Erin Brier of Erin Brier Birthing is a professional doula, childbirth educator, and author who has been supporting families since 2017.

She shares all about her "why" for doula care, her mindset for her first birth, her thoughts on *virtual* doula care and her second pregnancy, and so much more!

Q: What are your thoughts on virtual doula care?

A: I’m kind of shocked that more people aren’t talking about it. Virtual doulas have a lot of the same impact on positive birth outcomes and the families that are experiencing birth that in-person doula support does. That includes more feelings of confidence and preparation and feeling good about making those medical decisions and knowing how they want their birth to unfold—or, at least, feeling knowledgeable about what may occur and how to make those decisions in real-time. Even down to less NICU admissions and lower cesarean rates.

So much of what I do as a doula, even as an in-person, there-with-you doula, is really on the front end in that education piece and building relationships leading into the birth. So much of that happens before we’re even in the birthing space. That is really the foundation that sets you up for that birth experience and being able to feel prepared in the moment.

Things can go a million different ways, and you can never really truly be fully prepared until you’re in the situation—because you just don’t know. But, I think we’re going to see a little bit of a trend with virtual doula services becoming more popular because there are a lot of people who understand that the birth space is sacred and you should only invite people into that birth space that you really feel comfortable with—and that goes for support people like doulas too. So, I think this is really going to have a really positive impact on those people who really want to keep that space private and don’t necessarily feel super comfortable with bringing in a doula or a third party kind of person, but they can have that real-time support and talk to what’s happening in the moment.

I’m going to start dabbling in that now in my own practice and have a couple clients already. Even clients that I had last year whose births I was at, it just kind of shook out that a lot of the support I gave them was virtual leading into it. By the time they were ready for me to come join them, we were pushing. So, it’s really doable and makes a lot of sense for a lot of people. So I’m really excited for this new avenue of support that families can get.

Q: Did you always know you wanted to be a doula?

A: I would say yes and no. You know, you go through school and you kind of get towards college and you’re supposed to just know the direction you’re going to take. For me, I thought (without knowing anything) that maybe I wanted to go into Psychology. My thought process was that I did always want to help people, which is very broad. I love interacting with people. Growing up and, even still now, I’ve always been that person in my friend group that people come to to just unload on. I love being that person and being able to provide that safe space and give feedback if it’s requested. I think part of that too is always wanting to fix something, which you do have to be careful with in some situations. But I’ve just always really enjoyed that aspect of building relationships in my own life and being that person that people feel like they can come and talk to and I can help them get resources.

So, going into college, Psychology was the answer. Throughout college, that transitioned so many different times to maybe Social Work, which is a little more along the lines of what I was looking for. Then it turned into Human Development and Family Studies, which was my major. I didn’t know what I wanted to do with that—maybe some nonprofit work, which I did do for a little bit. But, in my last semester of college, I took a class as an elective called Birthing in American Society. That’s when I learned a lot more about the physiological process of pregnancy and birth and learned what a doula was, and I became very fascinated with it because, at the end of the day, always, my awe in this work is how amazing women’s bodies are and how strong and resilient and yet different every single pregnancy, birth, and postpartum experience is. Once I learned that you can support people through this process as a job, that’s when I knew I wanted to do it. But it was still probably six years out of college before I actually did it. A big piece that I let hold me back was that I had not yet been through the experience myself.

When my husband and I finally made the decision to put our roots down, I knew it was time to pursue it. I networked with doulas in the area and talked to someone, who ended up being my trainer for my doula certification and worked with for a little bit. I shared with her my hesitation of being a doula if I hadn’t gone through it. She told me my uterus does not define me and encouraged me that I could do the work. Even now, as I have moved into a support role for doulas and mentoring newer doulas, I find myself saying this work is about building relationships and supporting people. You can do that whether you’ve had children or not or ever plan to have children or not. It’s about the support and holding that space. I was really grateful that she said it in a way that sunk right in. It was 2016 when I finally went through my certification, so I’m going into my eighth year and coming up on the decade mark and still loving it. The burnout rate for doulas is five years on average. It’s exciting and mind-blowing that it’s already been that long.

Q: As a doula, what was it like to experience birth yourself?

A: It’s a really unique perspective, and I knew that going into it. I had a doula with my son. After being a doula for five years, my husband kept questioning whether we really needed a doula. I had been to so many births and had seen a million different ways they could unfold

When I’m with clients in the birth space, I feel like part of my role is truly being in it with them. So, there is potential exhaustion for really holding that space for who knows how long. But because I had that opportunity for so many years, I felt at ease about birth.

