How often have you been talking to a first time mom about doula care, and she seems so jazzed with the idea, and then her partner comes along. Suddenly, doula care is a non-option.

Ive seen many a first-time dad look less than thrilled with the idea of doula care. For many of them, a doula seems unnecessary. She is an unnecessary expense and an unnecessary intrusion. She is another stranger to be a voyeur at a private time, another person to boss you around. She is someone who might shunt dad to the side.

When addressing dads regarding doula care, it is important to listen to and validate their fears. It is perfectly normal for them to be uneasy and entirely understandable for them to feel threatened. It is completely natural for them to question the cost and necessity of your very existence. That is when you have to convince them.

Top five dad fears (not always articulated this bluntly):

1) Youll make them look bad

2) Youll exclude them

3) Youll make them feel dumb

4) Youll interfere with and control their partners wishes at the birth

5) Youre overcharging for something nurses do anyway

Youll make them look bad:

This can happen only if a Doula isnt doing her job. As far as I see it, part of my job is to support and enhance the family bond. My job is to make the dad look GOOD. I will quietly prompt, slyly hand over a Kleenex or a cold cloth, and make sure he gets as much credit as possible. They are the couple, they are the parents. It is not about me.

Youll exclude them:

I always endeavor to include the dad to the comfort level of both him and his partner.

How do I gauge this? I pay close attention to cues at the birth, and I make darn sure to cull information from the couple prior to the birth. I will ask specifically of the dad at my prenatal visit: What do you see me doing at the birth and what do you see you doing? What do you want to be in charge of?

As well, if the mom has indicated a wish for the dad to not be fully included in the labor and delivery, for any reason, I talk to her about dialoguing directly with the dad prior to the birth so that he is aware of her wishes directly. It is their relationship and they have a unique history. I respect that.

Youll make them feel dumb:

Again, only if I am not doing my job. In my experience, there is usually a Doctor or Nurse, less often a midwife, who does a good job of making someone feel just a bit dumb at some point during a pregnancy, labor or delivery. They dont need me adding to that dynamic.

My job is to make dad look on the ball, and empathetic, even if it doesnt come naturally. I am a big believer in always giving dad the opportunity to save face in front of his partner. That means I whisper, I pull him into the hall or the bathroom, I am subtle, I make things his idea and I prompt gently.

Youll interfere with and control their partners wishes at the birth:

Dads sometimes think Doulas are the crazy protectors of all-natural birth who will throw themselves over the mothers body to prevent any needles from entering her, anywhere! Frankly, some Doulas believe that. And some moms want that Doula. But that is not me.

Although I have my own, strongly held, well-informed views about the lack of necessity and over-use of many interventions, I also respect very strongly a womans right to informed consent and informed choice. The key for me is informed. If she wishes to have an intervention and has been informed of the risks and benefits, and still wishes to proceed, that is her right. It is her birth, not mine, and I have no right to control her choices.

I make darn sure to get a sense prenatally of her wishes for the birth and her philosophy around pain control, and his wishes, too. I try to ensure that they are both well informed and aware of non-pharmaceutical options for pain relief. I make sure that I am a well-stocked doula with lots of tricks and goodies to offer relief. I prompt position changes and upright postures. I dont end up with many epidurals, very little narcotics, and sometimes laughing gas. But it was moms choice and she felt in control.

Youre overcharging for something nurses do anyway:

This comes down to simple misinformation. Dads and moms dont understand how little time nurses have available at a birth for hands on comfort care. I simply let them know the information. One study put the average that 10% of the nurses time at the birth could be spent on hands on care. Even the best nurse cannot simply sit continuously with a laboring couple and offer the kind of care a doula can. Even if they wanted to, and I know many nurses who wish they could simply doula at a birth, they have many other responsibilities. They have to ensure that the equipment and supplies are set up for the birth. They have to chart and report out to the doctor or midwife. They have to assess the well being of mum and babe throughout. They have to fulfill their clinical duties and to do it well.

For that reason, I dont want to be the maternity nurse, folks; I want to be the doula. Then I get to do the continuous hands on physical, emotional and informational support and none of the other stuff.

So, that is my approach when confronted with the wary dad and the eager mom. Sometimes I am not convincing enough. Well, you win some, you lose some.

What I have found, however, is that the most resistant dads are usually first in line to call me to come for their subsequent birth experiences. Sometimes the only way a dad can value what a Doula can offer is for him to experience a birth without one. But dont say, I told you so!

Happy birthing.