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NYT Article - Doulas & LCs

post #1 of 33
Thread Starter 
http://www.nytimes.com/2008/03/02/fa...prod=permalink
post #2 of 33
Quote:
There are no national statistics on the phenomenon, and few women readily admit to doula discord. But according to a 2006 study of women who used doulas in Alabama, 44 percent of women described the relationship between their hospital nurses and doulas as hostile, resentful and confrontational.


Could it be because they were in ALABAMA?!?

I guess all of the wonderful doulas who serve as a buffer between women and the traditional hospital birth experience aren't newsworthy.
post #3 of 33
what a horrible article, shame on the new york times!
cant imagine, who was behind that!!!!
post #4 of 33
Um, yeah, it could DEFINITELY be because they were in Alabama. In Birmingham there is one particular hospital in which the nurse manager HATES doulas.
post #5 of 33
Hey, I'm in Louisiana and I feel your pain, Hayes. Funny how our intervention rates are so high and our FMR stats are too.
post #6 of 33
Wrote a letter. Who knows if anyone will ever read it, though.

Editor:

Re: your doula story (http://www.nytimes.com/2008/03/02/fa...prod=permalink)

As a doula, my job is to help parents make informed decisions regarding their child's birth, then to implement those decisions to the best of my ability. If I've done my job well and established mutual respect, I can easily support their choices without second-guessing them. I also know that they have put as much effort in choosing their primary caregivers as they have in choosing me. To undermine the efforts of other professionals would be intentionally sabotaging my clients' birth experience... unthinkable.

From my point of view, if other care providers approached clients and their doulas with the same level of respect and intention, there would be a lot less conflict out there. With that said, ultimately clients set the stage for their care with their choices, and ultimately they must bear responsibility for the outcome of their decisions. This fundamental truth sometimes gets lost in all the paperwork.
post #7 of 33
Quote:
Originally Posted by SamuraiEarthMama View Post
From my point of view, if other care providers approached clients and their doulas with the same level of respect and intention, there would be a lot less conflict out there. With that said, ultimately clients set the stage for their care with their choices, and ultimately they must bear responsibility for the outcome of their decisions. This fundamental truth sometimes gets lost in all the paperwork.
Very nicely said!

That article had such an axe to grind. Very disappointing.
post #8 of 33
Quote:
Originally Posted by Hayes View Post
Um, yeah, it could DEFINITELY be because they were in Alabama. In Birmingham there is one particular hospital in which the nurse manager HATES doulas.
thats too bad. my brother lives in birmingham and now i know i could never live there, i wouldnt be able to work!
post #9 of 33
Horrifying article.
We are in the middle of a backlash! It is clear the purpose of the article was to find disgruntled clients who did not like their doula or lactation consultant.

I'm in NYC and there is also a symposium coming up soon for doctors only at NY Cornell Hospital in Manhattan so OB/GYNs can discuss and support the new ACOG statement against Homebirth and against the movie "Business of Being Born".

Crazy mixed up world!
post #10 of 33
The Journalist who wrote the article in the NY Times has a new book that will be released next month (April 2008) called “Parenting, INC.”

I think this author sounds interesting and it looks like her book is one that many of us who are anti-consumerism in how we parent could get behind.

However from her NYTimes article she seems to lack any depth of knowledge or understanding of the current politics of having a normal birth or breastfeeding in America, and how vital a doula and LC's are for woman interested and/or knowledgeable to seek assistance in having a “normal” experience.


“Parenting, INC.”
By Pamela Paul
From Publishers Weekly:
Pamela Paul, mother of two, probes the business of parenting, exposing the high price of raising kids in our consumer-driven nation. Paul points out that it costs upwards of a million dollars to raise a child in the U.S. these days, especially if one buys into the theory that baby must have everything on the market. Following the money, Paul dissects the booming baby business, including smart toys that don't really make kids smarter, themed baby showers and parenting coaches and consultants. The text is a tireless rundown of parents' seemingly bottomless pocketbooks when it comes to bringing up baby, and according to Paul this is not just an upscale, cosmopolitan phenomenon—throughout the country parents are reaching deep into their pockets to fuel this spiraling craze. Though Paul incorporates the pithy quotes of a number of experts, such as psychologist David Elkind's observation, Computers are part of our environment, but so are microwaves and we don't put them in cribs, readers may find themselves wishing for more commentary and less litany. But Paul isn't preachy, although she does reveal that what babies really need is holding, singing, dancing, conversation and outdoor play.
post #11 of 33
Someone on another forum think that they found the actual study in Alabama
http://www.pubmedcentral.nih.gov/art...?artid=1595283
It was sent to ELEVEN mothers, NINE of whom completed it.
post #12 of 33

