Doulas too?

One more post here in response to Joyce McFadden’s blog From Doulas to Doctors; Women are still dismissed.” Here is an extract :

• A woman says to her male doctor, “Since the surgery I have pain right here.” The doctor says, “That’s not possible.” Almost a year and at least $5,000 worth of medical expenses later, she’s proven right. A woman says to her female doula, “There’s something wrong with the labor, I need to go to the hospital right now.” The doula repeatedly tells her she should just hang in there, it’s not time yet, which proves to be a bad error in judgment.

See that middle sentence? That’s a problem.

I’m so glad that Penny Simkin teaches in her doula trainings and conference sessions the sage point that a doula must leave her agenda at the door and let the mother lead her birth.

When encouragement turns to persuasion the gift of the doula is crumpled. There is an urge among either the naive new doula or the doula on a crusade to rescue birthing women. I’m not saying it isn’t motivated from a reasonable desire to protect her from the kind of care described in the previous post. But the desire backfires.

When we seek to rescue we loose the equanimity of the mother doula relationship. We are no longer equals, no longer peers. The rescue worker doula has disconnected from the mother’s choices to meet the doula’s (and this sounds bizarre) desire to offer her more choices.
A pure motivation doesn’t justify sloppy communication.

Think about it. I think it is the hardest thing about being a doula. The doula sees the spectrum of behavior coming from medical staff. Some excellent, some brutal. That’s a fact. But the mother holds in her heart that she will be welcomed appropriately, celebrated for bringing life, as I’ve said, and cared for compassionately. She expects that. She may not be thinking defensively about avoiding interventions. And even if she was, it is not the doulas role to prevent her from having them, but only to educate her about them before birth, and to be compassionate about her use or non use of interventions during the birth.

If the mother herself chooses not to use a routine intervention the doula can offer a number of ways to support her choice. But the doula has a line that she can’t ethically cross. And certainly that line would be access to care!