Just for some information, I am primarly looking at locus of control and how that effects the way doulas need to help women. Look at this link for info http://en.wikipedia.org/wiki/Locus_of_control
MOM is in charge of pain control ... if she has hired a doula, she has entrusted her to make the appropriate suggestions, give her accurate information, and be a focus point to encourage mom during her rushes :) All in all, ultimately, it's up to MOM.
For me personally I go through periods of internal and external locus of control moments during birth. I am a pretty internal locus of control personality, so I mostly keep to myself practicing my hypnobabies for most of the birthing time (don't really want anyone touching or watching me or reading me hypno cues - leave me be!), informing my midwife of my progress as I see fit. But with every baby there has come a point, often at the end sometime either in transition or pushing where I lose it and rely on the steady head of my midwife to pull me through. You know the, "I can't do it any more" moment. Mom is exhausted. She has given so much and just wants to be done, but alas there is more still to do. It is during these moments that I have wandered from my hypnosis training and need to be reminded of what I know - relax the face and the bottom, deep breaths, etc. This is a very vulnerable feeling - a sort of, "help me!" moment that a doula can be so helpful in assisting with pain management - being in charge to refocus the mom. But that again is me. If you had a woman with a more external locus of control personality type (or someone who isn't prepared well - which maybe only a part - the first time I pushed, it was awful. It hurt and I was just a crazy lady. It wasn't until the midwife said, "Push into where it hurts" that I learned, Ok that sounds CRAZY but it works! Who knew!), she might rely on the doula more throughout the birthing to guide her to a comfortable birth.
So, here's another question. How did you let people know when you needed something or not? Beyond just words, what kind of signals or cues did you give?
The mother is in charge of her own comfort measures. The doula provides the support and guidance that is in alignment with the mother/family's needs.
Founder/Organic Mommy & Baby Healthcare Solutions
I believe the mother is in charge of controlling her pain, but part of being "in charge" is accepting that you don't necessarily know everything and may need help. This is where, IMHO, the doula is invaluable, especially for a first-time mom like me. I was very educated on pain coping techniques ("Birthing from Within" was a great class!), but when I got into "labor land" where the brain doesn't really behave normally, I really needed someone to suggest different things for me to try based on my symptoms. So while I think the mother is technically in charge, part of exercising that control is surrounding herself with people who can provide her the support, suggestions, and assistance for her to manage the pain.