Are Doulas For Hospital Birth A Good Thing?

Quote:

The Center for Unhindered Living http://www.unhinderedliving.com/doulas.html Are Doulas for Hospital Birth a Good Thing? Although I know doulas want to help women, I don't think we should try to make the hospital experience more "comfortable" so women will think their births were OK and will choose hospital birth again in the future. I think they need to see it for what it is, and be forced to confront for themselves whether they really want to participate in this experience again or not, whether what occurs there is really "right" or not. I don't think most of them will do that if we make it "comfortable" for them. I don't think we need to try and be a "stepping stone" - we need to represent a clearly DIFFERENT option, one in which the woman is in complete control. I think when we teach our classes, we need to focus on getting across to them that the "natural birth in the hospital" idea is NOT possible. It's an illusion which the medical establishment promotes to get more women to come in. There is no such thing as natural birth in the hospital, because natural birth is more than not having drugs. It involves the total environment, and whether or not you are free to pursue whatever your body indicates is "natural" for you, even if that means howling at the top of your lungs. It also involves being in a "safe" environment, which the hospital is not. So in my classes, I make a clear distinction so that they can see that if they are thinking they will try to create a good birth experience in the hospital, it is NOT possible. And even if they leave the hospital THINKING it was good, that this too is an illusion. It is never good when you are dominated and controlled, even if you later come to believe and are brainwashed into believing that your experience was "good" and the domination was part of that good. What I am trying to do in my classes is to reverse the societal brainwashing most women have received, and I can't do that if I let them leave my class believing in any way, shape or form that the hospital environment can provide a positive experience in ANY measure. As an example, I tell them about my first birth. Even though it was a horrendous experience, when it was over and I was laying in the recovery room, I kept repeating to myself...."It's over, it's over, I'm not pregnant anymore" and I just kept feeling relieved that, no matter what I went through, it was over. I kept having this feeling of gratitude toward the hospital until about 18 months later. At that time I received a book from a friend, and learned for the first time that much of what I went through in my pregnancy was due to a vitamin deficiency that could have been corrected, but that of course the medical establishment doesn't believe this or has no clue that things can be managed this way. I got very angry and finally LOST that gratitude, which is a necessary thing if one is going to progress to becoming empowered. One cannot view the hospital as a positive place. That is what I am trying to create in the women who take my classes. I do not want to perpetuate the institutional myths of our culture, and I want to represent an option women can choose which is diametrically opposed to institutional care. Doulas are part of the institutional care model, whether they like it or not. Doulas, whether they like it or not, are being USED by the medical establishment. They are being used to keep the laboring woman under control. Even though WE feel we are helping women, the medical establishment uses us to give the woman the ILLUSION that she has some control, to help keep her calmed down so she is no trouble. Believe me, I have attended hospital births in the form of a hospital support person, and unless you are going to get aggressive and get in people's faces, you are just NOT going to be able to accomplish anything, because you are not seen as a professional who knows anything, and you can suggest nicely that the laboring woman wants this or that, and you will be overlooked and told no because you aren't seen as an advocate, you are just seen as someone to pamper the mom so she will be quiet and no trouble. The hospital sees your role as totally different than you do, and they use you in that role. I refuse to be used by them, so I choose to advocate a radically, totally different option for women. That's what The Center for Unhindered Living is all about, giving women options, and support for deviance from societal norms. We are about creating a safe place and a better world, and about remaining autonomous.

Just to let everyone here see what I read today..... I found this in many ways upsetting but everyone has a choice.
There's one on this site about kissing your baby, which has good.
I hope no one gets offended by me posting this.

[fearlessbirth]

Wow..that was really intense. I can see where this woman is coming from in some aspects. I have wondered myself if I would be comfortable doula-ing in a hospital since I am all for natural, homebirth. But the more I thought about it I realized that there are probably LOTS of women, who no matter how educated they were on matters, would not feel comfortable giving birth outside a hospital. And don't they deserve to have support and someone to explain their options? Even if they don't choose like we would? Hmm...alot to ponder.

I know that's what I thought. It is her choice. For me not to support someone just because they're wanting a hospital setting, would be completely hypocritical for me to say "No". Both of mine were in hospitals. It is her choice & that's what I support. I have the upmost respect to women who go natural....

[Stacie]

Um, I have looked at their site before and, well, take it all for what it's worth.