A lot of the struggle that I had in my first pregnancy was really in the prenatal period, which is interesting because, as a doula, we do support families throughout pregnancies, but I have more hands-on experience being in the birth space with them. I check in every once in a while throughout pregnancy, and they can reach out to me and I can get them resources, but a lot of that stuff is a little more surface level—especially for me at that time prior to having my own experience.

So I felt like actually going through that firsthand threw me for a loop. I struggled a lot mentally in my first pregnancy. A lot of that too had to do with the transition into motherhood. I had really worked hard to become a person and build this life that I really was proud of and, knowing that motherhood just changes things, I was really nervous about it. So for me, in that first experience with my son, pregnancy was really hard.

Birth was kind of exactly what I expected it to be. I knew I should expect anything to happen, so I was just very open-minded about it. I had a rough birth plan that was like I want to go unmedicated for as long as I want to (whatever that means), because even though I’ve been in it with so many women, obviously I’m not feeling those sensations, so who knows what it actually feels like until you’re feeling it. I really wanted to listen to Beyonce because she just makes me feel empowered and I wanted to have the option of getting in a tub. That was my rough birth plan. I was borderline a psycho about requesting this tub throughout triage. As soon as we got to the room, they filled up the tub and I did not get into that thing once. I didn’t listen to Beyonce once. I remember in between contractions at one point looking up and seeing the tub across the room full and serene and beautiful and I was just like nope, not happening.

So, there was a lot in my birth that, going through it myself, was really a great and fine experience. I think that has to do with knowing and being in so many birth spaces for so many years prior, but there were also some things like doctors being a little pushy and the one who ended up delivering my baby was one of my least favorite in the practice.

My mindset with having a rotation of doctors was that I know how infrequent doctors are in the room. They come in and catch your baby. That’s one of the things I prepare clients for. Yes, I think it’s very important to feel like you have a good relationship and rapport with your care provider because you do see only them. You don’t see nurses then, or at least not the nurses you’re going to see for the big show. But it’s the nurse that is with you. I really believe a nurse can make or break your labor. So virtual doulaship will be something new to navigate because, when you’re there in the space, your whole role and goal is to feel out the vibes. So, if a nurse comes in and the vibes completely shift, it’s really easy for me being there to ask how we are feeling and if we need to request another nurse. You really can do that. So it will be new to navigate not being there and how to ask those kinds of questions.

Doulas are great scapegoats for things like that. Fixing the environment is one of our roles. But your nurse is the person who is with you for the long haul and will be reporting back to the doctor. So I think it’s really important to have a nurse you vibe with, but for the doula to also build that relationship and rapport because they can have a lot of impact on how things unfold and what they're sharing with the doctors and then what the doctors are going to recommend. It’s kind of like a little game of chess, where each person has a role and you have to figure out how to buddy up to the right people. We’re part of a birth team that has different layers and different roles. So nurses are the people for births.

Q: Did you find birth to be magical, blissful, and amazing—or did you find it to be hard?

A: That’s something that I still feel like I’m kind of trying to unpack. My child is almost three now. Truthfully, overall, the experience was fine. There were some things that were a little annoying but, for the most part, it went smoothly. I was really fortunate in the fact that this almost never happens. Being a doula who has supported so many births, few times did I see where your labor just goes on the perfect curve.

Really, for me, it was like once things started, they just kept going. So, I didn’t have to deal with any stalling—and that’s part of why I never ended up opting for an epidural. It was in the back of my head, but you can’t really get a coherent thought out. When you’re in labor and things pick up, your brain waves actually slow. You’re super sensitive and all of your senses are on high alert, so you can hear everything that’s going on and understand what’s going on—but to react and speak back is almost close to impossible. So that’s kind of where I was at. All I could do was get through the next contraction and, in between, it’s like getting that second of recovery before it comes again. So I didn’t really have the chance to change the plan up.

It was a fine experience. But at the end of birth with clients, no matter how they deliver, I always ask at the bedside “Do you feel like a badass? Because you just did something so amazing.” But I never really had that feeling. Even now, I don’t think it was blissful. It was hard—and I expected that, so I’m not surprised. But I don’t really have a good word to sum it up. It was fine. I hate even saying that because it feels so underwhelming because really nothing about it was traumatic or anything overly negative, but I never had the feelings. Maybe it was because of the mindset struggles I had around motherhood. So once I was done, I was just like okay now I’m a mom.

I did a lot of the work on the front end of coming to terms. But that is part of birth a lot of people don’t prepare for—like the mental stuff. So maybe that overshadowed a little bit. I wasn’t immediately attached to my son. It wasn’t until the morning of the day we were being discharged that I felt almost a little spark. Even pushing him out and putting him on my chest—in those moments, I was just exhausted. It was not the euphoria that I see so many people experience.

