My Doula Guide: how to make confident decisions when nothing feels certain.

The pressure to make the right decisions during pregnancy, birth and postpartum is enormous; but how are you meant to do that when birth is unpredictable and you’ve never done it before? 

As I tell my antenatal and doula clients, the answer has far less to do with the outcome and far more to do with you…  

The pressure to get it right is where things start to go wrong.

A few births ago, a dad-to-be called me during day four of latent labour to vent his frustrations.

“I have just had enough of deciding and choosing and thinking. I want someone to tell me what to do and that it will all work out okay.”

It might not surprise you to know that I hear this all the time.

From the pregnant crew at Bump Club, to the new mums at The Nest and of course to all my 1:1 antenatal and doula families, everyone wants to do it right, and to have zero responsibility for it going wrong.  

Because getting it wrong is a universal fear: humans don’t like messing up at all, but when it comes to our babies and our births, the thought of a mistake is absolutely intolerable. 

And that makes sense; it’s evolution.

If we didn’t care that much, we’d have gone the way of the pandas… 

The problem though is not our insatiable quest to get it right, but the way we try to get it right.

• We do X so that Y happens. 

• We avoid A so that B is less likely. 

In essence we make decisions based on what will happen if we do them, seeking to control the outcomes of our birth and be the mistresses of our own destiny that society has raised us to be. 

The problem is that birth doesn’t work like that - and while we know that, rarely are we able to settle with that. 

Which leaves so many of us stuck in a cycle of doubt and confusion, regret and guilt about our decisions before we’ve even lived the moment we’re planning for.  

And as a doula, this is not something I am okay with.

You can control your decision but you can’t control the consequence.

The discussions that happen around the mat at The Nest reveal a lot about the state of the birth world in Cornwall, and I’ll be honest:  the horror stories of birth and postpartum outweigh the positive. 

Importantly, the reasons for the horror stories is rarely what happened. 

It’s how they felt. 

From the people belittled by authoritative midwives, to vulnerable new mothers left confused by health visitors who undermined both them and the advice given by others, their stories all settle on emotions. 

And when they reflect on those moments, the same phrases come out. 

• “I should have said…”

• “I wish I had…” 

• “I wanted to, but I didn’t…”

When we talk further about these things, there’s often a great deal of regret that they didn’t do something else, didn’t say what they wanted to or didn’t choose a different path. 

The reasons for that usually come back to one thing: they didn’t know what to do for the best. 

Aka control.

They were trying to create a consequence rather than react to an emotion. Instead of trying to satisfy a need in the moment, their focus was on creating certainty and long term security, based only on things that might or could happen or be true.

In attempting to do the impossible, they ignored the reality and tolerated something that made them feel distinctly worse. 

The result?

A lived discomfort and an ever present regret that they didn’t make a better choice.

FYI: this mindset has serious consequences.

As a birth and postpartum doula, I know what happens to people when they start to doubt their decision-making.

As humans, our self-esteem and self-confidence comes from our lived experiences.

Where we make ‘good’ choices, we build the resilience and respect for ourselves that helps us to face increasing challenges as we go forward. 

But the converse is also true: when we live experiences that make us question our abilities and capacity to make good decisions, so our self-esteem and self-confidence drops. This in turn makes facing the challenges yet to come even harder. 

And the journey through pregnancy and parenthood never gets easier: each challenge is harder than the last. 

So when we cast these judgements on our own decision making, based on the outcome rather than a feeling, we create a negative loop for ourselves. 

But this could easily be solved with a mindset shift. 

Remove the outcome from the decision, instead focusing on the decision itself. 

As Annie Duke explains in her pretty awesome book, ‘How to Decide’, good decisions are separate from the consequences of that decision. They are based on strong, unbiased and holistic information alongside emotional intuitiveness, and an appreciation of impact and likelihood rather than anything certain or specific.

This mindset is revolutionary for pregnant, birthing and postpartum families and I use it with my antenatal and doula families all of the time.

