I hope to be able to get back to Brasil to do some more workshops for your
nurses on the basics of being "with women". In the meantime, I have written
a Diary entry http://www.birthinternational.com/diary/index.html
on doulas that you might like to read. A bit controversial but I think
these things need to be said.
Look forward to seeing you again!
Andrea
Dear Andrea…
Just to add my two cents worth to the doula debate…I agree with your position on the potential here to add another "layer of health professional" to our already over medicalised maternity service….I too have great concerns about the potential for hospital administrators to recognize the value of the doula to the birthing woman (and more for their bottom line)…in preference to employing more midwives….HOWEVER…having said all of that….I strongly support the work of doula's to offer support for pregnant and birthing women….as Karen Arthur argues so well…our current system doesn't allow midwives to provide the continuous one-to-one support that doulas can provide….(roll on NMAP!!)….Doula's can never detract from that much needed support of family and friends….any doula worth her 'pinch of salt' would embrace the circle and sanctity of family to enhance her work 'with woman'…..
I see the very argument used here against the "doula craze" …could also be employed to that of lactation consultants….childbirth educators (with all due respect Andrea) parenting educators etc.. The proliferation of all these 'professionals' has only served to create layer upon layer of 'professional' who all seem to have assumed such knowledge that was once considered to be midwifery knowledge and women's innate "ways of knowing"…….only to be slowly eroded away with the medicalisation of pregnancy and birth and the advancement of all these so called 'experts'.
In an ideal world…the professional doula…CBE's and LC's, parenting educators etc etc…..would all be redundant. Women would live and birth locally within their own communities with the local midwife/wise woman in attendance…All this education and support…would be done informally as part of the woman's preparation for birth…a community responsibly…integrated throughout her life informed from life experiences….all normalizing the work of labour, birth and motherhood….Sadly however…as we all know to well….this is very much a romantic notion….as in today's society….birth like death has been removed from our homes…our communities. We tend not to live by the seat of our pants anymore…or follow our instincts or intuition…we live quite removed from Mother Nature and all her splendors….
Our family dynamics are different….the nuclear family has shrunk and in some circumstances been totally reoriented…our extended family (mothers.. grandmothers…sisters… aunts etc..) is diminishing…so our 'mother/wise woman' role models are now few…Therefore women have little experience with pregnancy, birthing, breastfeeding and parenting…through the lived experiences of others…It isn't until they find themselves doing it, with no real guides or role models for advice/counsel or support, that they seek out more formal avenues for information support and advice…hence the proliferation of the "doula craze" that you describe…
At this point in time… doulas are offering women…what contemporary midwifery in this country cannot…a continuous supportive presence during their labour and birth. As I see it, this is far from "moves to undermine the humanizing of birth"…woman have taken steps to humanize the experience for themselves and to devalue the doula in her supporting role as "mothering the mother" ….is to devalue woman's right to choice…when in our highly medicalised techno birthing world…choice is very limited….
I see that professional doulas will continue to grow in popularity in the absence of a strong and autonomous midwifery profession. In countries where there is a strong autonomous midwifery profession…. where midwives can offer that one-to one continuity of carer….professional doula's are very few….To turn the tide midwives need to make a conscious shift in their thinking about their willingness and ability to provide midwifery led care….until they do I believe that doula's will only continue to grow in popularity….as midwives continued alliance with the medicalisation of birthing….only continues to serve 'the system'…not the women in their care….
Yours in midwifery,
Tina Pettigrew
Bachelor of Midwifery Student
Victoria University.