I think that’s just important to talk about in general. I haven’t really talked about it all that much because it’s not a typical question that you ask about someone’s birth story. But I think it’s important to note because I’m not alone in that. I know there are other people who aren’t instantly attached to their babies and probably feel really guilty about it. For me, I didn’t have a lot of the guilt attached, but it was just like going through the motions a little bit until I had that moment of a little bit of spark. Then it’s just like, boom in the thick of postpartum. Obviously, eventually we had the bonding moments and all of that, and I’m so grateful for my experience in motherhood as it’s been so far knowing what my expectations were. But I think it did overshadow the birth itself a little bit, and maybe that’s why I don’t have the words yet for it.

Q: When you think of virtual doula care, how do you see that going in terms of who is the medium of communication?

A: Typically, with in-person birth services, there’s always at some point a passing of the torch to the partner. They are the one I end up communicating with once they’re in the hospital and whenever they’re ready for me to be there. So there’s always a really natural passing of the torch in that way. So I expect it to be that way similarly in the virtual aspect.

I think there will be a little bit more work on my end of touching base more frequently because, typically now or for in-person services, I am very constantly in contact once it’s labor or induction or whatever that initial start of labor looks like. There’s a lot of little education along the way like here’s a good time to call your doctor or, if it is an induction, it’s here’s what you can expect and what they might recommend next and help prepare.

Usually, once they’re at the hospital and settled and they’re not ready for me to be there, I really give them their space. I might check in every once in a while, especially if it’s overnight, because the goal is to rest—but I really wait for them to reach out to me unless it’s been a while since I’ve heard from them.

I think virtual care is going to be more intentional and crafty about what I ask and when to really try to get a full picture. You don’t know what you don’t know and, even though a partner is the constant, they are usually less informed. So I think there’s going to be a lot more digging to try to get a full picture of what is going on so I can know what I can recommend and how I can support.

I think some of that holds true with in-person services before I’m with them and even when I’m with them sometimes—a lot of my support is following their lead. If they are not overly communicative and totally okay with just going with whatever the doctor recommends next, I can still interject with information and help inform them, but my role as a doula is not to make your birth how I think it should be. So there’s a lot of that relationship building and vibe checking before we’re in the room. I let my clients set the tone for how they want to be supported. They don’t always want all the information and to know every little thing. Sometimes it’s that their doctor said this and that sounds good and I say alright. It’s not my job to change your mind or argue with you. I can give facts and education.

But it’s the same with the idea of this virtual care and that’s what I’m really excited about. There will be people for sure that virtual services aren’t right for. If they’re planning an unmedicated birth, they’re probably going to want a lot of physical support, as they should. Husbands definitely can give that if they’re informed. It’s going to be a new subset of people who are going to find benefit in the new virtual services. It’s going to be a nice option for the profession of doula work as well to prevent some of the burnout because it takes a lot of energy to hold that space.

Q: What is the most common challenging part of birth that you see people struggle with or have questions about?

A: I think a big consistent piece is those last weeks of pregnancy and leading into labor starting on its own versus being enticed by induction and this arrive trial, which is a study that came out in 2018 that essentially said for a low-risk pregnancy, a 39-week induction doesn’t have worse outcomes for mom and baby than labor starting on its own. So, doctors love that. That is a common theme that I am seeing and is something I am quick to talk about with clients.

But if they want that 39-week induction, then my job is to support and educate them through what that is going to look like. Whether the client is open to induction or they really want things to start on their own, it’s a common theme of those last weeks of pregnancy in terms of what is actually an option that is sometimes not phrased in a way that makes it sound like it’s an option. I think that’s pretty consistent as an area of education I have really leaned into and need to really lean into that.

Then, throughout labor itself, consistently across the board, no matter how clients decide they want to labor—whether its medicated, unmedicated, if they’re open to cesarean or whatever that looks like for them—a lot of it is the in-the-moment interjections and filling gaps as far as when options are presented to them and being able to provide that balance between the education and the space while doing so cohesively with the team aspect of medical staff. That is something I think takes real grace and delicate talent to be able to really show up and advocate for your client and what they need and what you’re feeling that would be best for them based on what you know about their wishes and how things are unfolding, but also respecting the recommendations of the staff.

A lot of that is just creating space of getting the information and recommendations from the staff and then letting the client, the family, and the medical team have that conversation—and then I just kind of jump in and tell them they don’t have to decide right now and can take a couple of minutes to think about it. Usually that invites the staff to step out and then, if I need to, I kind of go in with a little more direct information that doesn’t step on any medical provider’s toes because they have way more medical education than me. I have experience in the birth room and can speak to a lot of these things based on education and experience, but they are the medical professionals. So I believe scope of practice and what they say is to be respected, but I think sometimes you can rephrase or put it in a different perspective that will better suit your client. So I see that being a big part of what I do in the labor room.

