Doulas and Health Care Providers

On a recent interview with an expectant couple, I was asked if most health care providers accept a doula’s presence during labor and birth. I told them that barring some occasional confusion as to what role I played, I’ve never encountered any negative reactions from nurses or doctors. Many have asked my opinion, talked pleasantly to me, thanked me, and in general included me in the proceedings. I have read articles or blogs concerning certain providers not only being unappreciative of having a doula present, but occasionally downright hostile towards the doula. Fortunately, as stated, I have never encountered any hostility. Since the question was raised recently, however, my mind began working on a few suggestions:

If you are having a doula with you during your labor and birth,  it’s a nice idea to let your provider know about this. This will give you an opportunity to explain what a doula is, what she does and what she does not do.

When writing your birth plan, include that you will have a doula. There are a few reasons for this suggestion, the first being that any staff change will understand who the “other” person in the room is with you. Once when I accompanied some clients to the hospital and mom was well into active labor, the admitting nurse hurriedly assumed I was a friend or relative and tried to shut me out of the room. Fast, hard contractions didn’t give us the time to explain who I was, nor was it the time for me to be separated from the laboring mom.  In that case the situation was rectified quickly. If you head to the hospital before your doula is with you, the hospital staff will know to “buzz” her back when she arrives. A doula can stay with you during some medical procedures that others may routinely be asked to leave during — an epidural, an amnio-infusion, etc.

Remember that a doula will not make medical decisions for you or your baby. She is there to provide comfort measures, provide information and resources, and help you and your partner enjoy the birth experience as much as possible. If there are certain items you are adamant for or against (such as not receiving an episiotomy), you, your partner, and your doula can rehearse in advance how to handle the situation. If a client of mine has stated she would rather tear than have an episiotomy, but I see her OB/GYN reaching for sharp objects, I can alert mom or her partner, or simply state in a neutral manner what my client has put in writing in a birth plan. This makes sure the client receives the best care by communicating directly to her provider, even if the client needs a small reminder of her birth plan. Trust your doula, but remember this is your birth and you will ultimately have to make decisions concerning your health and the health of your baby for the rest of your life.

If you have concerns about your provider not accepting the presence of a doula at your labor and birth, ask yourself: Is he/she the right provider for me? Are you avoiding facing certain fears or asking important questions because you feel your provider does not have time for you, will not listen to your preferences, or glosses over items of importance to you regarding your pregnancy and labor? Be certain you pick up on any red flags — it’s never too late to find the right birth team.

There are a variety of reasons that an expectant mother and her partner hire a labor doula. Comfort measures, suggestions to help labor progress, an extra set of loving hands, information and resources are but a few of the benefits of having a doula. Not to be discounted or forgotten, though, are the large and numerous studies proving a doula’s presence at a birth reduces labor time by up to 25% for first time moms, reduces requests for epidurals and/or narcotic medication, reduces other interventions such as surgically assisted pushing (vacuum extraction, forceps), and reduces the chance of having a cesarean section. Make sure your provider knows of these benefits and studies. Ask your doula to obtain some printed materials you can show your provider. If your provider has worked with doulas before, chances are he or she has had a favorable reaction and appreciates the one on one support offered by a doula. If this is the first opportunity your provider has had to work with a doula, it may help dispel any myths and open up more options and services for other pregnant women.

Nurses are generally very appreciative of having an extra set of hands provided by a doula. It makes their job easier and less stressful because if a mom in labor needs a snack, the doula can get her one. If the laboring mom needs more pillows or an adjustment made to the bed, a doula will help with that. After baby is born, your doula can help you with breastfeeding, freeing up your L&D nurse to turn her attention to other matters.  Most nurses find they can attend to other laboring women, charting, and other business while your doula takes care of YOU.

Happy birthing!

All Rights Reserved, Kimberly Sebeck, Knoxville Doula


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