Tuesday, April 29, 2008

Breaking in

I have met with 2 college students in the last year who have an interest in birth. More specifically, they want to learn more about being with women in birth.

This is a golden opportunity in any circumstance. Here it seems even more precious. Both students plan on attending medical school.

You're with me, right? Imagine having their first images of birth be complete, holistic, respectful. For comparison, I have the stories some physician friends and clients have told me about the births they witnessed during rotations: panicked teen mothers, women with no prenatal care showing up in the ER, families fighting in the halls or delivery room. And, of course, no sense of birth as a continuous process. Instead, they saw the snippets of cervical exams, pre- and post-epidural mothers, and a few dozen babies being caught, pulled, extracted from the mothers.

The problem is, it is very hard to find clients willing to add another body to the birth room. I can't blame them. I certainly wouldn't want an additional person at my birth. One of the primary reasons most clients contact me is that they want to preserve a high degree of intimacy around their birth. It is often a concession to that wish to add even a doula to the plan. I can barely bring myself to raise the question: "Would you be receptive to a prospective doula observing your birth?"

I do raise the question, but couch it in very deferential language. I make it clear that my expectation is that they'll say no, but I always as just in case. I have never had someone say yes. Even the clients who were pretty immune to crowds -- who had 6 family members in the birth room and even permitted an EMT trainee to observe -- did not want another doula in the room.

So what do we do? How do we, who have access to amazing women and amazing births, who frequently work with physicians, midwives and nurses receptive to the supportive, respectful birth, who can introduce budding caregivers to birth as a normal, healthy process, how do we do this?

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10 Comments:

Blogger Bekah said...

I think part of the problem may be in your presentation of the idea. If you expect them to say "no", then they will. If you present an extra doula there as a wonderful advantage to them, and explain all the ways having another person can be helpful, as well as how important it is to preserve the knowledge of supporting normal birth, then you may get different results. There is always something for a second doula to do.

7:52 AM  
Anonymous Jamie said...

I think your presentation to your clients is appropriate. When I suggest to clients that a student would like to observe a birth, I make it very clear that they are doing the student a favor and have the right to say no.

I saw normal births in videos, went to volunteer doula births with women who wanted to avoid medication at the hospital, and then took on private clients including homebirths. It might be too much to expect that the first birth a person attends is perfectly normal and not interfered with.

My first birth was medically complicated and took place at 34 weeks, and it was a successful VBAC. The mother was thrilled and I learned a lot about the reality of birth. I had been reading Ina May and watching homebirth videos, so it was good for me to see that sometimes birth does not go as planned but aspects of the mother's experience can still be salvaged.

8:55 AM  
Anonymous Michelle (in Windsor) said...

I agree, it is difficult. When I first started out, a fellow doula and I had an arrangement that we would try to sell ourselves to clients as a team, being newbies who needed experience. It just didn't fly, at least when I asked. However there were, at the time, more experienced doulas in our community who managed to almost always get their clients to agree! So, luckily, many of my class of local trainees (including myself) had quite a few opportunities to shadow at births. I wonder what the magic trick is? I'll agree with bekah though; presenting it without pressure but highlighting the benefits is probably the best way to go. I'll also add that when I've been resistant to trainees attending (doulas, midwifery students) it always ended up that we were grateful to have the extra person there for some reason or another.

1:24 PM  
Blogger Sheridan said...

I think it is partly the way it is presented. I have gone to 2 births as a shadow. I have also done 2 births with another doula, we as equal partners. That was totally fun and the parents LOVED having 2 doulas for the price of one.

The doula I shadowed just asked her clients if they were open to having a second doula come, we also back each other up, so they had met me previously. If they connected with me at the doula meet and greet, then they are more open with me coming. So maybe if they have a chance to meet these other people before even asking them?

2:25 PM  
Anonymous HelloKitty45 said...

I'd say yes! (But I'd want it understood that I might want everyone out of the room at some point, and that that choice would be mine with no hard feelings).

I guess I think that if a woman is open to a holistic experience, and hence having a doula there, she would be open to wanting to help a prospective medical student, doula, midwife - it would be spreading the word of how our care as women can and should be different.

Be positive, be honest, don't assume they will say no. Just ask - she might surprise you!

9:42 PM  
Anonymous Anonymous said...

Jeez, too bad you weren't there for my son's birth. I had my Bradley baby with a midwife at a large teaching hospital, and IT WAS IN MY BIRTH PLAN that I would like to invite student nurses, residents, or med students to be in the room as quiet observers. I believe it is SO IMPORTANT for mainstream medical providers to understand that unmedicated labor, spontaneous pushing, and working with a woman's body are normal, not scary...unfortunately, I guess they forgot to invite the resident who was on the L&D unit in; the midwife was lamenting not pulling him in later. Anyway, by the time I was pushing, Santa, Johnny Depp, and Jesus could have been in there and I wouldn't have noticed.

4:02 PM  
Anonymous Anonymous said...

i would say yes, unfortunately i live nowhere near you!

10:16 AM  
Blogger doulicia said...

Thanks for the suggestions. These are very encouraging. I have a client due in July. I will try framing things differently when I present the idea to her.

12:14 PM  
Blogger cooler*doula said...

I'd say yes too.

Birth Center birther here due in, oh, two to three weeks...

Unortunately, it would require a lengthy trip down south.
:/

11:41 AM  
Blogger Sandy D. said...

I know that with my second (when I was past worrying about privacy for the birth, and was just interested in having another helpful pair of hands to clean, fetch, etc.) I was thrilled to have a student midwife in attendance.

I would have said no way the first time around, but the second time I knew I would be happy to have someone else helping the midwife and dh. Especially someone I'd already met in the prenatal exams. And it was good, though I felt a little bad when I accidentally kicked a bucket of very dirty water all over her when she was cleaning me up during the process.

1:32 PM  

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