Roles we play :Iattended a CAPPA conference in may, 2004. In one of the sessions we attended we did a fun activity. Each of us made a paper hat... all kinds of hats. Then the organisers put a few on their heads and ran down the aisles trying to balance them.
Recently a friend asked about the roles various people played in birth, and I was reminded of the hats we wear. Here is what I thought works in birth rooms.
1. The doctor's role is primarily to look at the things that may go wrong. That's what they train for. In any case they have crisis check list, and they are the safety net to circumvent the items on that list. However, over a period of time defensive medicine has become a routine.
2. The doula role is that of support but there is a thin line of what the doula sees as support and what the mother sees as support. Therefore, it is very essential to be informative, have discussion before labour begins. There may be a time for a doula where the mother may want an intervention, much against the belief of the doula but focusing on the goal...
support ..unconditional
The care giver may be a midwife ... in which case the welfare of the baby and mom then lie in her purview.
3. If there is a hypnobirthing practitioner involved...like a childbirth educator they have no active participation role in childbirth. Their work is to educate, facilitate discussion, protect the moms' evolution of birth philosophy. Note, I said protect, even as educators we cannot force our opinion on them. Even when we know something to be right it may still not be right for everyone...
It a complex situation yet simple in premise. Each one of us are a link but its her birth.
So an important step is to reflect what our boundaries are... all boundaries are dynamic and self imposed. There isn't a clear cut line ever. Also reflect on the role and significance of the role of others. For example : as a hypnobirth practitioner I may say in my class that the hospital staff can assist with Hypnobirth by making no mention of pain. But do I take the responsibility of educating the hospital? What happens when I have more than 5 couples in a class who are going to different hospitals? Does this responsibility now lie on the expectant couple in my class? Will they add this to their birth preference? The educator may not meet every doctor how ever she can say, when you are discussing this with your doctor, I will be happy to be with you for one visit/ speak on the phone/ have a handout explaining about Hypnobirthing in detail for the doctors consumption
As a doula do I support Hypnobirthing philosophy? Am I involved prenatally? More communication in the mom - doula- educator triad. Can the doula take the responsibility of being with the mom while she presents her birth preferences... and does the make want her to take charge to protect the environment at the hospital... or will her birth companion do that? many subtle undertones here as well
To what extent the doctor regard her wishes. Considering the circumstances around every birth, think will this doctor stay with what she/he has intellectually agreed or if faced with stressful moment revert back to his medical training. We have understood the mind enough to know that long term memory will override. that's why change is slow and seeing is believing... seeing over many many birth.
I have faced these dilemmas for many years now and reflective practice is a powerful tool for growth here. Change can be best made from within. Confronting people with what wasn't done will make them defensive and less likely to change.If every one closes up there are even lesser opportunity for SEEING IS BELIEVING to work. Define and reflecting on our roles will make us define our responsibilities and make us aware of what more we could have done.Also cuts out the blame game creating harmony. Acknowledging what ever progress will motivate everyone.
The most important part is ... how the birth mother her birth... ITS STILL HER BIRTH. If she is happy lets share the happiness and take this experience to share and grow.
Val Staples in an interview as a doula :
Dear Divya
ReplyDeleteThis post is profound. I have thought about this and always wondered how to define these roles. There is so much clarity in what you have tried to communicate. I am going to use this when there is a need to do the balancing betwen the care giver,the couple and birth professionals like us.
Cheers Deepa Santhosh