your experience :doulas

[AspiringNurseMW]

Hello ladies,

I am working on bringing a doula program to an NYC hospital to help decrease the c section rates (in partial reaction to the Joint Comissions new mandate)

I'd like to point out that the doula's we'd use have a scope of practice that includes NEVER to give out medical advice to our clients. Aside from doulas who overstep the medical boundaries what are your general thoughts and opinions on doulas?

Are there any points/suggestions /questions /comments as nurses I should bring up /include to make l&d nurses more accepting of a doula program?

As a doula and as a l&d patient I notice that a lot of medical staff do not give mom a full scope of benefits vs. side effects (pitocin, cervadil, epidurals, false positives on EFM that can lead to an unnecessary c section etc). No one sure as hell told me as a laboring mom about the side effects. And if I did sign stuff I was in too much pain or too preoccupied to read through medical speak. So I was thinking about collaborating with medical staff and create a medicine & procedures "cheat sheet" that lists benefits and side effects in layman's terms. So that if and when a patient asks me, what do you think, I can hand it to them to look over in conjunction with encouraging them to call the nurse or Ob to discuss it. That way they can get some more information without doulas overstepping boundaries.

Stuff like that. Questions comments issues experiences welcome!

[bagladyrn, RN]

The biggest point I would make would be to strongly encourage your doulas to foster a collaborative rather than defensive attitude toward the nursing and medical staff. Emphasize that they are NOT there to "defend" the patient from the staff but rather to facilitate communication and cooperation so that both the patients wishes and the necessary procedures can be done.

With this in place you will be able to work everything else out.

[monkeybug]

The biggest point I would make would be to strongly encourage your doulas to foster a collaborative rather than defensive attitude toward the nursing and medical staff. Emphasize that they are NOT there to "defend" the patient from the staff but rather to facilitate communication and cooperation so that both the patients wishes and the necessary procedures can be done.

With this in place you will be able to work everything else out.

^this!!! And also tell them that if they ever, ever, ever do a cervical exam on a patient when the nurse steps out, then they will be dragged out back and crucified. I have limited experience with doulas, and what I do have is not positive. I love the idea of them in theory, but in practice what I've usually found is someone who sets out to put a wedge between me and my patient. And then there was the one that we caught gloved up with hand in the patient's lady parts...

[Marymoomoo]

Oh, wow. That is way outside the scope of a doula!

Doulas are a wonderful resource for mothers and families. I'm sure the OP's hospital will find better birth outcomes overall and more satisfaction with their birth experience, for families who choose to use a doula.