A note from the author

Hi there,

I like to pay attention to what readers say about my articles, especially in a former on Mothering, a magazine I like and respect. I'm sorry to hear that so many of you were disappointed with the article. My hope is that it would heighten the importance of a good doula and a good LC; after all, people who practice in either area and don't do a good job damage both fields, and aren't helpful to the individual women who come to them for assistance.

Having breastfed both of my children exclusively for over a year, I know the importance of a good LC. But I know many women who were turned off to breastfeeding by having improperly trained LCs at hospitals (the hospitals often give their nurses quickee courses rather than pay to hire real IBLCE trained LCs as a money-saving measure), that I think it's important to publicize the problem so that they get proper care and are supported in their breastfeeding.

In the story, I state up front that doulas and LCs can be godsends, and that studies show the merits of using a doula during childbirth, as well as the dire need for good LCs. However, with an increased need and increased usage, comes increased problems. Just as the number of C-sections rose when childbirth became increasingly medicalized, there are problems that come along with the increase use of doulas. Most women were reluctant to speak out about these issues not because they didn't exist, but because they feared being attacked if they dare go public with their bad experiences. I think it's important not to silence people, no matter their experience. Finally, I spoke to many doulas and LCs, as quoted in the story, to be sure to represent their point of view, which I hope I did fairly.

The bottom line here is that experts say parents need to be careful when choosing a lay caregiver, just as they would when choosing a doctor. I am sorry if this story came across as negative about either field; I think that making both these fields the best they can be is a shared goal all of us can aspire to.

All best,
Pamela
post #13 of 33
I think the fact that the article appeared in the 'fashion' section says a lot about it.

As for the author, perhaps her intentions, as she stated, were good. I'm completely ready to believe there are underqualified/unqualified doulas and LCs out there who make women's experiences worse, and that definitely needs to be addressed. HOWEVER, there is a serious lack of positive examples, and simply starting the article by saying that doulas and LCs can be a godsend is insufficient. If we lived in a society where people were well-informed about and comfortable with doulas and LCs, this article would probably be fine. Since a large portion of the population may never have heard of a doula before, though, this article does the profession a major disservice by not giving the uninformed enough positive examples.
post #14 of 33
PPaul,

I appreciate your good intentions, but I found your article very confusing. You start off with a birth horror-story (nothing shocks as well as a scary birth story), which is likely to leave a bad taste in anyone's mouth. You follow with a very short blurb about the good a doula or LC can do, but then go on to bash them for the rest of the article. All in all, it came across as very negative: "they can do some good, but few do" was the message I took from your article.

Perhaps, if your intentions were to "heighten the importance of a good doula and a good LC," it would be more effective to start out with a positive birth story, extensive explainations of the benefits a good doula or LC can offer, with a short but well stated section about the importance of choosing a doula or LC wisely.

I, for one, would love to see a follow up article.
post #15 of 33
Not to mention, it lays all the responsibility for adversarial relations between doulas and hospital staff at the feet on the doula, completely ignoring that many mothers hire a doula in part to deal with the staff for them.
post #16 of 33
Quote:
Originally Posted by honolula View Post
Not to mention, it lays all the responsibility for adversarial relations between doulas and hospital staff at the feet on the doula, completely ignoring that many mothers hire a doula in part to deal with the staff for them.
: The fact that ACOG has been systematically trying to stomp out midwifery for more than a century should really shed some light on why they might find doulas get in the way of the "medical aspects" of birth - that's part of the point because birth is not a medical event. The article was completely one-sided.
post #17 of 33

another response from the author

Hello again,

I want to respond again because this discussion has become really interesting. I'm going to apologize in advance if this is my last post here, and if it's rather brief, but I have a crazy day at work and a doctor appt for my toddler.

