Getting over NCB bias

Dese · 05-23-2008, 01:18 AM

I'm still debating about whether becoming a Doula is the right choice for me. I have a 5 month old right now with plans to have more sometime in the future. That's another subject, but I guess my biggest concern right now is that I am honestly very biased towards natural childbirth. I know being a Doula you have to be able to accept without judgement the birth choices of your clients. I'm thinking in general women who seek out Doulas are probably more inclined towards at least trying for a natural birth and being all about informed choice... less likely to seek out unnecessary inductions and elective c-sections. Am I right or wrong here? I know the reality is sometimes c-sections are helpful and necessary, and the same goes for inductions.
I had a 10 hour labour, at home waterbirth... and it was great. I just don't know how to open myself up more to the reality of women not necessarily wanting the same natural birth experience I had (and loved). Does anyone have any experiences with this or have you felt like this and been able to deal with it?

DoulaKaren · 05-23-2008, 07:09 AM

For me, as a new doula myself who has only been to seven births, the more I understand that I have a lot to learn. There are a lot of different people and a lot of different labors -- no reason to think that everyone will want the same experience. Of course I say this as having had a high-intervention labor that ended in a csection and a low intervention vbac. So I have seen both sides of the coin.

I get to know my clients very well prenatally and I make sure they have the information they need to make an informed choice. After that I can really accept and support their choices.

doula Michele · 05-23-2008, 09:24 AM

I guess you can always 'specialise' in one type of birth, but you need to stay open to the ideas that everyone may have a different idea about what they need, or at any given time during labour they have the right to change their minds, and you still need to give them unconditional support.
This is emotional and demanding work....take your time and think about what you want.

christiecookie · 05-23-2008, 09:47 AM

Interesting that you should ask the question. I too had a "natural" homebirth, and went into it, and since then expanded, certain ideas/attitudes about how birth can be (I'm careful not to use "should"). It's been several months now since I started exploring the idea of becoming a doula, and it's been an interesting ride. I've talked to a few doulas in my area, one at length, about that very thing: how do I deal with my feelings, attitudes, and beliefs about natural birth, especially while working with families in hospitals? Maybe those who want hospital births, who desire some amount of intervention?

I don't have the answer. I'm just working through all of that myself.

MothertheMother · 05-23-2008, 09:59 AM

I believe that if you have a bias toward unmedicated birth and you aren't sure you can leave those feelings out that you should not take on clients that are comfortable with those interventions. There is nothing wrong with becoming a doula and deciding to only work with women who chose to have unmedicated births or even only homebirths. This may be where you are best suited to work.

I hope this comes across as gently as I intend it but I basically think that a doula with this kind of bias is not the right doula for a woman who wants an epidural or even wants to just see how it goes and isn't dedicated one way or the other. No matter how good an actor a doula is I just don't believe you can really hide these feelings if you are thinking your client is making the wrong choice constantly. It's one thing to hope they'd make a different choice because you know the statistics of the outcome but it is entirely different to think the choice is just wrong because they aren't going to have the good kind of birth.

LParks · 05-23-2008, 10:09 AM

I'm kind of dealing witht he same thing. I don't think an epi or other interventions are wrong really. For me it really is more about informed consent. I really feel that most women when given the information would choose a low intervention birth. I haven't had any births yet but i really feel that if a mom educates herself, and still chooses an epi or other intervention I would be able to support it.

I know what you mean about being so happy with your birth and not understanding how others wouldn't want the same thing. For me the harder issue to deal with is bf'ing. I really don't understand not even trying to bf and think I'll have a hard time with that if a client chooses to formula feed from birth. But I guess that's a whole other issue.

doula Michele · 05-23-2008, 10:45 AM

Quote:

Originally Posted by LParks

I'm kind of dealing witht he same thing. I don't think an epi or other interventions are wrong really. For me it really is more about informed consent. I really feel that most women when given the information would choose a low intervention birth. I haven't had any births yet but i really feel that if a mom educates herself, and still chooses an epi or other intervention I would be able to support it.

I give all of the women that I work with info, and we talk alot about informed consent, etc etc..... Alot go into labour thinking they want things a certain way, no drugs, no interventions and part way through they change their mind. Thats ok. Often at some point they just want it over or want it out, and that takes precidence over the low/no intervention birth plan that they thought they wanted.

