Doulas--help me understand - Page 2

[1stimestar]

Originally Posted by MsBlack

Maybe a doula's role is tougher to manage than the midwife's in iffy/bad situations--since the midwife knows more about what is going on (hopefully!) and can 'do' more about it. The midwife also (hopefully) knows the difference btwn 'iffy' and 'bad'--also impacting emotional reactions. A doula has to keep her calm, and continue giving to the parents, even if she knows little about what is going on. From a recent other thread here started by a doula, it seems that some doulas do have this challenge of coping, and still remaining supportive, when things go 'wrong' somehow and the doula is afraid partly because she doesn't exactly know how serious the situation is (NOT a criticism, btw--same comparison could be made btwn mw and OB; we all have our 'specialties' and limits..besides, we all have 'firsts' in our work).

After a while, you do end up learning what is bad and what is iffy. You also learn what's what as far as medical situations go. We actually can use this information in order to educate our clients before hand. Most of the work I do is in my prenatal meetings.

The doula who had been part of the difficult situations was stimulated to learn more in general about birth, had the greater opportunity to learn how to stay calm and provide support even when things get scarey.

Let's say a doula has seen VBAC/HBAC; now she can say she is VBAC-experienced. If they all went well, fully supported by med/midwifery staff, she may have a false sense of confidence about her ability to support VBAC...she still doesn't know how she'll do when a woman has to fight for her natural birth, or when things don't go as expected otherwise. Or maybe she has worked w/a csec birth...well, there is a difference between a csec that mom agreed to, after first agreeing readily to a cascade of interventions, and one that is the result of a long struggle against interventions and med. coercion. And the pp period, and BF initiation, is also far different depending on whether mom feels 'ok', or 'ripped off', or 'totally traumatized'.

Exactly. You end up learning more, the more you are challenged. This is where the client needs to educate herself in order to find the doula that is best for her. If she KNOWS she is going to have to fight for what she wants, she is better off hiring an experienced doula.

It is also difficult for doulas to attend traumatic births, especially those that a mom considers birth rape. We sometimes feel as if we should have been able to prevent things from happening even when sometimes that was simply not possible. Traumatizing births can really increase the whole doula burn out factor.

Appropriate expectations are a good thing! No, I don't think that there is a magic minimum # of assists required to call yourself a 'professional'. Yes, I do believe that every birth one attends is part of training, whether you 'worked' or 'observed'. As I hope you can see, I think there are numerous factors that impact preparation and 'experience'...and as it seems we all agree, there is a necessary component of confidence and giving oneself credit due, that needs to be balanced by humility and respect for the vast variety of situations possible at birth.

Thank you all, and if there is more to be said I would love to hear it.

One of the biggest obstacles that I think new doulas have to face is learning how to meet the client where they are. Lots of doulas want to "save" the momma. What some do not yet realize is that that information is not the only factor in a client's decision making process. Just because one has been shown the cascade of interventions does not mean that a client wont choose to go that route. There are so many different things that play a part in their choice that has nothing to do with simple information. Past history, their beliefs and society, opinions they have been and are being exposed to, their education level in general as well as their birth education, their support system, all make a difference. So one has to learn that not all women want to be "saved" from the doulas' perceived obstacles. We have to learn to let go and support the woman where she is at, support her choices even if they are not the ones we would make ourselves.

On the other hand, new doulas have so much passion about what they are doing and the road they are on. There is no "tiredness" to them. Most are just so excited to be on this road and to be able to follow their dream that it is nice to be reminded of and exposed to that excitement occasionally. Not that I do not get excited or that I am no longer passionate, only that I have experienced burn out before. I have cried on the way home from births before. I have felt totally deflated, defeated, and useless before. I have sat and cried with parents and been asked "why" before. It does tend to make me more reserved I think.

[happyartmama]

Interesting thread, I'm glad it was started.....I'm a very new doula (trained through ALACE 7 months ago; have attended 14 births--12 in a doula capacity). Before I was "officially" certified through ALACE, my business card simple said "ALACE trained." I'm very upfront with all potential clients in telling them my level of experience. Some ask specifically what was involved in the training or how many births I've attended, and I'm happy to share both answers.

I also state clearly that I in no way think I know everything about birth (no matter how many books are read!) or would know how ton advise in every situation. What I can assure the woman/couple of is that I will provide the continuous labor support (and pre-natal/postpartum visits) using what knowledge and experience I've had thus far. If something arises in labor that I'm truly not familiar with, I acknowledge that, step out for a few minutes, and call one of several CBE's and more experienced doulas for additional information to pass on to the couple.

As for fees, I attended my first 8 births for either very reduced (about a quarter to half of the average going rate) or free. However, the two births I attended for no charge I did feel slightly taken advantage of. When I met the couples, the way I phrased it was "I'm asking for ____, which could help offset my training expenses but more importantly child care costs while at the birth, but that I was willing to work with them for free if there was a real need, because they would be helping me). So the two couples express a real "need" and couldn't otherwise afford a doula, so I was told.

At both births, there were several mentions of both "having" to have their daily large Starbucks or two, weekly pedicures for mom to be, and a recently purchased high-end camcorder. My feeling was, if they could afford all of those things, they might have offered some type of small gesture (monetary or otherwise) as a show of thanks. At the very least, have the brains not to keep listing all of the recent new purchases in the presence of the person you just told you couldn't have otherwise hired!

I'm still happy for the experience, and grateful to be doing this work. Most nervous about encountering situations that I wouldn't know how to handle and fear later that the couple may have been better served my a more experienced doula. But you have to keep woorking to get that experience...

[MsBlack]

And yet more satisfying responses....

Yes, the new doula (or midwife) has that fresh enthusiasm that the more experienced might not...and the more experienced have a steadiness that the newer ones might not.

Yes, either one often goes into the work hoping to save the family from the wicked whatever that might trip them up...and 'give them' a good birth....and the best ones hang in there and learn boundaries and perspective and due proportion.

Yes, each family has to find what's right for them in a doula or midwife (or doctor or dentist or...). And I do think there is a lot of value in working with fresh energy for many families...and a lot that a less experienced doula or midwife can offer--just different stuff from what the seasoned birthworkers have to give. Does depend on the situation and what is most needed. Now, though I am far from being as experienced as I someday hope to be as a mw...and though I know I have things to offer that I did not as a 'greenie'...sometimes I miss those old tireless and endlessly enthusiastic times when I was so green!

And double dang YES, I just hate it when people beg off full fee for 'financial reasons' and then you see that they have money, just don't seem to value the service we provide as much as the Starbucks, the camcorder, or other 'necessities'....I've seen this a few times and grrrr.

more thanks to y'all