Wednesday, October 24, 2007

Some thoughts on Doulas

with in an hour it went to a marginally poopy day to a great day.

i woke up really annoyed with how some folks are talking about my profession as a doula (as it was described in the book Pushed). not that i do not agree with them on a whole that doulas could be supporting women in some really medically over managed births and trying to make it into a good experience when they otherwise may see it as something that was not the way it should have gone - sugar coating the experience it has been said. i think it is not the fact that we are in there i think it is that most doulas dont really get in there and be there more hands on when it can make a difference. especially in the past year i find that if you are more respectfully active as a doula the mother gets left alone more and the nurses back off a bit or getting creative with the bumps that come your way like constant fetal monitoring.

i was at a birth that after i left the nurse told the couple that i was so hand on and present for the mother where most doulas she worked with sat in the chair and knit or read a book while the mom was in the tub, just chillin or doing her thing. i take a book or knitting but i find i rarely get to pick it up and if i do it is never in the room with the mom. it is different to attend a mother in the hospital than in their home. in the hospital if a mom is in the tub i am kneeling on the floor just being there with her if that is what she wants (sometimes the mom likes alone time or just time with her partner in there) if mom is in the bed chillin' i may not say anything or do anything special but my attention is still on her and she can tell the difference. in the home it is her space and she may want you with her or not but there is more flexibility because she is in her space and usually does not feel she needs to be anchored or protected from anything. and it is hard for me to attend a homebirth and a hospital birth back to back because there is a huge difference.

i think a lot of doulas do this work so part time it is hard to feel a sense of authority or be able to have a strong presence in the hospital. many are just intimidated. i have seen some messed up stuff and in postpartum visits sometimes light bulbs start going off but sometimes it does not happen until a year or more later.

i am just getting so peeved at the are doulas good or bad debate. WOMEN ARE TALKING ABOUT THEIR EXPERIENCES LIKE THEY DID NOT BEFORE. there may not be the direct change that some may want but there is change occuring. a recent client of mine had her mother come into town and was so happy that her daughter had her baby in a room of women and supported. to this line of women this was a huge improvement from the grandmothers birth in the 70's where she was alone, shaved, enema, in stirrups surrounded with strange men.

ok, i am getting more into this than i meant to right now. the c-section rate and birth in general is complicated. it is a social/cultural issue, an business issue (insurance and hospitals), and education issue. i believe in what i do and how i do it and i hear what folks are saying but i think they are being very short sighted and shallow thinking.

BUT THE FLIP SIDE OF MY MORNING: last night i got a facebook friend request from a friend in australia that i havent talked to or been able to get a hold of in three years. that made my morning and my bitchy mood has been defused. thank you.

3 comments:

Christa said...

See, this is a tough subject for me. not the necessity of doula's...I agree with their importance. And yes, maybe they do sugar coat hospital births, but the majority of women are still going to birth in the hospital, so why not make it the best birth possible?

I'm not sure how "hands on" I need to be at doula births. I never sit there and read unless the mom has had an epdiural and is sleeping. But sometimes I wonder if I should maybe step back more....I don't want them to see it as me being the one that got them through their birth. I hate being told " I couldn't have done this without you", because I want them to feel they did this all on their own. Am I causing them to rely on me instead of their own instincts? Their own ability?
I also think about everything Odent says about the importance of leaving the birthing woman alone.
So I'm not always sure of what my rold should be. I do know though that I liked my doula's constant hand on my arm during my birth.

Kate said...

i hear you. i really feel uncomfortable with a woman telling me "i couldn't have done it without you" i don't think in my practice i interfere with their instincts but i do help. most women have never seen birth before so they have nothing to draw from and i think it is helpful for supportive attendants not to do the work for her but to facilitate her in finding her instincts. many times i try to facilitate the partner having the hands on. i am not a tools and tricks doula at all and i guess really i dont literally mean hands on. i think it is more of a emotional intention with the situation rather than "doing stuff".
i agree with odent but especially with moms birthing in the hospital and in this country there is a huge head trip in they way of them feeling safe enough and confident enough in their bodies and themselves to do this very natural act.
i never know what my role is and i have come to the point in consults and prenatals that i just tell them that the whole thing is really just going to play out- here are the guidelines- and we play it by ear. there is no formula or script to this work. and most of the time i do nothing but sit on the floor or in a chair and do what seems to be nothing but i remember just the fact that my doula was on the couch next to me at my home or holding my hand in transition in the hospital made a huge difference in my confidence in myself to do the work needed to have my baby.
a lot of doula work is be present with full attention on the situation and patience. one thing i notice at hospital births is that it is hard to be present and do nothing for long periods of time.
being a doula is an odd job. an anchor is sticking in my head. it is under the ship strong support and unseen just hanging there but doing a very important job. not the captain not the flag just there when needed. i love my half assed analogies. ok- this is really another blog post in itself.

Christa said...

I am not one with a lot of tricks either. I hate when people ask me what I carry in my doula bag, because really, not a lot, and it's mostly for me lol. I keep thinking I should buy some more "stuff" just because a good doula has all that. I just don't think tricks and stuff make a doula. Give me a birth ball and some aromatherapy oils, my heart and my hands, and I am good to go.