Certainly these are precious relationships. A doula would never dream of assuming the role of the laboring mother’s own mom, sister or friend. There is a connection there and it is not a professional doula’s place to step into the role of closest confidant.
In fact, a labor support tends to be much more effective if the person doing support is NOT be emotionally attached to the laboring mother. Though it seems counterintuitive, it makes sense from the perspective of the support person. It is difficult - if not near impossible - to expect a close confidant to detach themselves from their emotions while they watch their loved one experiencing labor - even when they cognitively and intuitively know that labor involves a measure of pain.
Sympathetic friends and family members tend to be just that - sympathetic - and they usually just want their friend to be comfortable. Their hearts are absolutely in the right place when they want their friend, sister, or daughter to “feel better.” They want to “fix it” - but the problem is that “it” isn’t broken.
Birth is normal. It is hard, rewarding work, but it is usually very uncomfortable. To ask a loved one to check their own emotions at the door in order to support a birth isn’t necessarily fair to ask of them.
Furthermore, a laboring mother often times will pick up on the way that their labor is making her loved ones feel. In her vulnerable mental and emotional state during labor, she will often times take steps to make those around her comfortable, even if that compromises what she wanted for her birth.
Birth doulas go through months of training, and upon certification, continuing education is required for certification maintenance. A doula is well versed, among other things, in the mechanics of labor, the various ways to support labor, the emotional signs of the stages of labor, all available birth options, evidence based birth, optimal fetal positioning, birth medications, effective communication in all birth settings, and the risks, benefits and alternatives to all the available options in birth.
These are all crucial skills to have in supporting a birth. Birth support involves understanding and navigating all the available options as labor progresses and changes. A supportive friend can be effective emotional support, but they likely can not bring the professional skills that a doula does - unless they are a doula.
For example, say you are experiencing back labor. Back labor is usually caused by the back of the baby’s head pushing on the lower back. It is best remedied by turning the baby into a better position for birth. If you are experiencing back labor, a doula will be able to provide hands on physical support specifically tailored to back labor that will keep you as comfortable as possible. Meanwhile, she can suggest positions and utilize tools that are known for encouraging the baby to turn into a more favorable position.
During a back labor, your nurse may (or may not be) able to offer suggestions for positioning strategies. Either way, she will not be able to stay with you to provide her recommended support. Her job is to monitor you for medical safety - not comfort. A supportive friend may mean well when she encourages you, but she likely will not have the knowledge base to understand the baby’s positioning, contraction patterns to watch for, or what types of positions and counterpressure are most effective for managing a back labor.
Ideally, a mother will have the best of both worlds. She can have the emotional support of a sympathetic friend, mother, or partner, along with the birth expertise that comes with her birth doula. The combination of the two will give her all the uniquely tailored support she needs to labor in a way that is best for her. Additionally, the doula will support the other support people who are present, giving them a peace of mind about the normalcy of birth.
Have someone that understands YOU present.
Have someone that understands BIRTH present.
That combination will make YOUR BIRTH optimally supported, and give you the best chance at having exactly what you want.