Ways to effect change?

[syncreo]

Kimberely's post about her last birth experience as a doula got me thinking about what the best way to effect change is or what as a doula you think the best way to change a system or particular hospital practise you don't agree with is?

I will come back and reply later but right now I am running out the door. I wanted to get the question down before I forgot or got distracted

[doula Michele]

Just keep doing what we are doing, educating one woman at a time.
I think the key is lots of prenatal education. If women learn their options, learn where to find the research, learn to say NO, then sooner of later we are seeing more and more change taking place. But it can not be the 'doulas' pressuring for change. I think it needs to be the women we are educationg. Doulas are just the catalysts. It can not be doulas vs medical staff, or doulas vs gov't. It must be tax paying families standing up and saying " we want better care'.

Women (and men who love the women) need to find out what their politicians views are ( I am not political at all, but I am learning they hold the money). and vote accordingly. They have to demand change.

But it all starts with doulas educating one woman at a time.

[UtahDoula]

Absolutely the best and most efficient way to get change to occur is by educating the CONSUMERS that they need to speak up! If a doula tells a hospital "You need to do this" - they'll just blow it iff and say that business is fine. But if they are hearing from CONSUMERS that they are choosing to go elsewhere or that they are unhappy and won't be returning, well that speaks volumes.
Some things I do:
I've researched and can provide names and numbers of specific PEOPLE that women can contact with complaints. Generally this is the women's center director or similar. But I *always* find out who the director of marketing (or PR) person is and recommend my clients cc them on the letter. From my experience working inside the hospitals, once the person responsible for the image of the hospital gets a bee in her bonnet about something that reflects badly on the hospital - changes start happening. It may take 3 or 4 or 5 letters, but I've seen it work.
I teach couples in my class to be good consumers. (Not good patients!) I draw a comparison to a car salesman - that the car salesman doesn't know you and your family and the specific needs and desires you have, and you shouldn't let the salesman be the sole decision maker in which car is right for you. However, he does know the cars pretty well, so you can and should ask lots of questions to get the info you need. I teach them the BRAIN process and get them to see things and weighing options and making decisions, rather than being compliant.
We have one local hospital with NO midwives on staff. Not a one. There are 11 other hospitals that do births within a half hour drive of this hospital, all of whom have CNM service. This hospital happens to be 2 blocks from my home. The former CEO of this hospital lived in my neighborhood and I was acquainted with him from having children in the same school. I spoke with him every time I saw him and asked about midwives. I let him know that I was often asked by neighbors about good care providers, and that I had to send them to other facilities to get midwifery care. I make sure he KNEW that I personally drove right by his hospital while in labor to get better care. It got to be a joke between us, but eventually he DID invite me to attend a meeting of an exploration committee to look into getting midwives on staff there. It was interesting, there was a LOT of resistance from the OBs rep. But Bob got offered a job at a bigger, swankier place and is no longer there, so I'm starting over with the new CEO.

[AmandaB]

Utah, I love the idea of teaching expectant parents to be good consummers .... I may use that. Do you mind?

[dorothyh]

Quote:

Originally Posted by doula Michele I think the key is lots of prenatal education. If women learn their options, learn where to find the research, learn to say NO, then sooner of later we are seeing more and more change taking place. But it can not be the 'doulas' pressuring for change. I think it needs to be the women we are educationg. Doulas are just the catalysts. It can not be doulas vs medical staff, or doulas vs gov't. It must be tax paying families standing up and saying " we want better care'. .

[Mile High Doula]

I believe in prenatal education and that clients can help facilitate this change but I also believe in educating the medical staff. You can do this by hosting inservice's or seminars to your local hospitals. Some do mini-conferences and offer CEU's to encourage attendance at these events. I am hoping to put something like this together next year for a bunch of hospitals. We want to facilitate change as well...1 person at a time.

[earthgirl]

Changing the system of maternity care is one of the greatest obstacles we face as women today. Personally I don't think one woman at a time will be effective enough for an about face. We need a complete overhaul. We need advocacy from women's rights groups, we need women to take an active part in the care they receive instead of putting their lives and bodies in the hands of professionals. We need women to demand better care, and we need the world to wake up and realize that how women give birth, and how babies are brought into this world matter. Education on a mass scale. Inundating the media with the travesties that can be avoided with true evidence-based care. Allowing for midwives to do what they do best, and on equal ground with OB's who do what they do best.....when they are truly needed. We cannot avoid the politics of what needs to be done. It is quite astonishing that many in this country are unaware of what exactly is a midwife, what she does, or what normal physiological childbirth looks like. I think one of the first steps besides educating the consumer and expecting the best care, is getting the country, and insurance companies to realize that we have too many OB's practising, not enough midwives. On a community level we have to look at the laws in the individual states and fight for the midwives.... and in that giving woman true autonomy in childbirth. We need options for choice...if we cannot legally choose a midwife to attend a homebirth in some states then we have lost some of our rights. We need to fight...women of the world unite!

[syncreo]

Great post Stacie. We have funded and regulated midwifery care here in Ontario so in some ways that fight has been fought and won. BUT, I was just speaking with a student midwife who was saying that the consumer movement that was so active during the push for regulated midwifery care has all but disappeared in Ontario yet there is still so much work to be done. After over 10 years of regulated midwifery care in this province we still have most of the problems and issues that the rest of you face. How is that?

We need to get the fires burning again because the work is not overwith yet.