Dese · 05-24-2008, 01:45 PM

Thank you for all your replies! I guess it really is a matter of just providing as much information as you can then supporting the mother no matter what choices she makes. I am just going to have to work on my attitudes. I think, really, it is more a matter of seeing how some women don't seem to know their options or that they even have any. But again the woman who seeks out a Doula is probably more informed than not.
Just working through it all.

strawberry · 05-24-2008, 01:53 PM

Hey Dese

While I havent had any kids yet, I kind of have the same opinions as you. I am 100% an advocate of home birth, esp. water birth. Thats so inspiring that you had a long labor process, and got through it all. What a strong lady

I think you're right in believing that if a woman considers having a birth doula in the first place, she is def. (in my opinion) a little more open-minded and ready to fully embrace the birth process. I wonder how many women wanting doulas are full advocates of medication in the labor process?

amymaew · 05-24-2008, 01:55 PM

Quote:

Originally Posted by strawberry

I wonder how many women wanting doulas are full advocates of medication in the labor process?

I've had plenty! From women who wanted the epidural in the parking lot, to women who prefered an episiotomy to tearing, to women who wanted to be induced. They all still need support in my experience.

TommysMommy · 05-24-2008, 03:10 PM

Why don't you become a NCB educator? That way you can still be in the birthing community and have a predictable schedule...and be an advocate for what you feel passionate about! Best of luck in your decision and congrats on the sweet baby!

patricelondon · 05-24-2008, 07:03 PM

Which orgs train in NCB? I'm looking into ALACE and birtharts. I think I'd be happy to simply know that the women I work with know their options and go on to have the type of birth they want but because I am very biased towards homebirth and natural birth, I'm not so sure. I've given birth 3 times, once in the hospital, a birthcenter and last June at home in a birthing tub. My hospital experience was horrific. If I could have had my second at home I would have but had to wait and do it with the 3rd. I was thinking that for my certifying births I'd intentionally seek out different types of birth, hospital, birthcenter and home, so that I can have some experience. I've done one hospital birth some years ago (when I first thought about becoming a doula and did a little training). I know I'm not so comfortable with what goes on there. I still want to do it though just to see how I feel because though I didn't like how things went, I enjoyed being there for the young lady.

amymaew · 05-24-2008, 07:21 PM

Quote:

Originally Posted by patricelondon

Which orgs train in NCB?

I know Bradley does www.bradleybirth.com

MothertheMother · 05-24-2008, 07:59 PM

Quote:

Which orgs train in NCB?

you might check out Birth Arts as well. They just started a new cbe program and from some of your posts it sounds like it might be right up your alley!

www.birtharts.com

swissmiss · 05-27-2008, 12:50 PM

Quote:

Originally Posted by Dese

Thank you for all your replies! I guess it really is a matter of just providing as much information as you can then supporting the mother no matter what choices she makes. I am just going to have to work on my attitudes. I think, really, it is more a matter of seeing how some women don't seem to know their options or that they even have any. But again the woman who seeks out a Doula is probably more informed than not.
Just working through it all.

You would think that, wouldn't ya? But of my two clients so far (I know, not a lot, but, hey, I just got my packet in December!), both were relatively uneducated about birth beyond the "What to Expect" kind of information. Both wanted a natural birth. The first ended up with Pitocin for an induction/augmentation (kinda weird story with her) and had the epidural. My second is due any day now and has professed a desire to go natural, but isn't opposed to the epidural. She's also more than willing to be induced (for no medically indicted reason), which tells me she isn't really all that gung-ho about going natural. And if she does have the induction, she likely will have the epi (since for some reason the SOP seems to be to crank the Pit up continually until baby is born, and then just once more for good measure

) So, I don't think that women who want doulas are all that knowledgable about birth. I think some just really like the idea of support for her, particularly when there's questions in her mind about getting it from someone else (baby's father, mother, sister, etc). I know that's the case for my second client.

As far as your question goes, I realize that the most important thing is that the woman have the birth she wants. If that means an epidural, fine. If she walks (or is wheeled) out of the hospital with her head high and a grin a mile wide on her face, who cares how we got there?
Check your PM.