Moms spend nine months preparing for their new bundle of joy, making choices about their life before they’re even born, and planning as best we can to have a comfortable and safe labor. However once those crucial hours of laboring arrive, many women suddenly find themselves pushed to the backburner of their own experience – by the very people they thought they could trust the most: their doctors.
An overwhelming survey shows that pregnant women are experiencing disrespectful, abusive, and neglectful treatment by hospital staff during their labor in health facilities all around the world. But even more shockingly, it’s happening right here in North America.
90% of Doulas and Delivery Nurses Have Witnessed Doctors Mistreating Laboring Women
A survey conducted in 2014 found that close to 90 percent had witnessed a care provider engage in procedures without giving a woman time to consider and almost 60 percent had observed providers perform procedures that were clearly against the wishes of the birth mother.
More unexpectedly, however, it is not the primary care physicians, OB/GYN, or nurses who are reporting this treatment, but instead, it is doulas who have been speaking out on the vast number of occurrence of obstetric violence: abusive maternity care, that is happening on a regular basis.
Obstetric Violence: Abusive Maternity CareÂ
Simply put, there is a hidden epidemic of doctors abusing women in labor.
Emily Varnam, a doula, and reproductive health educator in Detroit who had previously worked in New York City described her experiences to VICEÂ recently of witnessing obstetric violence as draining, maddening, and deeply traumatic to witness.
She adds that she saw abuse on a regular basis while attending births at just about every hospital in New York City. “Whether that’s from lack of evidence-based care or lack of compassion or lack of respect for the human race, you pretty much just never see the care that feels appropriate. Either it’s how they’re spoken to, or nonconsensual vaginal exams, or coercion, or bullying, or scare tactics.�
Many doulas have experienced similar horror stories, however out of fear; they are only able to share their stories anonymously. For example, an Alabama doula, who spoke on the Birth Allowed podcast in 2017, described seeing a “doctor straddle a laboring patient from behind as she leaned over her hospital bed.â€� She goes on to say, “If that had happened outside of the hospital, he would be in jail…(9) It was a sexual assault, and it was very sexual, the position of his body.â€�
So What Is A Doula Exactly? (And How Can They Help?)
Doula in Ancient Greek means “a woman who serves.â€� Although they are not trained to provide medical care, they are trained professionals in giving continuous physical and emotional support for mothers at all stages of pregnancy. In the 1920’s, before the start of the epidural, women relied less on hospitals and turned to a doula instead.
Usually, the doula is a confidant for the mother’s fears, offering informed advice, and physical and emotional support during labor, and even after labor.
Why Choose A Doula?
Research reveals that mothers who received the support of a doula reported:
- Less labor time
- Natural births
Higher APGAR scores (a test given directly after birth to determine a newborn’s physical condition) - Decreased rate of interventions during labor
- Less need for pain medication and fewer requests for epidural
- Higher satisfaction with birth outcomes
- Much lower C-section rate
- Reduced stress and greater advocacy during labor at the hospital
The most crucial aspect of a doula’s job is to empower women to make informed decisions in order to have the birth they desire. Dr. Greenwald-Tragash, a psychologist and behavior analyst who is also a certified doula, argues that modern birth procedures take birth away from the mother. In 2017 she presented for a TEDx Talk, with her central message to all women being: you take back your pregnancy.
 You can watch the video here:
Doulas Are NOT Midwives
There is a common assumption that midwives and doulas are one and the same, however, while midwives and doulas may do similar work, “A midwife is a trained medical professional. Doulas are primarily for emotional and physical support.� (7)
While Midwives can replace your regular OB, doulas can not. Doulas use supportive techniques during labor, in conjunction with the doctor. However, the main dissimilarity is that a doula’s care begins long before the birthing process. For example, Dr. Greenwald-Tragash says that she usually meets with her clients while they are anywhere from 15 to 20 weeks along in their pregnancy. (7)
The first meetings allow for introduction, getting to know one another, learning about the mother’s goals, her experiences, expectations, etc., while also providing the mother with resources and information. Dr.Greenwald-Trasgash states that “These prenatal meetings are crucial to building a trusting and open relationship with the parents, she notes. “We talk a lot about personal matters and preferences and fears and vulnerabilities,� she says. “So it’s really nice to have that opportunity.�(7)
Where Can You Find A Doula?
Some birthing moms ask their family, friends, or a midwife for recommendations. If you are thinking about hiring a doula, it is recommended that you begin your search as soon as possible so that by the 15-20 week mark you will be on your way to finding a doula that is the right fit for you.
Keep in mind things like personality types that work best for you, especially in demanding situations. Do you like the mentor type, or maybe a gentle nature type? It is important that you pick a doula that resonates with you and that you comfortably connect with your doula because she will be the one that is with you during one of the most intimate and vulnerable times of your life. (5)
There are organizations you can also reach out to like Dona International or Doula Match to find certified doulas in your area.
Some Questions to Ask a Prospective Doula
- Why did you become a doula?
- What kind of training do you have?
- Do you have experience with birth complications?
- How do we contact you during labor? Are you always on call?
- How do you work with husband or partner? (5)
- How do you work with midwife or doctor? (5)
- How do you approach birth? (5)
- What is your doula philosophy? (5)
- How would you describe your “style�? (5)
- How do you support the laboring mom? (5)
- Do you have any special tactics for pain? (5)
- How many other clients do you have around this time?
- Can I email, text or call you with questions?, and Is it OK if it’s in the middle of the night?
- How many births have you attended?
- Do you have a backup doula and will I meet her? (5)
- What coping techniques do you find most helpful?
- What are your fees?
Conclusion
A doula is able to provide birthing moms a calm and encouraging presence which in return eliminates their fear, anxiety, and stress. Unlike an OBGYN or a nurse, a doula is there for YOU and your partner. This is because Doulas don’t work for a birth center or hospital, their primary job is only to answer to you. They’re not busy dealing with the medical aspects of birth, or the shuffle and bustle of a hospital. Their sole purpose is to be there for you, making sure you do well physically and emotionally through the entirety of your pregnancy and birthing process.
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