Doulas in l+d,hospital setting

  1. Hi all, I've been a lurker on the site for months now, and finally posting an introduction. I am a certified doula, and a med student as well. My question/concern to throw out to the group is in regards to birth/doulas in a hospital setting. I have sensed tension between staff in a hospital l+d with doulas. Is there any l +d nurses or Ob's that support a natural uninterupted/no intervention birth these days???? The comments I've heard made to women seeking a natural birth in this setting by competent professionals has appalled me. I support women who choose a natural birth (at home or in the hospital)or a medicated birth as well... I am there to support their choices and to offer them evidence based research in regards to making these informed choices... is there anyone out there who supports a natural birth in this profession w/i the hospital setting ? BTW, as a doula I do more than just hand hold... see www.ALACE.org .I welcome any and all replies... : ) Just my 2 cents...
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  2. 12 Comments

  3. by   erniebobernie
    hi!
  4. by   Tweety
    Welcome! I moved your forum to the OB section of this website where you might get some conversation.
  5. by   bagladyrn
    Hi - I'm one of those nurses who enjoys taking care of the woman planning an unmedicated, low intervention birth. While I fully support women's choice in their method of birth, I just don't enjoy taking care of the ones numb from the ribs down who are watching tv and chatting on the cell phone practically till the baby is crowning.
    There are times when all the interventions become necessary, and that is the time that the woman who hadn't planned on these most needs the support of her nurse and her doula. Unfortunately, this is when I have seen some doulas tend to undermine the pt's confidence in her provider or her decisions. Not all of course, but I actually had one pt. whose doula left in a huff in the middle of her labor because she opted to take some pain medicine. This was the same doula who followed me out to the desk and suggested that I lie to the pt. and tell her she was too far along for pain med!!
    I tell you this not to suggest that all or even most doulas act in this manner, but to say that one experience like this sticks with you and can color your perceptions. I'd suggest talking to the manager of the dept. at the hospitals you will be practicing at and see if you can do an inservice for the nurses to explain your role and answer any questions they may have. This would probably go a long way to improving the atmosphere when you arrive at the hospital.
  6. by   rpbear
    Hi,
    I work in a hospital that has a doula porgram, these are hospital employees on call for anyone that needs or requests a doula. These doulas are great, they know what thier limitations are and what the RN's role is. I love working with these doulas. We also have pt's that choose a private doula. These situations can be a little sticky. Some of these doulas push thier role a little, they may unpug monitors, or take pt's for walks without the RN knowing, they may suggest things that are not possible for this pt in a hospital setting, such as using the tub if the baby has mec, or is having decels. The pt then feels the tension between the staff and the doula, this can make for a sticky situation. The best thing is to know the hospitals policies on things, and if you are unsure then ask the staff what is available for that pt.

    Good luck, I love having pt's with doulas!
  7. by   SmilingBluEyes
    Welcome to our forum. Here you will find,most of us are very clear on the role of a doula in the labor/delivery and post partum process. You have a very important job. Glad you found us.
  8. by   betsyrnc56
    A qualified doula is wonderful and I am always pleased when one of my patients has one (they are far and few between, however). The doula's role (as you well know) is strictly to support the mother and father. It is never to get involved with any of the actual monitoring,etc.

    I,too, have seen doulas undermuine a mother and that is usually the thype of doula who has her own agenda on her mind and not the mother's. That's wh some doulas give the concept of doulas a bad name.

    I honestly don't think most docs (let alone lay people) even know what a doula does or what her role is.
  9. by   firstyearstudent
    I have a question for the doula, actually. How do doulas feel about Bradley and having father/spouse/life-partner in the role as primary support?
  10. by   LizzyL&DRN
    I support whatever kind of birth the mother to be has decided for herself. If she would like a completely interventional labor with epidurals, pitocin, AROM, etc. etc. I will support her decision and care for her as best as I can. On the other hand if she wants a "natural" birth without the above interventions, that is absolutely fine with me. The only thing I request all mom's to have is IV access. This can be in the form of a heplock only. It just makes me more comfortable if the patient has it.

    I have worked with doulas in the past and although i've heard of the conflicts the nurses and doulas have with one another I have not experienced this. :smiley_ab

    It is the job of the nurse to ensure the patient has all the information available to them in regards to their pain options. How many Labor nurses have seen patients originally plan on no pain interventions and change their minds once in active labor? Nurses need to continue to offer the pain medications/interventions as long as the mother is in pain. Nurses have been sued for not attempting to control a pts pain level. As long as the doula and nurse understands her/his role in supporting whatever decision the mother makes everyone should get along just fine.

    "Can't we all just get along?":kiss
  11. by   CEG
    Quote from firstyearstudent
    I have a question for the doula, actually. How do doulas feel about Bradley and having father/spouse/life-partner in the role as primary support?
    Having a dad present does not displace the doula. In fact, if dad wants to be involved, I make suggestions to him and stay in the background. In a Bradley birth, dad has the knowledge, but may not be sure what is going on or how to apply it. A doula can assist him with that.

    I can attest from my own births that even the most educated, well-meaning dad may not know what do to when faced with his wife in pain. Doulas and dads work together well.
  12. by   crosfam
    I am or was a doula also. I found that it was too difficult being a doula in the same unit I also work as a L&D RN. The md's expected me to function as the RN when in the doula role.
    I think all L&D nurses are essentially doula's, but hey just have all the CYA paper work added to their duties along with all the medical interventions.
    :innerconf
  13. by   firstyearstudent
    Doulas are great! I wish I could have afforded one, but at $1000 out of pocket it just wasn't an option... I've still enjoyed two easy, all-natural hospital births with the support of hospital staff and family!
  14. by   ladybugsea
    This is why I am in nursing school. I hope to eventually become a CNM.

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