Stuck between a doula and a hard place

9 years ago

I’m not going to watch the Ricki Lake video. I'm not giving birth at home. But nor am I comfortable with a purely medical birth. In an ideal world, I think, I would have my baby in a birthing clinic, with a midwife. With yogic breathing and candles, maybe water. And definitely no drugs. But as a first-timer with a high anxiety level, that doesn't feel like an option. I am with one of the best practices in my city, and will give birth at one of the best maternity hospitals in the world. I’m blessed, but increasingly alienated from my birth practice. I like my doctor but the whole experience is entirely medical. I have a hard time standing up for myself, feel too rushed to ask the questions I need to. The other day I got a bill for a $352 test I didn’t even know I had had. And when I have minor pains or mysterious ailments I face a stark choice when considering whether to call my doctor: they will either tell me everything’s fine, and to take some Tylenol. Or, I’ll come in, and more big-budget tests will ensue. Neither is a very comforting choice. Often, the whole experience of doctor visits leaves me a little empty inside.

So, I decided to look into doulas. I have followed, and been grateful for, the work of Katharine Stone and her writing on Postpartum Progress. I take very seriously the threat of postpartum depression and I want to prepare against it. The BirthWithConfidence blog (written by Lamaze) cites a recent study:

Related to the findings on the mental health of new mothers, what struck me most was that at the time of the survey 63% of mothers were likely to be experiencing some degree of depressive symptoms and 18% appeared to be experiencing symptoms of post traumatic stress related to their birth experience.

The writer continues,

Childbirth educators and doulas have noted for years now the increased incidence of PTSD and have shared with each other women’s stories that seemed to describe a relationship with both the escalating rate of medical intervention..nearly routine induction, unnecessary and frequent internal examinations..and impersonal, routine, and, sometimes abusive treatment of women in labor. It’s not just the stuff that gets done to women…routinely, abruptly, and uncaringly. It’s the powerlessness that women feel in an environment that is inherently frightening at a time when they are vulnerable and literally at the mercy of the system. Gone are the days of kind words and encouragement and loving touch. Now it’s get the job done fast or you’re on the cesarean fast track.

A doula seems like a great compromise between the reassurance of a high tech hospital birth and a more human experience. The statistics of doula-assisted births are quite stunning and very heartening. I’ve met with a few, and really enjoyed it. Although you hear a lot of backtalk about “touchy-feely” doulas fighting with doctors at the birthing bedside and trying to deny screaming women painkillers, I haven’t yet seen any evidence of this. The women I’ve spoken to have been professional, knowledgeable, and surprisingly pro-doctor.

My favorite new birthing blog, “At Your Cervix,” written by a labor nurse who is becoming a midwife, writes this cautionary post about a recent worried first time mom and dad at the hospital:

“…Of course, when the doc made his (minimal) appearance, early on in the observation period of time, he was quite negative with her and her husband, regarding what to expect in labor. He came across as very pro-epidural, and pro-interventions, when she and her husband were adamant about being low key, low intervention. They expressed their frustration with me, regarding the doctor, after the doc left the room. I told them, basically, that I respect (and agree!) with their low intervention wishes, but that the doctor was just trying to encourage them to keep an open mind about their options in labor/birth. I apologized for his behavior to them, to help them feel a little better about the situation, even though I was irritated with the doc's attitude. At the same time, I could see where the doc was coming from - keep your options open! Don't shut off completely to options available! Be flexible in your game plan/birth plan.

Basically, I’m torn. I love the idea of a doula to help advocate for me, and coach me to follow my birth plan. I see her as a key piece in my good-mommy armor. But I worry the doula annoys the doctors and nurses! I worry the hospital staff resent the woman with the doula?

What have been your experiences with doulas?

If you know of good doula blogs, please send them along. The Canadians, no surprise, have a strong doula presence online. Here are two I've enjoyed:

Doulicia

Radical Doula

 

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