I understand some have the need and desire to live as much of an unhundered life as they are, but it is not for everyone. Homebirth, too, is not for everyone. So I have no issue supporting a family who wants or must have a hospital birth. Is the medical establishment using me? Or is the family using me? Who cares as long as the family is happy.

[DL]

I'm all for homebirth , but every birth that I have supported so far has been in the hospital! Home birth is not very common in a lot of places, and that's just the reality at this time. (I soooo want to attend a home birth, btw!!) I don't think that stopping hospital doula support would make moms change their minds about where they choose to give birth. If anything, that action would cause regression in standards for hospital childbirth. Whether we see it as "right" or "wrong", some mommas are more comfortable with the hospital or birthing center idea, and I need to respect them in their choice.

Anyway....if you ask me, moms in hospitals REALLY need good doula support, especially if she wishes to avoid interventions! I think that as doulas, it's our job to help the mom to have the very best birth possible for her. That would be by her definition, not mine. It's her birth, not mine...so I have to constantly keep that in mind. I educate them, make sure that their decisions are very informed, and then I support them in their desires....hospital or not....yes, even drugs or not. (Although I'm thrilled when they choose and go through with a natural birth; I'm happy to say I've supported more natural births than not!!!)

I think the author certainly has a right to her opinion, but I find her attitude somewhat arrogant (and that would be my opinion! ). To state that a natural birth can ONLY take place at home is absurd, IMO (your mileage may vary). It sounds to me that she is brainwashing women on the other end of the spectrum! Yes, it's much more difficult to achieve in a hospital setting, but I've personally been in on some wonderful natural births at the hospital, attended by some great CNMs I know. No, it's not always easy to doula in the hospital environment; I think she had some struggles and was too quick to quit if you ask me. Well.....that's my

Happy birthing, everyone!!!....be it home, hospital, or wherever!! (I still look sooo forward to attending that homebirth someday!! I bet it's just awesome!!)

Off the now!

Carrie...... thanx for sharing! No, I'm not offended by you posting this; but you know how we doulas are... we're a passionate bunch!

oops! Edited because it should have been "brainwashing", NOT "brainstorming"! LOL

[DL]

Quote:

Originally Posted by Stacie ...Is the medical establishment using me? Or is the family using me? Who cares as long as the family is happy.

Stacie.....I love that! Besides....I love birth so much...USE ME, please!!!!

I just didn't want anyone to be upset at me... Yes, the author does have the right to their own opinion. Wanted to give everyone a heads up on it.
Yes, please use me... lol

[Stacie]

You know, I love homebirth, I would be all about homebirth, but in my area doulas don't regularly attend homebirths as the hb midwives work in teams of two, and they come asap when labor begins. If I attend a hb it's mainly to take care of the sibling(s).

I wanted to have this baby at home, but this baby wasn't planned, and it was too much money for this college family versus an insurance-covered hospital birth -- maybe with my next baby .

But realistically, we know from working with families not everyone is comfortable with homebirth, and that's perfectly fine in my book -- I would rather someone have a hospital birth with all the comforts of technology than have a hb and be scared out of their wits, you know?

I have issues with blanket statements and fear tactics -- whatever side of the fence they fall on!

[JerseyJess]

Hmmm....I'm really not sure how to start. As someone who has had 3 hospital births and 1 homebirth, yes I can totally see the distinctions.Personally, my goal is to aid my clients in having a positive experience-whatever that means for them. I want them to be happy about their births. I try not to reframe their experiences (in a negative light, even if it is more truthful) because ultimately their perception of that day is way more meaningful to them than it is to me and the majority of them are not looking to reform the birth world. They see it as a stepping stone into motherhood-they don't want to feel angry, victimized, disappointed, hurt (even if they have every right to feel that way). In fact, spend some time in a room full of more main stream women and you will probably come across women who revel in the retelling of their horror stories. They wouldn't change a thing, bc some wear their labor abuses like medals of valor. As in "just look what I was willing to go through to have my baby" I would caution anyone against trying to enlighten such a woman that her trials were unnecessary-she doesn't want to hear it.

