Doulas are Goddesses gift to birthing mothers and their partners. They are there to encourage, inspire, calm, and communicate. They are not medical practitioners. They do not provide medical services in anyway. But they are a vital part of Birthing naturally.
3Cheers for Doulas!!!! You're AWSOME!
Thursday, June 24, 2010
"You can't take the effect and make it the cause," is a saying I quite like, immortalized in a song by The White Stripes....
Doulas have been around since the beginning of time, doing our warm-fuzzy bit for birthing women and new moms. But in the last few decades, this role has become far more political. Now we are also called upon to be advocates. As the doula profession grows stronger and stronger as more and more women request our services, we are becoming more scrutinzed, criticized, and even ridiculed by many medical professionals, despite most of our clients' excellent outcomes, both clinical and experiential.
Consider this: our modern role developed BECAUSE loads of women weren't enjoying their obstetric experiences. Women were coming away from delivery rooms feeling confused and traumatized about what went down. You've all heard about Twilight Sleep and all babies being yanked out with forceps. It was the women who said, "We need to figure out whether this debilitating treatment of us in birth is actually needed! Were we not born capable of figuring most of this out on our own like those women we hear about who squat in fields? What's wrong with us that we need to be knocked out and cut and without our husbands?" And as the women looked for more gentleness in birth, their concerns being picked up and validated by compassionate medical people, they realized that in the throes of intense labour sensations, they may not have the power to communicate their worries, and were terrified of getting caught in a cascade of interventions they didn't need or want.
Wonderful people, such as Klaus and Kennel, noticed how much better women felt about themselves and their birth experiences when they decided to take another woman with them into the birthing room. Even just the presence of another woman contributed great things to the birth experience, never mind a female who also knew how to provide great emotional support, communication of the mother's needs (not decided for her BY the support person, but translated to the medical staff FOR her if the labouring woman couldn't speak herself), and soothing comfort measures. These researchers took the time to conduct some well known and well documented studies which confirmed their observations. Lo and behold, the presence of a non-medical, nurturing woman in the birthing room drastically reduces the need for medical interventions, as well as the desire for pain relief from labour sensations.
I can kind of imagine how medical people, who have busted their humps to get through the gruelling hell that is medical school, becoming skilled at diagnosing complications and executing amazing feats to spare mothers and babies from death, might scratch their heads and go, "Say what?" when a friendly woman NOT in scrubs asks them, because the labouring couple are clearly very focused on the work of dealing with huge contractions, "if it's not truly necessary to stay lying down, this lady would enjoy walking around to help soothe her labour pain. She would like to have a natural labour if this is how things work out, and being upright seems to help her a lot. Would this be okay with you?" If that doula/mother/partner team do all kinds of strange things together, like slow dance, everyone massaging and murmuring sweet nothings to the mom, who drapes herself in unfamiliar positions chanting oddities like "oooopen!" and even yelling out tension releasing expressions of pain that would fill the uninitiated with fear, you might feel extremely wary. If you as the doctor are simply not comfortable with these shenannigans, having learned a way of managing labour that you are secure with and within your knowledge base and experience keeps your patients safe, you might, if you're not actually impressed by the birth unfolding naturally, feel odd. You may feel usurped. You may feel resentful that the couple seemed to respond emotionally far better to the person with the strange smelling back of doula tricks than to you, who is the one ensuring their safety, for Pete's sake! You may feel downright angry that some chick with her essential oils and hippie talk of breathing away tension came into your delivery room and messed around with your sense of rightness, in your own place of work no less!
We get that. I think it would probably be quite a normal human reaction, considering the doctor is the one in the room who bears all the clinical responsibility. But the thing is, our strange ministrations to these women ALONG with excellent clinical care actually create more favourable outcomes, for doctors, mothers, babies, and partners (fathers or other mothers). Even if medical people want to look at doulas sideways, believing we are puppet masters who pull our clients' strings to make them carry out our evil plots of undermining medical authority, it's important to take a breath and get some perspective.
Doulas do NOT attempt to assume medical care of a client (decent, run of the mill doulas don't, anyway). It may seem like it to a doctor or nurse if a mom is being yelled at to get angry and PUSH while we're smiling at her silently, not joining that enthusiastic cheering squad. It might irk nurses to hear us say, "your body is amazing! It knows how to birth that baby. You know how to do this." Please know this is not a covert attempt to undermine anyone's medical authority, but to execute the wishes of the mother, made known to us in advance. She has spent her pregnancy reading up, figuring out how she wants things in her birthing environment if things go reasonably normally, and discussing those things with us. We open their eyes to other possibilities they may not have learned in their hospital based childbirth education classes, yes, but if a mom is not interested in something, we don't go there. If our clients have different ideas from what is typically done in a hospital, it is our job to lead them to resources that will help them make decisions about their care...we don't tell them what to do, we make sure they've informed themselves from several different sources, so as to better make choices for themselves from an empowered place. We absolutely encourage them to discuss their wishes with their caregivers. Then we support what they want. If their ideas are not sympatico with typical hospital protocols, it is important for medical people not to assume their patients are weak minded, malleable creatures whose minds were warped by the likes of doulas. Patients need more credit than that. In fact, that's probably why we're here, because even up to the latter part of the last century, birth practices were still pretty barbaric in many ways..and women became fed up....
HERE to read the entire article by Mother Wit