Doulas and doctors: Very different Roles

There are many people you may have with you in your pregnancy and birth journeys. A few possibilities are:

•  OB-GYN or Midwife
• Fertility specialist
• Lactation Counselor, or IBCLC
• Chiropractor
• Acupuncturist
  
• Pre-natal Yoga instructor
• Spiritual Guide
• Your partner
• Your family and friends

• And if you decide, also your Doula
  

As a doula I believe that I am one member of your "birth ensemble."


Why build a Birth Ensemble?

Ensemble Definition: noun, plural ensembles
1.all the parts of a thing taken together, so that each part is considered only in relation to the whole.

I used to think of my self as a team member.  But team also brings up images of competition, of "winning," of someone "sitting on the bench" or a "most valuable player." 

During pregnancy and birth, it is absolutely inappropriate to have a "winning" and "losing" side.  Unfortunately, that is not what some women take away from their birth.

As doulas, part of our role is to help the entire birth space be calm.  That includes the medical staff, your partner, and anyone else that enters your space. 

All the people that will come in contact with you need to work together.  A partner can't do what a midwife does.  A midwife can't do what your family does.  A doula can't do what an OB does, and vice versa.  Every member has a role to play, each unique to their strengths. 

When a laboring woman has the intimate connection from her partner, the medical training and expertise of her care provider, and the emotional and attuned care from her doula, they all work to bring about a unique setting that is appropriate from that woman. 

Having a birth "ensemble" gives a woman the reassurance, freedom, and knowledge to make decisions that will be best for her, and the ability to take ownership of her birth.

Doulas are NOT medically trained professionals

Because doulas are not medically trained professionals, doulas do not provide clinical or medical care.  This means doulas do not provide examinations.  They do not provide assessments.  They do not provide recorded monitoring. 

• No vaginal exams
• No blood pressure checks
• No diagnosis
• No suggestions for treatment

Doulas are also not a guarantee of an outcome.  We are not able to predict how your baby will be born, or give you any certainty that your birth will end the way you first thought. 


When doulas and doctors work together:
The result is a better birth

An unfortunate reality with today's medical system is that hospitals staff have more and more responsibilities.  Doctors are balancing office hours with laboring clients.  Nurses are trying to chart accurately and give attention to women, some who need more from them than they can sometimes provide. 

The reality is that an efficient system of patient care management may not allow for the amount of attention a woman feels she needs in labor.

A doctor's main concern is healthy mom, healthy baby.  A doula's main concern is healthy mind, healthy bond.  Neither of these is more important than the other.  

This is how doulas can help birth at hospitals:

• By encouraging increased conversation and understanding, the mother will understand or ask for clarification ensuring that informed consent has been reached.
  

• Important factors influencing patient satisfaction during labor are the quality of the caregiver-patient relationship, involvement in decision-making, and amount of support from caregivers.  Having a doula present can greatly increase the chance that a mother will remember her birth as a positive experience. 
  

• The recent Cochrane Collaboration review of over 15,000 mothers in 22 studies confirmed that births with trained doulas present are less likely to have certain interventions. Thus, certain complications that may occur as a result of their use do not happen.  (*This does not mean that having a doula present will result in a certain outcomes.) 
  

• Influences of family structure, language, culture, exhaustion and personality can mean various challenging social situations. When the doula is aware of the mother’s desires she can intercept or smooth over interpersonal problems between hospital staff and the patient. Although the mother employs the doula, the doula increases communication, understanding and respect between the physician and the family. 
  
  

Worth repeating:

When a laboring woman has the intimate connection from her partner, the medical training and expertise of her care provider, and the emotional and attuned care from her doula, they work together to bring about a unique setting that is appropriate from that woman. 

Having a birth "ensemble" gives the mother the reassurance, freedom, and knowledge to make decisions that will be best for her, and the ability to take ownership of her birth. 

Healthy mom, healthy baby, healthy mind, healthy bond.  When doulas and doctors work together, families benefit.

Authored by A Swift Doula

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