A Doula's Role in an Unplanned Cesarean Birth

Recently, I had a mama call me in tears saying, “we don’t need you anymore.”

Here is the backstory: Her bag of waters had broken, and she was admitted into the hospital. Soon after, it was discovered that her baby was breech. She was at a hospital that was unable to accommodate a vaginal breech delivery. While she was waiting to be scheduled, she called me in tears.

I could hear the disappointment in her voice. This wasn’t what she had hoped for. When we think realistically about what we are getting ourselves into by bringing another life, another personality, into this world, there is always some expectation of a loss of control in labor, but my client had not even been given a chance to get this baby out on her own. She had been dealt a crappy deck. It wasn’t fair. And she felt she had lost all control.


As a doula, part of my job is to help my mamas make peace with their birth experiences. So when she called and told me, “we don’t need you anymore,” I felt like she misunderstood my job in the first place. I am not part of the birth plan that gets thrown out when the flowery, quick, painless vaginal delivery goes off course. On the contrary, the moment things go off course is the moment I get to work. If everything went as planned, you wouldn’t need me in the first place. If it were up to you, you might prefer to push that baby out in an hour and head home to a warm bath.


Of course, it is YOUR birth. It is YOUR choice to respond to your circumstances in whatever way you see fit in the moment. But here’s what I can do if you allow me in:

  • I can still bring those LED votive “candles” that we were planning on, and place them all around the room while you wait.
  • I still have massage oils and a license to provide massage.
  • I can still be a supportive voice through what is still going to be a very influential time in your life, and probably scarier than what you were expecting.
  • I can still help you understand what your options are, and what the doctors are saying.
  • I can still be your friend, your sister, your “birth slave”, even though this isn’t how you were expecting my role to play out.
  • I can still assist you with breastfeeding, or make sure there is a lactation consultant on shift, because you might need a little extra help once your baby comes via cesarean.
  • I can contact your placenta encapsulator, because with this new turn of events did you remember that you had planned for that?
  • I can tell you jokes if you need a little lightheartedness in the room, or cry with you if you need someone to break down with. I can empathize, sympathize, be loud, be quiet, bring you water, hold your hand, and offer you the support that is my job -- my honor -- to provide.


I’m still pretty new to this, but in my experience, things NEVER go exactly as planned in labor. That’s why you have me. It’s up to you how you want to use my offerings. Know that whether you decide you “need” me or not, I’ll be in the cafeteria for as long as it takes, until I hear that your baby has been born and you are both safe and sound. And after today, I’ll be calling you to process this experience. Because birth is a traumatic event, no matter how your baby comes into the world. Everything in your life changes around this moment. And while it is your job to protect your baby and your family, it is my job to look out for you. Please, let me do my job. Let me in. It’s why you hired me in the first place.