Ok, so this is a funny situation. I am both a hospital doula and a private doula. I had an OB complain about a birth I attended as a private client to my boss at the hospital. He did not know I was one of their doulas. What he said was all lies really because I do not speak for my clients.
Anyhow, as a hospital doula, where do your interests lie?
My interests lie with both the patient and the physician but this OB basically made up some stuff. It was weird. I try to facilitate communication between the staff and my clients. I don't tell my clients what to say, nor do I say it for them. I have been hired just because I was a Marine and they want me to yell at people for them. I don't do that either. It is very clear that I do not speak for my clients, that they have a voice and I am there to help them use it.
Basically, the OB said my client needed an episiotomy. The way he presented it was walking into the room performs no exam, but sees baby is close to crowning and says, "You don't trust my 20 years experience that you need an episiotomy?" No hi, how are you? Nothing. My client says, "I don't want an episiotomy." This goes back and forth between pushes with my client looking to me for information. All I say to her is, "It's your choice or do you consent to the episiotomy now?" I never speak to the Dr. I don't even look at him while this is going on, however, he says that I told him that my client doesn't consent. What an idiot! I am not in charge. If she doesn't consent, don't ask me, ask her! Why is he listening to me anyhow if I said this to him?!?! He also said that I said the same thing to him about the vacuum extraction however, this procedure was never mentioned. My clients don't recall him saying that and they were like, "If he said vacuum, we would have remembered that. He didn't."
Anyhow, my clients are super happy and they never felt that I spoke for them. This was not their OB, but the on-call OB. She would have rather had the nurse deliver the baby actually because he was so negative.
So, the ethical question for you hospital doulas is...where do your interests lie? Is it with your client or with the hospital? I knew this was going to be an issue and this is the 2nd hospital I have worked for and it rarely came up actually, but the reason it has come up today was because in speaking with my boss, she had told the Dr. this, "If it had been one of my doulas, this wouldn't have happened." This was before she put 2 and 2 together. I am one of her doulas and I wouldn't have done anything differently hospital doula or not.
So, what do you do in this situation? A client doesn't want something, do you tell them it's their choice giving them a voice? Do you be quiet? Leave the room without saying anything? Tell your client to do it? What?
Food for thought. Let's ponder this.