October 02, 2002

More feedback on doulas

I've received some more feedback about my previous comments on doulas.

Lynley wrote:

Well I really want to be involved with women giving birth, i think giving birth is a magical experience. After having two children of my own I have just wanted to help other women support them and help them achieve a birth they can forver be happy with. I want to become a midwife but with my youngest son still only 7 months old i can't start going to uni yet. So i became involved with Doulas. I have been doing the denise love course and have nearly completed it by correspondance. I also have a workshop coming up with terri shilling which i am also looking forward to. I am just really eager to help women and I someday hope to be like you andrea. that is my goal. be able to teach people the way you do, you help so many people. With my first pregnancy your book preparing for birth- mothers was the only book i could find that had everything i wanted to know in it and i often use it during my studies. I have always look up to you since becoming interested in childbirth. But with the veiw you have on doulas i just can not work it out. I think the number one prioty is what the pregnant woman wants. I'm sure they have planned their birth out and either through doulas, midwifes, or their own sister or mother i think as long as she gets that birth or attempts that birth that is the main thing. If a woman feels she needs a doula i think that is up to her. But you have a very strong opinion one that people really listen to especially pregnant women. I think saying what you did about Doulas isn't very good when having a doula could quite possibly help a woman and in my opinion would help a woman. I had a very rough birth with my first son and i had my mother and husband right by my side. but i'm sure if i had someone next to me who could help me to work through my contractions who knew about birth it would have made all the difference. i did have one midwife through the duration of that birth who stood by my side and helped me to breath and work through the contractions. she was brilliant but when shifts changed i had a midwife who seemed not to care at all. at least with a doula i would have had the exact supporrt i needed. You are right when you tell midwives to talk to the women they have looked after to try and save their ward or hospital. maybe you should do the same ask women about their experiences with doulas then give an opinion. thanks for listening.

My reply to Lynley:

Your thoughts on the doula issue are similar to many of my own. I have been a birth companion for many women over the years, and I appreciate what you are saying. When you've been involved for a while, especially when you find yourself in a difficult situation as a doula, perhaps you will see what I am getting at..... for example: I can well remember being a support person for a young woman who had no-one else to be with her. She was doing fine through the labour and was handling the labour without drugs. This was in a hospital in Sydney (now closed). The midwives were obviously rather put out by my presence, and I sensed this, so I made sure to stay with the woman all th time. Eventually I had to go out for a pee (they made me go down three floors to a visitors toilet, even though I knew there was a staff toilet nearby - shouldn't have asked where the nearest toilet was!) and when I came back a few minutes later, the midwife had given the woman pethidine. When I queried this I was marched outside and backed against a wall and, with her finger pointing at me, was dressed down by the midwife "we only want what is best for her, don't we?"

It is these kinds of experiences that expose the vulnerability of being a doula and the very limited role that one has. You have no authority and your presence can, on occasion, be an actual hindrance to the labouring woman. I'm telling you this not because I want to put you off, but because the reality can be quite different to the imagined role you picture yourself fulfilling.

With the current trend toward paying for a doula service, there is another element. If the parents have paid you to be with them, then there is a certain expectation on their part - a contract if you like. As a doula you will have no influence on the outcome, which will be a reflection of the primary caregiver's attitudes and practices, and so there is a potential for the parents to feel you have let them down if things work out differently from what they expected. This limited role of the doula needs to be very clear before labour starts.

I am not against doulas per se, because I have often done this work myself. After all, being with a person who needs comfort is something anyone would hopefully do for another human being. It is the commercialisation of social support and sometimes unrealistic expectations on behalf of both parents and doulas that I am concerned about. I also wouldn't want women to get the idea that a doula is a person to engage ahead of close family and friends, and once money comes into it, the relationship between the various parties inevitably changes.

Since you mentioned that you would like to post a reply to the Diary entry that I wrote, I will post it there for you as a reply to an earlier entry. I will also post my reply to you so that others might read it as well. It is certainly a hot topic and I am glad it has got people thinking!

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