I'm all for presenting ALL options and I think childbirth education classes SHOULD delve more into the option of homebirth and use of CNMS/CPMS/CMs etc...but just as I wouldn't tell a woman that homebirth is wrong I couldn't tell a woman that hospital birth is wrong or that you cannot have a positive experience there. I have seen plenty of beautiful hospital births-where the nurses, and careproviders were completely hands off, where the women were naked, vocal, in dimly lit rooms, music playing, no time restraints etc... and it was their choice to be there, bc thats where they felt safe. I've also seen births that were more "managed" that were exactly what women wanted, they didn't want homebirths, they didn't want that level of responsibility. This was their idea of a perfect experience.

Also, out of birth experiences are just not an option for everyone (unless we're discussing UA but for the sake of this post I'll just stick with assisted) I had to have my platelets checked every week and if they fell below 100,000 then I was risked out that week. And at $4,000 out of pocket I don't think I could afford another homebirth. There are also women with real pre-existing medical conditions who need a more medical environment. I would hate to have told these woman that they can't have a great experience simply bc they have to go to the hospital.

I worry that these women will feel so defeated, should they ever have to encounter the hospital. Its also pretty obvious that she has her own unresolved issues about her own birth and she seems to be spreading that anger like wildfire.

[Rachel H]

Wow. I don't know where to start. I think I need to sleep on it before starting.

[earthgirl]

While I can respect what she says, it is her perspective, and I believe she is wrong in some respects. It doesn't surprise me that she had a horrendous experience (considering the tone of the article), so her actions follow her thoughts and her personal experience.
As doulas we are to empower women to take charge of their birth, not take charge for them, or keep them a quiet patient.
Of course, ideally women would all go back to having babies at home, with whomever they want attending. Doulas (hopefully) assist women, in making informed decisions through knowledge of alternatives. Including UC, HB, BC. But the truth is, until we can once again trust our bodies on a whole universally conscious level, birth isn't just gonna leave the hospital. Baby steps. This is just the beginning. Doulas blazing trails of options otherwise unknown to the average woman. And what about the woman so afraid of her own body, who only feels safe in the hospital? Trying to change her mind could be a dangerous thing.
I had the great fortune, to have unmedicated births at a hospital birthing center. I consider myself lucky. I didn't realize how much I didn't know, until I took my doula training. Damn I could of had my girls at home, damn why did I let them give my baby a bath...damn I wish I had a lotus birth....the list could go on. But I only have myself to blame. I did no research, and asked no questions. And I say I was lucky b/c, since attending births highly medicalized with OB's attending, it totally could have been me. I just happened to ask the right person who her care provider was, and she saw midwives (first time I heard what a MW actually was)
I hope I'm making sense...when I ramble I have trouble articulating my thoughts, so provoked. LOL!

[helpinghands]

Thought provoking, for sure..especially since I have had 3 hospital births and 1 UC, (not in that order, either),..and doulas at all of them, in varying capacities.

This quote here

"I don't think we need to try and be a "stepping stone" - we need to represent a clearly DIFFERENT option, one in which the woman is in complete control."

See.. I don't think that as a doula..my goal is to be a stepping stone. My goal is to be "with woman". To just BE there..holding the space, whatever she needs, comforting, supporting her through HER birth. I also don't think that it is possible for a woman to be in complete control of a birth. Birth.. happens...it unfolds,..we have choices that can have a ripple affect on that unfolding..but we cannot control it. Doctors and some midwives may TRY..but they cannot truely reign that powerful process of birth. I struggled for some time with the whole concept of doulas and hospital versus homebirth and UC, etc.. but I ultimately decided that it is not up to me to judge anothers experience..but I choose to support..to comfort..and most importantly..to just bear witness to this incredible journey these women invite us to walk with them, in their birthing rooms.

[Jadethedoula]

Hmm. Well, I don't see it as my job to placate women, (make them into "good patients")and make them think that everything was great when it wasn't. But I also don't want to project my own fears or analyses onto a mama's experience. And I certainly want to make the experience the best that it can be within the circumstances.
This has proven to be a difficult balance at hospital births I have attended where I witnessed the staff wanting the mom to be very passive, or where there have been a lot of what I know to be unnecessary interventions. How do I discuss this with the mom? How do I avoid taking center stage? How do I honor her choices? How do I shift the energy in the room without saying too much?
All good questions, no easy answers. I am always wondering if I said and did the right thing. Always fine-tuning.
One thing I feel very strongly about, though: Every mom deserves support. We should not force moms to "face the consequences" of their choice to have a hospital birth as some sort of punishment for what we view as a "wrong" choice.
We should protect and support her, and reduce the harm done in the hospital by helping the mom be in her power, and be treated with love. The more moms learn what its like to have respect and support from professionals, the more they will demand it.