Q: What differences do you notice generally speaking between at-home versus hospital births?

A: The options that we have as to where we give birth is a beautiful thing. Every person is going to feel differently about those options. Pros for one person may not be pros to the other person—and vice versa—when it comes to considering where you want to deliver. One of those pieces of birth prep is really getting clear on how you feel about all aspects, beginning with your care provider and the place you are going to deliver. You have to really think through a lot of scenarios and how you feel about each scenario.

We’re not necessarily encouraged growing up or taught to continue to lean into our intuition. I think, as kids, it’s first nature to just listen to our gut—that’s what being a kid is about. Somewhere along the line, it gets suppressed or isn’t encouraged. In pregnancy, and one hundred percent in labor (and so much of parenthood), it’s leaning back into that intuition. You have to practice that. In the prenatal space, every little thing is so much about weighing the pros and cons and learning your options and educating yourself—but you cannot discount your intuition, especially at this time where all of our senses are heightened. That is such a big piece of it.

So, when it comes to where you want to deliver, there’s a lot of reflection that goes into that. There is no wrong answer. It’s whatever feels best for you in that moment, and that can change for you during your pregnancy. I think that’s really important to remind people—you are allowed to change your mind at any point. That even comes down to your care provider.

I would say that ninety percent of the time, I am in the hospital. It’s just kind of the way it shakes out with clients. People give birth in hospitals because that’s what insurance allows people to do. There’s a lot of hoops that midwives have to jump through. So, the majority of people are birthing in hospitals, so that’s where I end up being a lot of time.

I have seen every which way a birth can unfold in a hospital. That can include really supportive care providers. There are midwives that practice in hospitals. I think the big difference between midwifery care and OB care is that there is a lot less fear mongering that I have to prepare them for. I go through the same education with all of my clients but, when I come to the 39-week induction with the midwife clients, I don’t have to really prepare them for it. We talk about it, but it’s not the same conversation I have with my clients who have OB care providers. But I’ve also been with OBs who are very supportive and hands-off for the most part as far as how to manipulate how the birth unfolds. It can go any which way.

I’ve been at birth centers where transfers have been necessary for really appropriate reasons. That’s why they have those safety nets in place. I’ve been part of home births where I’ve been surprised at how maybe the midwives are not as agreeable to some of the requests of the client because it falls outside of what normal unmedicated home birth might look like as far as requesting intervention like breaking a water or gentle induction.

That’s the really hard part about birth. It almost feels like a cop out of my job. I feel like a weatherman. The same is true for so many things in birth where there is so much gray area. That’s why having a doula as a support and informed person and being the constant can be so beneficial, because you don’t know what scenario you’re going to have to consider until you’re in the scenario.

At the end of the day, birth with who you feel comfortable with and where you feel comfortable with and know you’re allowed to change your mind and you really just have to lean into your intuition. That is something in motherhood. As a mom, you have that intuition for a reason and it will serve you the more you lean into it. It takes practice.

Q: What are you excited or curious about going into a second birth that might have changed for you?

A: I’m really excited to just share a lot of this with my audience on my social media and blog. I just announced last week that we were expecting. Last time, I had so much mental struggle around it. It’s so different already and, this time, it’s almost flip flopped—like I feel like pregnancy is hard and there are definitely hard parts about it, but I feel generally mentally well and excited. But now I have some fear around birth that I didn’t have the first time.

So I plan to work with an energy healer and a Raiki master who does wound healing. I feel like, as a doula now, my unique situation going into a second birth is, since the first time I gave birth, I’ve supported a lot of births that had tough outcomes and stuff that sticks with you as someone who is holding that space and witnessing something traumatic. So I want to make sure I’m not bringing that into my own birth space. Whereas my first experience was really wrapping my head around and healing around the mental aspect of going into this transition of motherhood, now I really need to put the work on preparing for birth in that way. That’s going to be my main difference as far as where I stand mentally and the vastly different struggles I’m working through this time versus last time.

It’s a really exciting experience this time around because I can enjoy this pregnancy and have the wherewithal to hit the ground running on figuring out some of the mental stuff I know I need to. Whereas last time, it was just such a hurdle because I was not in a good mental space. Now I can see it clearly and know what I need to do and who I want to work with and I’m excited to fix it and work through it.

I’m eager and anxious maybe to see the difference in how things go this time versus last time—knowing that things were pretty generally smooth last time, but knowing that birth can be a million different ways. I’m interested to see how that will go. Then, having a toddler in the mix of it—that’s another layer I will get to later.

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This blog post was written based on kozēkozē Podcast Episode 360: Doula Care, Birth and Mindset with Erin Brier.

If you’d like to listen to the conversation first-hand, tune in here.

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