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Old 11-12-2012, 07:47 AM   #30
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Re: Tell Me About Doulas

Originally Posted by melilo View Post
This is getting to be quite the interesting discussion.

I must add, please do not bash all of Ohio. Here in my area we have some of the best doulas. Most of them are DONA trained and abide by that code if ethics and conduct. The current president of DONA lives here in Ohio.

As to the comment about completely trusting the staff to take care of you, many mamas including myself simply cannot. The section rates are very high here and having the knowledge that I do, I know that I may need to disagree about my care at some point. I also know that I don't know everything and in a situation where I don't feel properly educated I would trust a doctor or nurse.

I'm sorry to anyone who has had poor experiences with doulas, but it is certainly not the norm everywhere. It is bad apples like that that give all doulas a bad name. Just like one bad nurse can spoil someone's opinion of all nurses.
I wasn't bashing Ohio. Ohio is a lovely state, I have friends and family there, and we had thought about moving there before. I was simply saying they aren't the friendliest of places to birth at.

Originally Posted by z2akids View Post
While I would agree that Ohio isn't a role model for "crunchiness," I birthed all 3 of my children at a hospital that 12 years ago had labor/deliver/recover/stay rooms. Babies roomed in. They had one with a deep tub. And, the '08 (I use those because I found them quickly) c-section rates were 16%. My first time around, I was GBS+, my membranes ruptured 12 days early and I did not go into labor on my own. Would up in extended labor and exhausted. I wound up with a bunch of interventions as a result. However, I did not have nurses and a doctor who rushed me off for surgery. I did wind up delivering with a bunch of surgical interns in the room, because we were heading in that direction. However, my doctor was ancient and my first was vacuum delivered. Anyway, I just think it's unfair to bash an entire state.

Again, I wasn't bashing Ohio No where in my previous responses did I say Ohio was bad or anything. All I said was it is not the friendliest places to birth in and that may skew a view of Doulas there. I have a family member who is a Doctor there at a large hospital there, as well as friends who live there. That was one reason why we had decided not to move there. Other than that Ohio is a lovely state to live in.

Even in this thread, I see very differing opinions from doulas as to what their role is. That was my question and ultimately is my concern. I think that it may be an excellent option for people who need an extra support person focused on making sure that they remain focused - encouraging, reminding them that it won't last forever, relieving dad or grandma, etc. As I said, it is not something I would have any desire for for myself. DH and I were happy to be left entirely alone for the majority of my labors with nurses in only intermittently. But, my lack of desire isn't because I think that they wouldn't be useful support people for others. It is simply my personality and my relationship with DH.

But, even on this thread, this isn't the only view of a role of doula that I read. The idea that it is the doula's job to give mom options seems a bit scary to me. I am trying to figure out exacty where the doula gets the education to be qualified to determine and discuss options. I have read that some L&D nurses doula in their spare time, etc. I an see them having the education to present options. However, I wonder how a mom knows if their doula is qualified to offer what appears to be medical advice.

Again, that is a hard question to ask because not all Doulas come from the same background. For a certified Doula they have to take a course which involves reading, assignments and a few births. Others will require that plus workshops and/or apprenticship with another Doula. Doulas do not give out medical advice. They can give out options for different positions, different things to help relieve pain (without medicine), etc. However, a Doula who is also a nurse may give out medical advice as she is already qualified to do so. A woman can find out what her Doula is qualified for by looking at her certification and/or prior education. If she is a nurse she can double check with the hospital she is employed with to make sure. If she's certified she can look up her Doula on the website to which she is certified with. There is also re-certification with most programs. You must be up to date in order to keep your certification.

Unfortunately, I think a mom comes in set up for a difficult time when the nurse says let's check to see if you're in labor and the doula replies - she is in labor. Sure, the doula may well be right, but right then she's pitting herself and by extension, her client, against that nurse. Certainly, it isn't a foregone conclusion that things will go downhill, but I can just see that nurse's mind jumping to the conclusion that it's going to be one of those kind of days where everything (even things that don't need to be) is going to be a fight.

There is a right way and a wrong way to say things. I think the woman who said that was saying it was for the mom and not really for the nurse. I wouldn't have said that however, as the mom needs to decide if she wants to be checked or not (vaginal checks upon coming to the hospital is not that common in the hospital near me however).

Again, I do come at this from the POV of a nurse in a medical setting. All of my patients are sick. I understand that low risk laboring women are a different patient entirely. So, I know that I come to this with the bias of how I feel when a random person tells my patient with serious clots that they shouldn't take the thinner that we wanted her on because it interferes with the high doses of vitamin K that his "natural" remedies company made. I still wonder from time to time if that woman is dead yet from that advice.
Yes your view is going to be different because you work with sick people. I work with, mainly, healthy moms. While *I* am a more crunchy person, I am not a crunchy birth professional. And I think that is what people who don't understand doulas or midwives think, that our work is crunchy, but it's really not. All of the certifications (and I do have a medical background from college) are comprehensive so I can work in any setting with any type mom. Homebirth, hospital, unmedicated, epidural, and even with c-section moms. I think if Doulas are as bad as some think they are then hospitals wouldn't allow them nor employ them. Some hospitals don't, but its few and far between.
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