Generally a writeup in the New York Times would be a positive thing for a community hospital in northern Virginia. And I really like my manager--she's smart, fun, and the best I've ever had.
But I do cringe at how this makes us sound. (And am I the only one who thinks it's weird to see pregnancy-related information in the "Fashion & Style" section?? How insulting!)
Believe me when I say that doulas are a touchy subject. I've trained and occasionally served as one myself, and research bears out that a continuous, supportive presence in labor decreases the need (or perceived need) for all kinds of interventions and increases parental satisfaction with the birth experience. I think that good doulas have much to contribute, especially in situations where the mother's significant other isn't able to be that informed, calming kind of presence. And I've seen plenty of fathers/mothers/sisters who couldn't--though also many who could, and in those situations a third person might have been more of a fifth wheel. I know a common refrain is that doulas just know so much more about birth than the average husband/father, making them so much more helpful in labor. Well...I guess there are two remedies for that situation. One is to educate and empower the average husband, and I suppose the other is to hire someone else to fill that role. Given the kind of earthy and birth-centric household Matt and I live in, I can understand that my perspective on this may be just a tad skewed. And if a doula can facilitate a father's support of a laboring mother, as I've seen the good ones do, while filling in any gaps in support herself--then I'm all for it.
On the other hand, I'm sure there are those doulas, like the one in the article, whose agendas are stronger than their loyalty to their clients. This is also the case with many doctors, nurses, and midwives. In terms of not taking on clients who smoke or who don't plan to breastfeed etc--as long as they are upfront about it, I think they have the right to determine the scope of their services that way. Better to preempt the relationship altogether than build it on a foundation of misunderstanding, right?
A larger concern I have, not with doulas but with the woman who hire them, is that I've gotten the feeling that hiring a doula is seen by some women as a sort of shortcut, a way to ward off the undesirable aspects of hospital birth in one fell swoop--as opposed to investigating, confronting, and perhaps ultimately rejecting those things (hello, birth center or homebirth?) oneself. It doesn't work. Instead, it sets up the situation for a lot of tension and resentment when the mother chooses a hospital whose protocols and ideals are at odds with her own. The hospital staff--even if they are well-meaning--then bears the brunt of her disillusionment, which she could have foreseen or prevented had she asked a few pointed questions before deciding where to deliver.
Don't get me wrong--I'm incredibly frustrated with what I see going on in hospitals across the country right now: outright deception of pregnant women regarding routine interventions, and procedures like induction and C-section. On the other hand, I also believe that pregnant women (like all consumers) should do their best to arm themselves with information. Our society is no stranger to this kind of informed decisionmaking: how many hours do we spend poring over books and websites and speaking with "experts" in order to plan a perfect wedding? How much thought goes into buying a car? Yet the number of women taking prenatal classes is at an all-time low. (Here is an excellent article on that, and other things.) Even without attending classes, we're lucky to be living in a time when this information is out there. So hiring a doula is fine, but it's no substitute for thoroughly educating oneself.
And the fact of the matter is that hospitals and doctor's offices are businesses. So if consumers /patients don't like their policies--no eating or drinking in labor, routine separation of mom and baby after birth, continuous electronic fetal monitoring, nonmedical inductions at 39 weeks--I hope that they'll vote with their feet, as they say, and take their business elsewhere, instead of merely hiring a doula, sticking their heads in the sand, and hoping for the best. Taking down the routines of the medical establishment is too much responsibility for any one doula to bear, but pregnant moms can walk the talk by choosing midwives, asking hard questions of their doctors and hospitals, delivering in a birth center, or having their babies at home. Because it's only by becoming a vocal and visible body that we'll continue to have the option at all.
But I do cringe at how this makes us sound. (And am I the only one who thinks it's weird to see pregnancy-related information in the "Fashion & Style" section?? How insulting!)
Believe me when I say that doulas are a touchy subject. I've trained and occasionally served as one myself, and research bears out that a continuous, supportive presence in labor decreases the need (or perceived need) for all kinds of interventions and increases parental satisfaction with the birth experience. I think that good doulas have much to contribute, especially in situations where the mother's significant other isn't able to be that informed, calming kind of presence. And I've seen plenty of fathers/mothers/sisters who couldn't--though also many who could, and in those situations a third person might have been more of a fifth wheel. I know a common refrain is that doulas just know so much more about birth than the average husband/father, making them so much more helpful in labor. Well...I guess there are two remedies for that situation. One is to educate and empower the average husband, and I suppose the other is to hire someone else to fill that role. Given the kind of earthy and birth-centric household Matt and I live in, I can understand that my perspective on this may be just a tad skewed. And if a doula can facilitate a father's support of a laboring mother, as I've seen the good ones do, while filling in any gaps in support herself--then I'm all for it.
On the other hand, I'm sure there are those doulas, like the one in the article, whose agendas are stronger than their loyalty to their clients. This is also the case with many doctors, nurses, and midwives. In terms of not taking on clients who smoke or who don't plan to breastfeed etc--as long as they are upfront about it, I think they have the right to determine the scope of their services that way. Better to preempt the relationship altogether than build it on a foundation of misunderstanding, right?
A larger concern I have, not with doulas but with the woman who hire them, is that I've gotten the feeling that hiring a doula is seen by some women as a sort of shortcut, a way to ward off the undesirable aspects of hospital birth in one fell swoop--as opposed to investigating, confronting, and perhaps ultimately rejecting those things (hello, birth center or homebirth?) oneself. It doesn't work. Instead, it sets up the situation for a lot of tension and resentment when the mother chooses a hospital whose protocols and ideals are at odds with her own. The hospital staff--even if they are well-meaning--then bears the brunt of her disillusionment, which she could have foreseen or prevented had she asked a few pointed questions before deciding where to deliver.
Don't get me wrong--I'm incredibly frustrated with what I see going on in hospitals across the country right now: outright deception of pregnant women regarding routine interventions, and procedures like induction and C-section. On the other hand, I also believe that pregnant women (like all consumers) should do their best to arm themselves with information. Our society is no stranger to this kind of informed decisionmaking: how many hours do we spend poring over books and websites and speaking with "experts" in order to plan a perfect wedding? How much thought goes into buying a car? Yet the number of women taking prenatal classes is at an all-time low. (Here is an excellent article on that, and other things.) Even without attending classes, we're lucky to be living in a time when this information is out there. So hiring a doula is fine, but it's no substitute for thoroughly educating oneself.
And the fact of the matter is that hospitals and doctor's offices are businesses. So if consumers /patients don't like their policies--no eating or drinking in labor, routine separation of mom and baby after birth, continuous electronic fetal monitoring, nonmedical inductions at 39 weeks--I hope that they'll vote with their feet, as they say, and take their business elsewhere, instead of merely hiring a doula, sticking their heads in the sand, and hoping for the best. Taking down the routines of the medical establishment is too much responsibility for any one doula to bear, but pregnant moms can walk the talk by choosing midwives, asking hard questions of their doctors and hospitals, delivering in a birth center, or having their babies at home. Because it's only by becoming a vocal and visible body that we'll continue to have the option at all.
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