Spirituality and the Doula

Our post this week comes from an interview with Heather Tolley, chaplain and doula. Heather has been an advocate of compassionate healthcare for over four years. She loves helping her doula clients have a positive experience with pregnancy and birth by cultivating confidence and providing individualized support. 

Can you share about your path to doula work?

Heather: I got interested in women’s advocacy work while going to the University of Utah. I stepped into healthcare advocacy at St. Marks as a multi-faith chaplain in 2014, and completed my doula training the following year. I now work as both a chaplain in hospice and a doula.

I think many people are not familiar with the role of a chaplain, can you explain?

A chaplain is an advocate of holistic healthcare, which includes physical, emotional, social, and spiritual needs. Care of the whole person helps the healing process.

In practice this can look like advocating for a patient or family’s needs/perspective, being a compassionate presence in times of crisis, providing emotional and spiritual counseling, and sometimes facilitating spiritual or religious ritual (prayer, blessing, scripture, mantra, etc).

Of course, doulas have long been aware of the strong connection between mind and body—which is why chaplaincy and doula work have so many similarities.

What does spirituality mean to you?

I personally hold a very broad definition of spirituality.  I think it’s the feeling of connection to something beyond ourselves; for some that may mean a higher power or deity, for others it’s the mystery of love or nature, or a state of mindfulness which wakes them up to the present moment.

I believe everything is spiritual and that we don’t have to do anything to make a moment or experience spiritual. However, some experiences speak more to our souls than others and as humans we find ritual and ceremony to be helpful conduits for creating mindfulness of the sacredness that is always present.

Is approaching spirituality in conversation something that comes naturally for you?

Yes and no.

I have always enjoyed studying many faith perspectives and religions. I love seeing and discussing with others what is sacred through their eyes and what touches their heart. I love matters of the soul.

There is such a spiritual component in birth; the awe it inspires within us, the profound sense that the experience is more than the sum of its parts. I think the sacred profoundness of birth is what draws so many of us to this work, and that’s certainly been the case for me.

So yes, I love talking about all of these things.

But actually approaching the topic initially can be uncomfortable. I grew up in a family where spirituality and religion were rarely discussed, and usually with contention. I think there’s an underlying sense of guardedness in being asked about one’s personal faith in our society in general, and particularly here in Utah. Also, spirituality is an uncommon topic in most professional relationships. All of these factors definitely created a sense of anxiety within me that I’ve had to address because it’s much harder to serve people’s spiritual needs without bringing up the topic.

How do you overcome that initial discomfort and initiate these meaningful conversations?

I’ve found that most people appreciate having a space made within healthcare for the spiritual aspect of themselves, even if they choose not to in engage further discussion; so long as the offer is phrased in a way that creates connection and communicates a lack of agenda.

I’ll often state directly that I don’t have a goal or agenda other than a desire to get to know them better and to serve them from within their own spiritual/religious framework.

Another approach is to frame conversation as an additional dimension of support from a desire to provide holistic care; that I’m seeking to care for them as a whole person and that I recognize for many that means engaging with and holding space for their personal spirituality in addition to physical or emotional needs.

When you share that you are just checking in about something that many people find meaningful, and give clear opportunity to decline, people aren’t likely to be offended.

What are some ways that doulas can incorporate spiritual support into their interactions with clients?

Honoring spirituality can be as simple as mentioning being comfortable with and affirming any spiritual expressions they intuitively feel to express in birth, and that you’re open to discussing what those expressions might look like.

Other ideas include:

• Including a question about religious affiliation on the intake form and then using the form as tool to invite deeper discussion with open ended questions 
• Work to not make assumptions. Just because someone doesn’t belong to a religious denomination or even theistic framework of belief, doesn’t mean spirituality isn’t an important part of their life
• Invite discussion of the broader definition of spirituality; that which connects us to something greater than ourselves. What helps them feel connected to a greater whole? What rituals bring comfort? I’ve had friends and clients who don’t necessarily believe in a higher power but find meaning in the verbal expression of prayer
• Talk about the sacred nature of birth and affirm the power of her own intuition and insights
• When discussing resources for various areas of care, communicate availability of spiritual resources for birth
• Learn about dream theory, to be able to engage discussion about any compelling dreams that have stuck with her, which can bring strong insights as she prepares for birth
• Become familiar with Mother’s Blessing ceremonies, aspects of which can even be incorporated into a traditional baby shower for a more emotionally and spiritually fulfilling experience
• Encourage her spiritual self care along with her physical and emotional self care
• Express gratitude for whatever a client shares about their spirituality to foster feelings of safety and trust

Of course, I pick and choose from these options as appropriate for each client, with the goal to affirm them bringing the best gifts from the spiritual area of their life into their pregnancy and birth.

When does addressing spirituality become a priority?

Definitely with unexpected outcomes, or when a client is stressed or upset. Sometimes I’ll use conversation in prenatal visits around alternate outcomes to also talk about meaningful ritual, or vise versa. It helps to know in advance what a client and their partner would find meaningful or helpful in a challenging situation, so I can advocate for those “comfort” measures that might be forgotten by a client or their partner when under stress. For example, in many cases taking time for a prayer or blessing before c-section can be accommodated by medical staff.

What are some good resources?

The Sacred Living Movement website has a wide array of online trainings including Birth Journey, Sacred Pregnancy, Mother Blessing, and Sacred Postpartum. They also have several books.

Members of The Church of Jesus Christ of Latter-day Saints may enjoy the book The Gift of Giving Life: Rediscovering the Divine Nature of Pregnancy and Birth, which is a compilation of essays and birth stories exploring the intersections between birth and the LDS faith.

The book Mother Rising provides a how-to guide for creating a Mother’s Blessing ceremony.

This blog post has ideas for simple additions to a traditional baby shower to foster greater feelings of support and connection for expectant mothers.

The article 10 Practices To Experience Childbirth As A Spiritual Journey provides straightforward tips for spiritual birth preparation.

More About Heather:

Heather has a degree in Psychology from the University of Utah, and advanced training to support those for whom birth may feel more emotionally complex, such as those with a history of trauma, loss, or faith transition, single parents, or intended adoption. She also provides bereavement doula services.