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Dimensions of Professional Labor Support: Advocacy

3/26/2015

1 Comment

 
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When I was pregnant with my oldest son I had done extensive research on childbirth, all of which lead me to create a very detailed birth plan explaining my wishes of a completely natural, unmediated birth. I made sure to include each and every one of my requests including what I wanted to happen in an unplanned emergency. I was extremely happy when I finally printed out my two-page manual I planned to give to my entire birth team and thought for sure it was my key to successfully having the natural birth I dreamed of. It was in that moment, that moment when I put so much faith in a piece of paper, that I made my second crucial mistake that lead to very disappointing birth experience (my first mistake had been made much earlier but was not apparent to me yet. I will explain this part in a minute…).

When I arrived at the hospital in labor, I had requested a volunteer doula through my hospital’s volunteer program but they usually do not call the doulas in until active labor is underway. Unfortunately for me, when I arrived I was only 1 cm dilated. They offered to admit me and I agreed instead of choosing to go back home (mistake number three…). Because I was still in very early labor, I labored at the hospital for quite a while before my doula arrived. During that time, my doctor arrived and checked my cervix again roughly six hours later and found that I was still only 2cm dilated. She knew that the early stages of labor often progress very slowly, and since I was already admitted, it was likely going to be awhile before my baby was going to make an appearance. It became obvious right then that she was not looking forward to a long labor because she told me that if it was ok with me she would like to break my bag of water to help speed things up. This shocked me. I had very clearly stated in my birth plan that I DID NOT want my water broken artificially! Did she even read it at all? This is when I realized that 8 months earlier I had made my biggest mistake in preparing for the birth of my baby: I did not choose a supportive provider. What surprised me more than my doctor asking to break my bag of water though was my response…. I actually agreed to her request. I was so surprised by her even asking to do the procedure that I felt unprepared to refuse it. I suddenly felt afraid to upset her and also afraid to disappoint the rest of my family who were there to support me by refusing to potentially speed up the birth of the baby they were all longing to meet. This was where I wish so bad my doula could have been there to help me…

Doulas provide support in so many ways, but for me and my first birth a major role my doula played for me later on once she arrived was that of an advocate for me and my wishes. Doulas make sure they have a good understanding of a woman’s birth wishes early on, and when it comes time for the birth, they make sure these wishes are known and understood by other members of the birth team and hospital staff. However, while doulas always make sure Mom’s wishes are understood, they cannot speak on her behalf. This can make understanding how doulas advocate for moms in labor difficult for some, but doulas are amazing at helping mothers to communicate their own thoughts and feelings to hospital staff when it becomes difficult for them to do so. One major way they can do this is by doing exactly what my doula did for me later on in my labor. My doctor once again suggested yet another intervention that I had clearly stated in my birth plan I did not want. When she made this recommendation, I once again sat briefly in silence, unsure of what to say. My doula immediately advocated for me by asking me aloud if I would like some time alone with my husband to discuss things. I quickly said that I did, and everyone but my husband left the room. This was the first time during my labor that I felt I was actually in control. I actually had time to think about what I wanted and what I wanted to say.

 This is just one of the ways a doula can advocate for a Mom’s wishes during labor. They can also help mothers ask the appropriate questions that they may be wondering themselves when certain interventions are suggested and make sure her medical rights are being honored and informed consent is being given. If things are happening fast and a doctor is about to perform a procedure quickly without fully giving a mother the information she needs to consent to it, a doula can speak up and inform the mother of what is happening and ask her, “are you ok with this?”. Above all else, they advocate for mothers by always standing by whatever choices they make for themselves and their babies. 

Doulas understand that a birth is not about what the doctor wants or even what they would want for their own birth. It is about the mother. It’s about the mother they are supporting and what she wants, because it is her body, her baby, and her birth.

This post was written by Gina McNally, a birth doula with A Woman's Design- Doula and Childbirth Services in honor of doula week. Gina is married to her husband Jeff & the mother to her two sons Xander & Parker who are her world. She is extremely passionate about pregnancy & childbirth and absolutely loves what she does.

1 Comment
Kayla link
4/18/2018 09:30:50 pm

My sister will be giving birth soon and she wants to make sure that she'll be actively participating in the decisions of her childbirth. It was mentioned in this article that mother's do have the liberty of how they wanted to deliver their child. Moreover, it will be best to hire labor support in advance to help out on the day of labor.

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