Friday, April 1, 2011

Doula Love and Accountability

I have raised a lot of eyebrows with yesterday's post so I would like to go back and comment and try to clarify. One message I was sent was this:
"Doulas don't cause Cesareans. Emphatically. Doctors, emergencies, and women's choices do."
Yes!! Absolutely! And we, as doulas, need to remember this. It is ALWAYS the woman's birth, and not the doula's. No matter where the path leads, it is the doula's mission to follow, and to respect and nurture the woman she is accompanying.

Another message went like this:
"When I'm at a difficult birth, even though I've only been practicing for a few months, I know that I am providing something that no one else can, and that is unconditional support. I know that I'm not responsible for the outcome of the birth, and I hope you realize that inexperienced doulas may take your words seriously."

Still another:
"Yes, we need to take responsibility for what we do - and if a woman in my care has an unnecesarian, I take responsibility, I try to work through it to improve my care."

Wow! Please comment on my blog. I appreciate your messages but I would like to make this discussion public.

To clarify, I would like to publicly apologize to any young/inexperienced doula who was hurt by my words. That is the last thing I wanted to do. I would like to engage in an ongoing discussion about responsibility and transparency. How do you feel when your client has an unexpected outcome? How do you feel when you have a feeling she will end up in surgery, even though she is planning a natural birth? Do you change your practice? Do you call in a more experienced or differently trained doula? What do you do when you are at a birth and things start going haywire? Do you reach out to other doulas?

Whenever I am at a birth that ends in an unexpected c-section, I always look back at my actions and the prenatal and labor process to see if I could have worked differently. Sometimes I know I did everything possible. Other times I know I could have done more. I know as doulas we are not held accountable, as medical professionals are. We form associations and collectives but we are accountable, in the end, only to ourselves. I know I am very hard on myself, always wanting to do better, and I would do good to accept that meconium happens.

To all of you, keep up the good work, and keep on loving.

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