a chance to voice their concerns and thoughts can ground the entire situation. Your job is to help them peel back the layers and explore their emotions, so they can get to the heart of their desires.

In many cases, clients may not even be fully aware of all their options. They may be overwhelmed by a rush of medical jargon or by the stress of the moment. This is where your role as an advocate comes into play. Be that calming presence, gently prompting them to slow down and focus on their wishes. You might ask, "Would you like more time to think this through?" or "What questions do you have right now that need answering?"

Taking time to gain clarity may also create a ripple effect that impacts the entire birth team. When the birthing woman can express what she wants, it sets a tone of empowerment and helps ensure that decisions are made with her full consent.

Research has shown that clear, open communication during birth can reduce unnecessary interventions, leading to more positive birth outcomes. In a 2018 study published in BMC Pregnancy and Childbirth, women who reported having clear, consistent communication with their care team were more likely to experience a sense of control and satisfaction during their birth.

Offer to Get More Information

Knowledge is power, especially in tricky birth situations. As a doula, you're not there to provide medical advice, but you can absolutely offer to get more information. If your client is unsure of the pros and cons of a particular intervention or decision, step in to support them by suggesting that they get a clearer picture before making a final choice.

For example, when an unexpected situation arises, clients may feel pressured to make an immediate decision. At that moment, you can calmly say, "Would you like me to help you gather more information on this option?" or "Shall we ask the care team to explain the alternatives?"

Informed decision-making is critical. According to research from The Cochrane Collaboration, informed choices in childbirth significantly improve the birthing woman's satisfaction with the experience. When clients feel they’ve had the chance to understand their options fully, they are more likely to reflect positively on the birth, regardless of the outcome. Doulas play a key role here by facilitating the flow of information between medical professionals and the client, ensuring the birthing woman isn’t rushed or left in the dark.

Sometimes, the more challenging the situation, the more important it is for clients to feel empowered. While it might be tempting to simply reassure them that things will be fine, offering them the tools and knowledge they need to make the best decision for themselves is far more valuable. And if they need time, suggest it. "Would you like to ask for a few more minutes to think this through?" can be a crucial question that offers them breathing room.

In some cases, you may find that your client is struggling with conflicting advice from medical staff or even family members present at the birth. In such situations, it's essential to encourage them to filter out external pressures and focus on what feels right for them. Offering to explore different resources or consult with other professionals can help ease their concerns and solidify their confidence in their decision-making.

This Is Not Your Birth or Your Baby

Doulas, by nature, are empathetic. It’s a quality that makes the work so impactful, but it can also make it difficult to separate yourself from the situation. When you're deeply involved in supporting someone through their birth, it’s natural to feel connected to the outcome and to want things to turn out in a certain way. However, a key question you need to remind yourself of is: "Whose birth is this?"

It's easy to get swept up in emotions, especially when a birth isn’t going as planned, or when you see a client struggling to make a decision. But no matter how invested you feel, always remember that this is not your birth or your baby. It’s a powerful grounding reminder. Your role is to support, not to direct or impose.

What might be a big concern for you—such as an intervention you disagree with or a path that veers away from a natural birth—may not be as important to your client. Letting go of your own ideas about what the 'best' birth looks like is essential to being an effective doula. Some doulas fall into the trap of projecting their own wishes onto the birth, especially if they’ve had strong views formed from previous births they’ve attended or their own experiences. Stay mindful of this. Take a step back and ask yourself: "Am I offering guidance based on what they want or what I think they should want?"

The emotional attachment that doulas often feel toward a birthing experience is understandable. You care deeply, but always keep in mind that your role is about support, not control. Each birth unfolds in its own way, and your client’s experience, not your personal beliefs, must take priority. This approach not only honours the birthing woman but also ensures you can step away from the birth experience without carrying any undue emotional burden.

Support Your Clients in Their Decision

Once your client has made a decision, whether it aligns with what you would have chosen or not, your job is to stand behind them fully. If they opt for an epidural after initially wanting an unmedicated birth, or if they agree to a caesarean after days of labour, offer your unconditional support.

Sometimes, your client’s choice may surprise you or feel unexpected based on the journey you've shared with them. But at that moment, it’s not your role to question or critique—it’s to be a pillar of strength for them. It can be helpful to say things like, "I completely trust your decision", or "I’m here for you, no matter what."

Research by BirthWorks International highlights the emotional benefits of having a non-judgemental, supportive presence during birth. When birthing women feel supported in their choices, they experience less fear and more confidence in their decisions. As a doula, your presence is integral to creating that emotional safety net, particularly in the most challenging moments.

One of the best things you can do when your client makes a difficult decision is to remind them of their strength. Sometimes, in the moment, clients feel like they’ve failed or like their bodies have let them down. Offer kind words of affirmation, reminding them that every birth unfolds in its own way and that making an informed choice is its own victory.

Doulas have a unique perspective, being present at so many births and witnessing the highs and lows of the journey. But it’s essential that your personal experiences don’t cloud the support you offer. Even when clients change their minds mid-labour or opt for interventions that might not align with their original birth plan, your unwavering presence will help them feel validated in their decisions.

Accept That You Have No Control and Don’t Get Attached to the Outcome

Doulas, by their very nature, love to nurture, protect, and create safe spaces. It can be incredibly hard to accept that in many birth scenarios, you have no control over the outcome. Birth is unpredictable, and while you're there to support your client in every way, the final outcome is not in your hands.

This is where the art of non-attachment comes in. Non-attachment doesn’t mean you don’t care; it means you trust the process. No matter how much preparation you and your client have done, things may still take unexpected turns. You might have a beautiful birth plan laid out, but birth often laughs at plans.

Remind yourself that it’s okay for things not to go according to plan. What matters most is that your client feels heard, respected, and empowered in their choices. Even when the situation feels beyond your control, you can still control how you show up. Stay calm, stay present, and trust that you’ve done your best to support your client in their birth journey.

For some doulas, releasing control can be one of the hardest parts of the job. But remember, birth is about the woman’s experience, not yours. You may have feelings about how things are unfolding, and that’s normal, but it’s important to process those feelings outside the birth space. Allow yourself to step into a place of acceptance and trust, focusing on what you can offer in the moment: calm, reassurance, and unconditional support.

Being a doula means carrying the stories of many births with you, but each birth is its own distinct journey. The unpredictability of birth is something to embrace, not resist. By staying grounded in your role, you offer your clients the reassurance that, regardless of the outcome, their choices are valid, and their experience matters.

The role of a doula in tricky birth situations is multi-faceted. You are there to clarify, support, and guide, but above all, to remain flexible and compassionate. Asking the right questions opens the door for your client to make empowered choices and those choices—no matter how difficult or unexpected—are theirs to own. By remaining grounded in your role, you can help your clients navigate through the twists and turns of birth with confidence, strength, and trust in their own power.