Doulas and Doctors

20 Jun

This morning there was a link posted by the Kootenay Doula Group Facebook page that I wanted to share here. It’s from a blog I hadn’t heard of, but will be sure to add a link to on my website now that I have!

The post can be found here.

We ARE guilty of attempting to “quiet down” laboring women. It’s not because we’re trying to keep them under control, or easy to manage, though, in my opinion. It’s because our natural instinct is to comfort, and when faced with a crying, screaming person, we have been taught that this person is in crises. This person needs us to step in and prevent further pain, and needs our help to bring THEMSELVES under control. We forget that when it comes to laboring women, the usual rules just don’t apply. I believe that this is true for doulas and midwives, as well as physicians, whom we often accuse of pushing meds just to make a patient more manageable. I’m guilty of this. I appreciated the post because it brought the issue to the front of my mind, and is now causing me to really ponder it.

If it is difficult for even midwives to discern when a woman is tapping into her natural birthing power, and when she is crying out for reassurance, you can imagine how difficult it must be for a family physician, or even an OB/GYN. These people specialize in the physical, and in making situations more bearable pain wise. Physicans are trained to approach birth as a medical event, and most medical events are best handled with medications, and pain relieving procedures. physicians do not receive training on how to address the emotional aspects of childbirth, or anything else for that matter. A physicians job is ensure the physical well-being of both mother and baby, and that is as far as it goes for him/her. Why are we expecting more when the system clearly doesn’t support it. Midwives can and do bridge this gap. However, when it comes to higher risk pregnancies, and the women who are often most vulnerable to birth trauma, using a midwife isn’t usually an option. And these women are often so focused on the health of their baby that emotional concerns go unaddressed during pregnancy, and then pop up unexpectantly in the delivery. She can then find herself utterly unprepared, lost, and alone.

What we should be asking of physicians is to be more open to having doulas in the delivery room. What I would love to see is physicians who recommend doulas to their clients. Wouldn’t this actually take some of the pressure and expectations placed on them, off their backs? Bring a doula into the mix, and I bet a lot more women become a lot more satisfied with the care provided by their doctor! Rather than viewing us with indifference, or even hostility, maybe they should view us as professionals providing and complimentary service to their own. Maybe they should just admit that they CAN’T provide a woman with everything she needs during childbirth, and understand that that is OK. As a doula, I couldn’t either! Maybe they could educate themselves enough on a woman’s unique needs to understand that what we are providing is just as valued a service as the one THEY are providing. Once the birth is over, and both mother and baby are well, it is how she coped, how supported she felt, how her emotional needs were tended to, and how she was treated that could affect her as a person, and as a mother, for the rest of her life. Maybe they could be a little more open and willing to willing to consider some of our suggestions and insights, so long as they don’t put mother or baby in danger. A little more flexibility on their part is all that’s needed. It would go a long way in improving women’s birth experiences, and women’s lives as a whole.  And in return, every woman who calls herself a doula must adhere to the highest standards of professionalism. We must remain within our scope of practice, we must present ourselves in a way that encourages mutual respect amongst the medical community, we must honor our clients, their families, their experiences. We must only associate ourselves with other doulas who conduct themselves responsibly, and we must maintain our integrity, honour our doula sisters, and be mindful of preserving our reputations when out amongst the community.

Just as one last note, I do NOT endorse free birthing (as seen in this video). I find it rather ironic to plan a free birth but then invite a doula in. As a DONA doula, attending a free birth would be a violation of the Code of Ethics I am bound to.


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One Response to “Doulas and Doctors”

  1. comadrona July 17, 2011 at 8:36 am #

    I agree – women who have medicalised birth care could benefit from a doula being there but if, as here in Australia, doulas are seen as a threat and have no ability to advocate, it might bring more conflict to the situation. Ideally the partner of the woman could advocate, with the doula bringing suggestions and support to the mix. Here in Oz midwives are still involoved in high-risk births for the most part, but unfortunately many of us are, ourselves, afraid of birth and unwilling to go against what the doctor says – even if it means the mother may not have the most complete information. I think doulas are doing the job which used to be the midwife’s – and the midwife is now too busy with paperwork, time constraints and hospital policy to truly advocate for the woman. I, too, have found it funny (and a bit like having an each-way bet) to invite a doula to a UC – I wouldn’t touch it because of the potential for blame and responsibility which would rest on her shoulders if things went pear-shaped! If you want an attendant at home, employ a midwife.

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