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I get a fair number of women who contact me to ask me if I would consider attending their hospital births as a doula. The following has been my response, of late:
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Dear Gentle Mother, Unfortunately, I don’t attend planned hospital births. I admit, it’s selfishness in large part. It is just too soul-destroying for me to see brilliant, healthy, smart women, who have spent lots of time researching the facts, and who are well-informed, go into the hospital with their birth plan, only to end up with trauma or surgery.
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The sad truth is that it really doesn’t seem to matter how much you know, or whether or not you have a great doula, or a team of great doulas: doctors have all the authority in the hospital, and at any time they can (and often do) override a mother’s wishes, and her consent, if they have decided, (even arbitrarily) that a state of emergency must be invoked.
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I have a huge amount of respect for doulas and the work they do, because they occupy a very difficult role: like mothers themselves, doulas have no authority whatsoever in a hospital setting, and for many doulas who are certified by one institution or another, their scope of practice specifically prohibits them from “advocating” on behalf of their clients. This is not to say that being a doula isn’t a very important job: bearing witness to what occurs in the hospital is important. Reminding a mother of her wishes when she is facing a barrage of pressures is important. Helping a mother process what was done to her in the hospital is very important. But this is not my job.
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Of course, if I am with a woman at home, and she determines that a hospital transfer is necessary, then I would certainly accompany her to the hospital. In that kind of situation, I would then become her “doula” for the remainder of her birth process in the hospital. But I simply know too much to be able to take on a planned hospital birth.
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In the past, when I have attended hospital births, I end up dealing with symptoms of PTSD myself, that can last for weeks, and which impacts my ability to mother my own kids, and to support my community. When I am present at a home birth, I have to deal with joy and euphoria that lasts for weeks, which similarly impacts my relationships and my outlook. There is no contest.
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Homebirth is a completely different scenario from hospital birth. The two are almost entirely unrelated, as far as experiences go. Simply leaving your home and stepping into the hospital environment is the first intervention, and as nice as this may sound, it really isn’t possible to have a home birth in the hospital. Doctors and nurses are totally unfamiliar with spontaneous, normal, physiological birth. They have literally never seen it. They are trained in medicalized, institutionalized birth, and even the mothers who are able to have unmedicated births, still, in may cases, have to fight with the staff from beginning to end, in order to “achieve” simply having their babies emerge from their vaginas.
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The hospital is the Caesarean Store, Epidurals R Us, Pitocin Place. You can show up at McDonalds with Anthony Bourdain in tow as your dining doula, and an explicit “gourmet meal-plan” in place. But I hope you wouldn’t be too surprised when they serve you the very best Big Mac they have on offer…and it’s still a feedlot junk-food hamburger.
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I know this may sound extreme, and I hope it’s not upsetting for you to read this, but I have to just give you the straight goods. I’ve seen it too many times, and it breaks my heart.
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The good news is that there are many wonderful doulas working in our area. And they’re a hell of a lot stronger than I am.
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Sincerely,
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Yo