Advocacy has become a powerful - and often misused - word in the birth world.
Too often, especially among doulas, advocacy is confused with confrontation: battling medical teams, positioning ourselves as protectors against the system, or inserting our own agendas under the guise of “fighting for the client.”
This is not advocacy.
And it comes at a cost.
Birth happens inside a system, yes. And systems can be rushed, hierarchical, and imperfect. But when advocacy turns into tension, conflict, or performative resistance, the person most affected is the birthing client’s nervous system.
A dysregulated room does not empower.
It destabilizes.
True advocacy is rooted in regulation, clarity, and consent - not opposition (or ego).
Advocacy is:
- Supporting informed consent through clear, calm questions
- Helping slow moments that feel rushed
- Translating information so the client can decide from understanding, not fear
- Holding emotional safety when vulnerability is high
Advocacy is not:
- Speaking over the client
- Creating adversarial dynamics with medical teams
- Assuming we know better than the person giving birth
- Confusing our own birth politics with the client’s needs in that moment
We must remember: stress directly impacts labor physiology. When a doula brings anxiety, hostility, or tension into the room - even with good intentions - that energy is felt. It can undermine confidence, safety, and trust.
Ethical advocacy requires maturity.
It asks us to regulate ourselves first.
The most powerful advocacy often looks quiet:
- A well-timed question
- A grounded pause
- A reminder of options
- A steady presence that signals safety
Advocacy is not about winning against a system.
It’s about protecting the client’s agency within it.
And that responsibility begins with us.
Reflect on your own advocacy style. Does your presence reduce stress — or add to it? Regulation is not separate from ethics; it is part of them.