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Central Texas Birth Network Member Profile January, 2008 - Susan Steffes, LPT, CD(DONA), Birth Doula 
For the past decade, doula Susan Steffes has accompanied women and their partners on the transformative journey of pregnancy and childbirth. Through her practice, Respectful Guidance, Steffes said that she strives to meet each woman on her own level and to help her birth in awareness. The result has been an empowering experience for countless Central Texas couples.
Q: How old are you and where are you from?
A: I’m 42, and I’ve been in Austin since 1991. I have three boys, Hans, Hogan, Haydn, ages 11, 8, and 6. I was born in Boston and grew up in South Dakota. I went to high school and college in New England. In college I studied physical therapy and eventually graduated from Southwest Texas. For awhile, I was a pediatric therapist here in Austin.
Q: Do you have an additional profession right now or is being a doula your primary career?
A: This is it for me right now besides being a mom.
Q: When did you obtain your doula certification?
A: I certified through DONA International in 2003, but I’ve been doing doula work since 1997. I started off doing it for friends and then began branching out and marketing myself after I made it more official with my certification.
Q: Where did you get some of your first impressions of childbirth?
A: My mother was an L&D nurse for over 20 years, so I was steeped in birth stories from an early age, most of which didn’t sound supportive of the woman. This led me to begin researching birth customs and realizing how unsupportive the medical community really is of birth as a natural process.
Q: How did you discover this line of work?
A: It was with the birth of my first child. I planned on having a doula, but my son was a month early and the doula ended up being unavailable. I had a great nurse at the hospital, but during my labor she was called off to do a c-section. She had to go, and that was it for me. I called uncle. After that I realized that I didn’t want other women to have the rug pulled out from under them. Continuity of care is really crucial. The person that you trust to get you through it needs to remain the person who is there to get you through it. For me, the most important factors in doula care are the continuity of care we provide and our ability to help women explore their core agreements about birth so that birth becomes experience focused and not outcome focused.
Q: Tell me about your practice.
A: It’s called Respectful Guidance. I respect where each couple is with their journey. I try and pull from women what it is that they already know about themselves and the birth process, and from there I help them learn more about the process in a non-judgmental way. With birth there’s not room for judgement in making decisions. I also help couples navigate the medical system if they’re having a hospital birth. (In the hospital environment) my interaction with staff must be non-confrontational. I have to have the ability to challenge but not confront. It is a skill you need to learn to work with.
Q: On average, how many clients do you accept on a monthly basis?
A: I only take one client a month. I clear my schedule two weeks before the due date and two weeks after. It’s a very purposeful decision on my part. Part of it is self -preservation, but it really gives a sense of commitment to my clients.
Q: In today’s medical environment, can you speak to the doula’s role as patient advocate?
A: When it comes to information, women in their first pregnancies a lot of times don’t do a lot of the digging for themselves, mostly because we all want to think that we can completely trust our caregivers. I like to provide encouragement with their own learning and teach them how to dig for information for themselves.
Q: What do you hope that your clients will take away from their birth experience?
A: My biggest hope is that they birthed in awareness and empowered. A woman has to have knowledge to birth in awareness. Birthing empowered is the ability to claim their birth as their own experience. When a woman can walk away from her birth, which looks nothing like her ideal birth, and claim it as her own unique experience knowing that she was informed, supported, and had a say her care, then we have done our best job and she has done hers. It’s about accepting what is, which is not to say that women are to be passive. It means they are to know that birth is unpredictable and can neither be scripted in a birth plan nor prepared for in every instance. The real preparation is to accept that birth requires one to be in the moment throughout which allows them the freedom to do the next best thing at any given instance, resulting in a sense of ownership of their experience regardless of the outcome.
Q: What have you learned from your clients?
A: I learn something from every birth. At my most recent birth I learned not to make assumptions. You cannot know what other people are thinking of you unless they express it to you. I have also learned that you can make a lot of headway with respect and softness. You don’t have to be a bull in a china shop.
Q: Have you ever passed a client along to another doula due to philosophical differences?
A: From time to time. For me it is about expectations. If I feel like their expectations don’t jibe with what I do, that’s when I say no. I don’t want a couple to think that I can provide them with specific birth experience. My role is to support them in what they want, to help them know that they have decision making power and to help them accept the birth that they end up with.
Q: Do you feel that doulas are becoming more mainstream?
A: I get calls from women who are having planned c-sections or medicated births, and I think that people are beginning to understand that having a doula is not always just about natural birth. Word is getting out and spreading. When women share their birth stories, that’s really powerful. When you work with one family, hearing about that birth experience can change the experiences of many other people.
Q: What is most challenging about this profession?
A: It’s balancing it with my family life. It’s very hard to say no to a couple that you feel an immediate connection to.
Q: What amenities would you like to see in the future for birthing women and their families in this community?
A: Midwives back in the hospitals, I think we all would love to see that. Even more than that, I would love to see a lot more freestanding birth centers.
Q: You are responsible for bringing a local production of the play BOLD (Birth on Labor Day) to the Austin area for the past two years and for helping to provide a screening of Ricki Lake’s recent documentary The Business of Being Born. Why is birth activism of this sort important to you?
A: The mission of education, truth and action is what drew me toward it. I want to see maternity care become more mother friendly and woman centered. There’s a take-away message (with these events) that informed consent is important and that having a voice is important. At the same time, it’s non-judgmental. That way the message reaches more people. And any little thing we can bring to Austin has a far greater reach. I think our actions go a lot farther than we’ll ever know.
Q: Do you love what you do?
A: So much. I love watching couples come into their own awareness and power and realize that they have choices and that what birth is about is being open to the experience. It’s about dropping expectations and being open to the moment. You get to see them become totally different people. And witnessing new life coming into the world, there’s nothing more beautiful than that. I've also been with some couples who have experienced perinatal loss. That transformation comes in a lot of ways. Healing is one way. Joy is another. I really embrace all of it.
Julia Hockenberry is a writer, reporter and doula living in Marble Falls, TX. She studied vocal music at Florida State University and was a classical music announcer for WFDD radio in Winston Salem, NC before becoming a news radio anchor for WNAV radio in Annapolis, MD. Hockenberry has also written extensively for The Capital newspaper in Annapolis, MD, as well serving as a contributing writer to The River Cities Daily Tribune and The Highland Lakes Business Journal in Marble Falls. In addition to being a perpetual student in the dynamic fields of pregnancy and childbirth, Julia is married to her husband, Jay, and is mother to three children, Clara, Ben and Calvin. |
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