Of course, the outcome or goal will come into the decision making, but by shifting the focus away from that specifically and more onto the conditions around the decision itself, everything can feel more stable. 

More certain within a maze of uncertainty. 

The ramifications of this are game-changing too. 

The mother who wanted a waterbirth but got an emergency caesarean will see the strength of her rationale choices, over the failed birth plan. 

The family who wanted a homebirth but ended up with a 42 week induction and forceps, can unpick every route they explored first and appreciate that they really did everything possible in the moment. 

The first-time dad who was looking forward to a calm caesarean delivery but who caught his baby on the bathroom floor, can let go of the guilt of not getting her to hospital sooner because he sees what he did in the moment with reality and value. 

Each of these scenarios paint a very vital picture: this isn’t about instagrammable birth pools and fairy lights. It’s about making and appreciating strong decision making in the moment, knowing how to achieve this so that you don’t only walk away from birth feeling proud and confident, but that you can look back on that experience and use it for every decision that comes next. 

Positive decisions feeding positive decisions to create positive experiences. 

Believe me, that’s what matters most.

Six ways to make confident pregnancy & birth decisions when everything feels uncertain.

Making better decisions doesn’t start with research or outcomes: it starts with you.

1.Be led by goals based on feelings, not outcome. 

Positive births (and postpartum) come in all shapes and forms - what matters most is how you feel during the event. 

So… start your birth and postpartum planning with the emotions you want to feel rather than the things you want to happen. Eg: if you want to feel calm, what will help you there?

2. Don’t settle: seek ‘perfect’ knowledge 

Informed consent is only given when you understand the full picture: the options, the consequences and the side-effects. Rarely do we ever get this from a flyer, a leaflet or a social media post. 

So… ask yourself the question, ‘what else do I need to know about this, that I don’t already?’ and then go out and find it. And if you can’t find it, ask the people who know where to look.

3. Focus on the weight of your options, by looking at the preferences, the pay-offs and the probabilities.

With every decision comes a million different options; a pros and cons list will keep things flat because it’s all objective. But by adding in the ‘you’ dimension, clear winning (and losing) options will emerge to keep your decision making strong. 

So… instead of a pros/cons list make a decision tree and include some indication of how strongly each option fits your preferences, how closely it gets you to your desired outcome, and the probability of that outcome happening. 

4. Get out of your own head & seek the outside view. 

We are all biased, and never more than when we feel strongly for or against something. This bias will affect your decision to make rationale thoughts, balancing information in a way that suits your heart rather than your head. 

So… discuss your options openly with a critical friend, someone who understands the issue and will play devil’s advocate so that you can approach your decision in a balanced, rationale way. 

5. Look forwards and back again: how will your future self reflect on this decision? 

You know yourself, and you know what you want; thinking about how future you will look back on your decision increases the chance that you’ll focus on your preferences as a person in the long term (thus safeguarding your mental health) than the immediate need to choose.

So… ask yourself what you’d think of this decision if everything worked out as you planned. And then consider what you’d think of the decision if everything didn’t go as planned. Is the decision still the right one?

6. Prepare for the setbacks: emotional and bad luck 

Birth and postpartum don’t follow plans and that’s not why we plan for them - we plan so that should something go awry, we can deal with it smoothly safe in the knowledge of what we want to get close to. 

So… when you’ve chosen a path, acknowledge how you’ll cope with it if it doesn’t go as you’d like. Who will you rely on? Who will you look to for support and solutions?

As a doula, creating this kind of certainty is what I do best. 

I can’t guarantee how a pregnancy, birth or postpartum journey will end, and I cannot - with any real certainty - tell anyone what will or won’t happen on the way there. 

The certainty I create is in the focus on you and what you need: emotionally, informationally, rationally, logistically and mentally. I am the consistent presence throughout your journey to give you what you need to stay steady and calm, whatever happens. 

That’s why doulas like me make a difference. 

Sound like something you need?

Take a look at my doula packages, book a FREE discovery call and we’ll have a chat about how I can help to make your journey into parenthood so much better.