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Hi Honey
Yes I most definitely debrief with the woman and her partner. Sometimes we talk about it briefly after the birth - sometimes it is just praise for all their hard work and joyous achievement. Sometimes it becomes more indepth, other times not - depends a lot on what has happened, where you are and who is present. By offering continuity of care, there is on-going discussion and opportunities for debriefing during the PN visits as well and often it takes a few days or weeks for things to sink in and questions to be asked. Before I hand over care to the MCH nurse and family GP, we also have another debriefing session to make sure there are no unresolved issues. Of course, not everyone will disclose all their feelings and concerns but I do try and provide an opportunity for the woman and her family to let me know how they feel and a listening ear. As I write this, I have had no experience of this since arriving in this country, my first client coming up due so I am aware that the cost of my visits and women choosing not to have as many visits as our NZ sisters (who get their maternity care 100% funded) this may impact on this slightly? I will tell you in a few weeks. Continuity of care also means that we usually have built a relationship of trust with each other that supports this process as well.
Kim Stead
Midwife : Birth-Wise Midwifery
-------Original Message-------
Date: 7/09/2004 7:32:23 p.m.
Subject: [ozmidwifery] doula discussion
Kirsten- Do women in New Zealand ask friends or relatives to support them at birth?
Kirsten you wrote "That the selling of the need for a professional doula undermines a woman's belief that she can give birth by herself, and is disempowering."
Women usually believe they need midwives and or doctors to give birth. On a very rare occasion do I see a woman who is prepared to birth on her own. I would say that sometimes when a woman chooses to have a doula she is actually doing something that is part of her empowerment in taking back the responsibility for her birth rather than leaving it in medical hands and asking a doula to support her in whatever her choices are, a lot of what I have been learning is how to support a woman to empower herself, by asking the right questions such as when they ask for advice or say what did you do? I would reply something like "How do you feel about that? and Would you like some more information on that? Would you like to go through the different options available to you? etc we do not give opinions recommendations or advice, we provide information on the risks and benefits if they ask for it, and we support them whatever their choice. Even if that means choosing to bottle-feed, having an elective caesarean or planning to have an epidural from the moment they enter the hospital. It is all about them and their choices. Some women will choose not to be informed in their choice and will decide that they simply want to follow the doctors suggestion such as when he says "if you were my wife I would want you to have a caesarean!" we can offer information but if they don't want it we will support them in that choice. Does that make sense.
I also have a trust in the women I serve, I know they can birth their babies, and I do not in any way suggest that they could not do it without me.
Growing up my godmother was the equivalent of a doula although I didn't realise it at the time, she would attend all of the births in the valley where she lived, some of the women she new well and some of them she'd never met, she never had any formal training but as she'd birthed 7 of her own and attended many births she was accepted as the person you rang in labour, and she worked alongside the homebirth GP or midwife.
I am still new to the birthing world, and I am open to learning and admit I know very little compared to most of you on this list, thankyou for allowing me to be part of the discussions.
A question for you all .
Is it standard practice for you to debrief a birth with a woman (and or couple) ?
If so, do you leave it open for them to also do more debriefing down the track?
Thanks again
Honey
----- Original Message -----
Sent: Tuesday, September 07, 2004 2:00 PM
Subject: Re: [ozmidwifery] doula article
I was not debating the validity of a doula, i was merely saying they are rare in NZ and why's that? I don't know the exact reason but it's interesting to compare the maternity systems and the popularity of Doulas here compared to the very small number in NZ.
I had 1-2-1 midwifery care and would never have considered the idea of a doula and the things that have been said about what a doula does, was in fact done by my brilliant midwives.
Now is that because i had independent midwives in NZ or not? I don't know. But i find it interesting.
I can see how the role of a doula for the post natal period might be beneficial. Since this discussion started i have also been working my way through a brilliant book, and it is pointed out in there that The arrival of the trained support person is more evidence of the medicalisation of birth. That the selling of the need for a professional doula undermines a womans belief that she can give birth by herself, and is disempowering.
As i said, i am new to the role of a doula and find it all abit confusing at times, and like i said, i can see the validity of the doula postnataly but am unsure of the rest. This is nothing personal at all against any doulas, it's probably more to do with my own philosophies..
Kirsten
student midwife
Darwin
~~~start life with a midwife~~~
----- Original Message -----
Sent: Tuesday, September 07, 2004 1:01 PM
Subject: Re: [ozmidwifery] doula article
Dear Jo
I was not intending any reflection on doulas and I apologise if that is how my comments came across.