[AussieDoula]

It's funny that this was brought up, because months ago I started contemplating this very thing (and touched on it lightly in chat one night) which led to an extremely long blog of my own that I won't bother to post here. For the last several days I have been trying to think of a way to word my response to the "Why Does It Matter To You" thread, and this topic is one of my points...

As for this woman's particular 'article', I really think that it was worded poorly and that she sounds too combative to effectively change anyone's mind - which is exactly what she sounds like she is trying to do.

It's sometimes hard to set aside your own feelings and look objectively at something, it sounds like the author still has many unresolved issues about her birthing experience and is using that anger and aggression as a platform for something that should be approached with tact. It is one thing to be passionate about something, but I feel as though she is losing a lot of her intended effect by being so one-sided.

Quote:

Believe me, I have attended hospital births in the form of a hospital support person, and unless you are going to get aggressive and get in people's faces, you are just NOT going to be able to accomplish anything, because you are not seen as a professional who knows anything, and you can suggest nicely that the laboring woman wants this or that, and you will be overlooked and told no because you aren't seen as an advocate, you are just seen as someone to pamper the mom so she will be quiet and no trouble.

I don't enter into this work for recognition by anyone else about my professional abilities, I do it to empower and support women. I have deeper thoughts on this - even extending to homebirths and midwives but I will save it for another post to stay on topic...
Our role as Doula is not to get in anyone's face. We don't make choices for our mamas. I don't suggest anything to anyone - nicely or not. It is mama's responsibility to speak for herself, and mine to teach her how to do that during our prenatals if she needs it.

This type of thinking and lapses in detailed training is exactly why there is such a problem with not having set guidelines across the board for Doulas. The lines become fuzzy and then there is confusion as to what our role is and how to effectively advocate for, teach, and support mamas.

We aren't there to control the experience for mama, or use our own beliefs to skew hers. We are there to allow mama to make choices for herself knowing we have given her the best information possible to do so, and then support that choice.

Honestly, depending on the type of Doula mama finds will dictate the chances of her making decisions through lack of knowledge or giving her the chance to make truly empowered decisions. Lumping all Doulas into the same mould is unfair, especially considering the vast variety of teaching styles.

To cut this short (because DC is waking up sick) I agree with this view to a certain extent and in a much more rounded light, but her delivery just wasn't doing it for me.

[douladot]

Quote:

Originally Posted by AussieDoula It's funny that this was brought up, because months ago I started contemplating this very thing (and touched on it lightly in chat one night) which led to an extremely long blog of my own that I won't bother to post here. For the last several days I have been trying to think of a way to word my response to the "Why Does It Matter To You" thread, and this topic is one of my points... As for this woman's particular 'article', I really think that it was worded poorly and that she sounds too combative to effectively change anyone's mind - which is exactly what she sounds like she is trying to do. It's sometimes hard to set aside your own feelings and look objectively at something, it sounds like the author still has many unresolved issues about her birthing experience and is using that anger and aggression as a platform for something that should be approached with tact. It is one thing to be passionate about something, but I feel as though she is losing a lot of her intended effect by being so one-sided. I don't enter into this work for recognition by anyone else about my professional abilities, I do it to empower and support women. I have deeper thoughts on this - even extending to homebirths and midwives but I will save it for another post to stay on topic... Our role as Doula is not to get in anyone's face. We don't make choices for our mamas. I don't suggest anything to anyone - nicely or not. It is mama's responsibility to speak for herself, and mine to teach her how to do that during our prenatals if she needs it. This type of thinking and lapses in detailed training is exactly why there is such a problem with not having set guidelines across the board for Doulas. The lines become fuzzy and then there is confusion as to what our role is and how to effectively advocate for, teach, and support mamas. We aren't there to control the experience for mama, or use our own beliefs to skew hers. We are there to allow mama to make choices for herself knowing we have given her the best information possible to do so, and then support that choice. Honestly, depending on the type of Doula mama finds will dictate the chances of her making decisions through lack of knowledge or giving her the chance to make truly empowered decisions. Lumping all Doulas into the same mould is unfair, especially considering the vast variety of teaching styles. To cut this short (because DC is waking up sick) I agree with this view to a certain extent and in a much more rounded light, but her delivery just wasn't doing it for me.

couldn't have said it better myself!