Many of you raise the question of why I didn't present positive examples alongside the negative ones. I would have loved to have offered more examples and more of the positive side, but please do not underestimate the restrictions of word count. This story was drastically cut as it is. There was a lot more to say. Truly, the only place to write more freely is in blogs and in books, and I try to do so with both. I have started blogging at HuffPo, and I also have a book coming out next month that is an expose of the commercialization of parenthood in which I go into some of these issues at more length. And there is always more to be said....

I think some of the misunderstanding here also may arise from how journalists (at least responsible ones) work or try to work. I'm not saying I'm perfect, but if I write a story about conflicts with doulas and LCs, it is not with an agenda in mind but with an intention to document a phenomenon that is occurring. OF course, it is my hope that the issue will make moms (and dads) more conscientious when choosing lay caregiver help, and will perhaps inspire both fields to educate parents about their purpose and training. Unfortunately, no matter what I write, there always seem to be people who get upset and it seems to go with the territory. Last month, I wrote a story on the resurgence of cloth diapering in Time magazine. (http://www.time.com/time/magazine/ar...702357,00.html) Was the disposable diaper industry furious? You bet.

Again, I am sorry if my story upset anyone, but truly, my hope is that women get the best possible care they can. I personally had a VBAC with my second child and the OB in NYC was so furious that I went through with it that he refused to speak to me or make eye contact while I was in the delivery room. I am considering getting a midwife the next time around, but as many of you know, options are severely limited in NYC as they are in many other areas. I want for their to be as many, and as good, options for women as possible, irrespective of income or insurance.

I wish everyone the best here. Again, I am sorry if I am unable to write again on this particular forum. But I hope that the discussion will continue in good spirit with or without me.

All best,
Pamela
post #18 of 33
Thread Starter 
I know that DONA International, for one, is working on a formal response to the article. This is such an important discussion. It's true that doulas and LCs can do as much harm as good when they act outside their scope of practice. But I hope there is some kind of follow-up that addresses the positive contributions that GOOD doulas and LCs make to maternity care.

And what about postpartum care? When is there going to be some focus on the gaping hole that exists in the care that women and babies receive after the baby has arrived? As a postpartum doula, I know firsthand how critical that kind of support can be - and how that is a very weak link to our existing system.
post #19 of 33

And then I truly must get back to work...

Dirtgirl,

I'd like to answer your post since you began this thread, and you raise an important question. I agree with you re: postpartum care. Again, not enough space in the story! But you'll be happy to know that I write about PPDs in my upcoming book, where I make the point that this is the kind of much-needed help governments in France and Britain offer new mothers for free! And don't even get me started on the subsidized maternity leave and childcare in both those countries...

Back to work,
All the best,
Pamela
post #20 of 33
Hi Pamela,

I truly appreciate you responding on Mothering; however I'm not sure there will be a way for you to defend the article. The focus was on a minuscule issue some clients have with doulas and LC's, however the tone was an indictment of all doulas and LC’s as unqualified interlopers giving unwanted support to innocent clients. When in reality it's an infrequent problem that stems from the few client/doula personality or philosophical mismatches.

Many thousands (millions?) of satisfied families have use qualified helpful doulas and lactation consultants who do not have an agenda or interfere with medical staff, but the article was not about them or how someone can find a doula aligned with what a family wants from the birth or breastfeeding experience.

I still don't understand the need for this narrow article when so many other pressing birth and breastfeeding related issues are vitally important to the overall well being of all women and babies and sorely need your investigative reporting light shined.

How about your VBAC experience with your doctor, you are not alone it has become a national universal issue for too many women who would want to give birth vaginally after a c/section, but not allowed.

~~~~~~~~~~~

In response to your candid personal VBAC story, I can offer a list of very qualified midwives who work in hospitals or birth centers or at home in NYC, they can help you have the birth you want next time and you will not have to continue experiencing your OB/GYN's agenda, or mistreatment shunning you when you make informed decisions for yourself.

There are numerous Midwives for you to choose from to start your well woman care before you get pregnant again. There is always a shortage of Midwives, but we have enough in NYC for you to find one that is a good fit.

I hope you have the opportunity to write a more balanced and fair NY Times article in the future. Your new book looks fantastic and so many of us are aligned philosophically with you to keep a less consumer driven frenzy out of our life.
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