Tuesday, November 11, 2008

More personal recriminations

Last Friday I went to a fundraiser for our local volunteer doula program, Doulas Care. It was very nicely done. I am hugely impressed by the amount of work that went into it. I know most of the employees and volunteers, so my gratitude is quite specific.

The evening was a delightful mix of socializing with birth colleagues , browsing silent auction items, and tasting wine. They had live music and a caterer. There were twinkle lights everywhere in the renovated barn where the fundraiser was held. It was quite enchanting.

I left with a high, great feelings for the increased awareness I've seen about doulas and birth in the last 5-6 years. I felt a sense of unity with these women and men who are committed to the same cause. I was affirmed by shared stories of births gone well, and women empowered.

By the next day, I was thinking again of this article a friend posted on his Facebook site. It's about maternal mortality and the persistence of high death rates among women in poor countries. The article has an accompanying slide show.

Between the images of spartan delivery rooms and descriptions of deaths that would be so easily prevented in developed countries, I realized how different the global issue of birth is from what I confront here in this little corner of Michigan. Yes, we have poor women here. Yes, women start labor without a minute of prenatal care. But there are places where they can be brought for safe delivery and recovery.

Insurance is, of course, its own issue. But if someone is hemorrhaging in this community, she will be given a transfusion at a hospital.

I was reminded again of a midwife friend who left the area saying she was "tired of these Ann Arbor women and their fancy birth plans." It sounded so cynical at the time. These were the women who were seeking her out for the amazing birth experiences of which she was so often a part. We needed desperately needed her and her birth philosophy here. How dare she leave.

She went on to work in rural Latin American countries and on American Indian reservations. Her patients were not concerned with whether or not they could birth in the squatting position. They were hoping, especially in Central America, simply to survive the experience and return home with their child.

I've thought about this before and come down hard on myself. On doulas generally. Aren't we all just birth junkies fortunate enough to have found this mechanism for getting to be present at birth?

Hopefully the answer is no. I think it is no. I think we want women to have a positive birth experience. Thankfully, in much of the developed world, fundamental questions of survival are largely taken for granted. We doulas arrive on a scene that has the luxury to focus on the smaller details: informed choice, minimal psychological trauma, enhanced bonding. But I suspect that if we were in a culture where birth was a dicier proposition, we would do what we could to assist on that level: lining up blood donors for each woman in advance of birth, helping women get to care, providing care to families in the event of loss.

It is a spectrum. We are fortunate to be on the more luxurious end of it. But we would serve even if we were not. Wouldn't we?



Blogger Paula said...

You speak well, doulicia. It's interesting. I believe that all women really simply hope to survive their birth and go home with a live baby. It is primal. The choices (squatting position, etc) are window dressing.

In our luxury, you know that we could do so much better. We doulas are educators and are on some kind of a grass roots level. Our outcomes don't compare well to all countries.

You are a thought provoking writer. I was shocked at the breastfeeding post that you had up a while ago. There is no shortage of data on the miracle food that is b-milk. Formula tries to be as good, it is after all artificial breastmilk. I read the arguments and found both lacking. LLL is all volunteers. Would be great to have a fabulous debater speak clearly about the gobs of research out.

Anyhoo- thanks for writing. You get me thinking!

10:20 AM  
Blogger doulicia said...

Thanks, Paula. Mostly I feel an echo chamber. I like thoughtful discussions about these subjects. So plesae keep reading and posting.

9:59 PM  
Blogger Do You Doula? said...

I thouroughly enjoyed this post, as it speaks multitudes on what it means to give birth. There are women who are 'seeking' another way- for the safety of their child, for their own empowerment, for whatever reason...
It does not matter if they have fancy birth plans, if they are hippies, if they are in South America; what it comes down to is that women are accepting this passage as a soul,mind,heart,body-moving experience...
it is all good & I appreciate your writings.


12:42 PM  

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