"Do I have any formal education as a health care professional? I've been waiting for this question. I do not believe a woman needs formal education as a health care professional to make informed decisions about her health. I think it is imperative that all women become more actively involved in their health care. This question was asked of someone in the homebirth community....sorry I can't remember the name. She had written a book one birth and was asked what credentials she had that would qualify her to make the statements she did about birth. Her reply: "I can read." I, too, can read. I hope you will not discount the wishes of your patients simply because they do not have the schooling you do. "
I would like to share my experience around this issue. I have three children; all were complicated pregnancies, with a c-section for the first birth and two VBACs to follow. With each birth, and a demise at 20 weeks in between the last two, I learned a little more about how things worked, with regards to both my own body and the general hospital environment. I read every pregnancy book I could get my hands on, talked to lots of folks, and was generally well-informed about my choices and comfortable with my decisions. I got so interested in pregnancy and labor in general that I decided to become a doula and help other women with high-risk pregnancies enjoy the kind of labor support that is often only offered to low-risk women. I entered training and was given a reading list with 10 or 15 books of required reading. I attended births as a volunteer at the local public hospital, often working with immigrant women who spoke no English and to whom our hospital system was terrifying. I loved my work and felt necessary and helpful, and felt even more well informed, well educated about how to help laboring women, and dedicated to my field. But I wanted to do more...and one day while driving home from a birth it hit me that what I really wanted to do was become a midwife. I talked to the midwives at the hospital where I volunteered about whether the licensed midwife or CNM route would be preferable; what decided me was the midwife who said, "I want to work with women of color, and most women of color deliver in a hospital, so that's why the CNM route was right for me." That winter I enrolled in a local community college to start taking prereqs for nursing school. Four and a half years later I graduated with a BSN, knowing that, just as what I had learned as a patient was a teeny fraction of what I learned as a doula, so what I learned as a doula was a teeny fraction of what I had learned in nursing school. Then I started my job as an L&D nurse and learned...that I knew nothing. That I could read every book and write every paper and ace every test, and spout every theory and statistic in the universe, and still it wouldn't matter, because there was no way to gain knowledge except through experience. My hands had to learn to palpate contraction strength, and feel for veins, and recognize the onset of chorio long before a temp started spiking. My eyes had to recognize the difference between strip patterns that looked okay and ones that heralded trouble down the pike aways, to see the difference between bleeding that was normal and bleeding that was not. My ears had to hear the change in heart tones that signaled I better get that patient back to the OR NOW, and to recognize when my Mag patient's SOB was due to incipient pulmonary edema and when it was her underlying asthma kicking up. And still, today, I am learning every moment. Every patient teaches me something new. My job is to prevent problems from happening, to prevent small problems from becoming big problems, and to provide care and comfort during those rare times when catastrophe is truly unpreventable. It is a hard, hard job, far harder than I ever imagined in all my days as a patient, as a doula, and as a student.
I am a mother and a nurse. Being a good mother is incredibly difficult. Being a good nurse is harder still.
I greatly respect every patient who takes the time to know her body, her own wishes, and what will make her feel safe enough to labor under my care. I respect the doulas who take the time to comfort and care for these women after undergoing rigorous and well-informed training themselves. I only wish these women would more often respect my experience as much as I respect theirs.