I was reflecting on my expereinces and understanding of birth!
Denise Hynd
"Never believe that a few caring people can't change the world. For, indeed, they are the only ones who ever have."
Margaret Mead
----- Original Message -----
Sent: Monday, September 06, 2004 9:36 PM
Subject: RE: [ozmidwifery] doula article
Hi all,
I have been reading the discussion on doula's with interest and am intrigued by some of the more negative comments towards the 'doula' profession.
I tirelessly work for Homebirth Access Sydney and Homebirth Australia - co-ordinating both groups. Which also involves supporting Maternity Coalition and the wonderful Justine Caines. I consider myself a staunch advocate for women centred and best practice care. I run Active Birth workshops and I work as a doula in my local community. I have 4 children - 3 of whom were born at home with a midwife and a doula, as well as other family members.
Working as a doula in the hospital system has been so eliquently explained by Honey and Vida that i won't go into it. What I really wanted to remark on is the role of the doula when 1-2-1 midwifery led care is present. I'm interested to understand the idea that if we were to have a system like NZ why there wouldn't be the need for doula's? Our roles are very different and a doula can be a benefit in all birth settings.
I was approached by our local homebirth midwife and asked to assist her and her clients at their homebirths, which i have been doing for about 6 months now. The midwife pays me - not the women and we work really well together, supporting one another the whole way. Which of course in turn supports the woman and her family. It is working wonderfully and have only had positive feedback from the families whom i have supported. Doula's benefit women, but they can also benefit midwives - even in an ideal system!
cheers
Jo Hunter
----- Original Message -----
Sent: Friday, September 03, 2004 6:44 PM
Subject: Re: [ozmidwifery] doula article
Dear Honey
I agree with all you say I am only asking for the full story to be in the article that as you say Doulas are needed by women in a system that is not women centred.
Denise Hynd
"Never believe that a few caring people can't change the world. For, indeed, they are the only ones who ever have."
Margaret Mead
----- Original Message -----
Sent: Friday, September 03, 2004 1:21 PM
Subject: Re: [ozmidwifery] doula article
HI Kylie
I am a Doula (or Birth Buddy as we call ourselves) and can put you in touch with the midwifes we work with here in the public hospital in Townsville. We are welcomed by them and work well together. if that interests you email me directly [EMAIL PROTECTED]
In response to Denyse I know 1-2-1 midwifery care would be the best option, but as we do not have that yet (I am one of the many consumers here pushing for it and a birth centre currently) Doulas fill that gap and more. On average a woman here going through our hospital system can see up to 35 different midwives through the course of her pregnancy and birth. On the other hand I develop a relationship with my clients,building trust and knowing them is so important, I do not leave them when my shift is up, I stay and support throughout the length of the labour. I also know of quite a few women who have other women, support people, mothers and or doulas even when they have 1-2-1 midwifery care. As someone else said we support the partners too, how often does a one on one widwife have time or take the time to make sure the partner has drinks and food and emotional support.
I know Andrea Robertson has written negatively about Doulas saying that our community should provide the support we need but Andrea has supported at births too she just doesn't use the word Doula when she does it. Also often our community doesn't always provide the support we need, and in fact many of us would prefer not to ask our mother or sister into the birthing room for a variety of reasons. In my community a huge amount of people here are army based often without family or friends nearby, and the women I have supported so far have become dear and close friends. I recenlty have been volunteering for a refugee family and this woman no longer lives in a tribal situation where the women gather round her and support her so I have become her friend and birth support person and advocate making sure she gets an interpretor when she goes for medical visits, taking the whole family to the beach for the first time in their lives, making them meals every two days since the baby has been born so that she can stick to her tradition of being pampered for the first 12 days and not overdoing it. I don't do that for profit but because i believe every woman should have that support if she wants it.
I don't think everyone wants or needs a doula but I believe that just as having a midwife is an important option in childbirth it is wonderful to have the choice of a doula.
I'll stop raving now
Honey Acharya
Birth Buddies
----- Original Message -----
Sent: Friday, September 03, 2004 10:04 AM
Subject: [ozmidwifery] doula article
Hi everyone
Wellbeing mag would now like me to do an article on doulas, also for the baby special. I have a couple of doulas to talk to and am looking at adding the thoughts of a hospital based midwife who has seen the benefits of doulas in the labour ward.
Let me know if anyone would like to help out.
Kylie Carberry
Freelance Journalist
PH: 02 42970115
m: 0418 220 638
a: 21 Susan Ave, Warilla, NSW 2528
e: [EMAIL PROTECTED]
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