doulas scared of Dr.'s? you work with?

[IrelandsMama]

Okay ladies I think it's time for an update on me. I'm still gearing up for doula work. I want to certify with ALACE really bad, but it looks like I'm going to have to wait until I can get to a training for them. So, in the meantime I'm going to start working. My friend offered to let me have her CAAPA packet as a reference until then and I'm working on as many doula books as I can. I ordered my business cards a week ago and just got them a few days ago. I've been busy passing them out, and quickly see the need for a pamphlet and a website (so much work and only so much me!)

Last week I attended a breastfeeding basics class. It was great! The RN/IBCLC that is both the leader of the breastfeeding coalition and maternity support services is truly happy to have me working in town. All in all our conversation was great but I'm a little worried about some things she told me.

She definitely sounds like shes scared of the doctors in our town. She was very clear that if anything gets back to them that I have contradicted their opinions/advice then they will call me up at my home and chew me out. She also said that they would badmouth me and blacklist me too. She explained that if she sees a mom who was told to supplement by her doctor and she thinks they just need to put baby to breast more often, she calls up the doctor and asks if its okay if the mom just nurses exclusively for 24 more hours and if there are no results starts on formula. I was blown away by this. I mean come on, IBCLC's know more about breastfeeding than doctors. Why should they boost their ego this way? Does this seem silly to you ladies??? Because honestly if a LC told me that she had to check with my Dr. first I would just leave and find a better LC. Anyways the lady is SMART and knows her stuff. She even told me she saw BoBB with Ricky Lake at a showing in Seattle, so I'm confused about why shes so dang scared! I choose mother over doctor. I mean it's not me against them but if it comes to helping mom or making doctor happy, it's not a hard choice for me!

Is this attitude normal ladies? Do I need to come to terms with the fact that I'm going to have to tip toe around the Dr.'s? I really don't like hospital birth too well but I want to help moms and babies, they need me right? I think I need to read more!

Sav

[MsBlack]

Not that I have a ton of experience with LCs...but the few I"ve known have definitely tended to more on the medical side themselves, and have tended to insert themselves as the 'low woman' on the totem pole that is medical heirarchy. When I want BF advice....and encouragement to trust BFing, moms and babies above any doc...I talk to LLL.

[MindfulBirth]

Well, you did say she was an RN. My guess is she has been steeped in the medical model of asking a doc about every sniffle and boo boo. I don't know what the percentage is of IBCLCs who are RNs vs those who are lay-entry, but it is much easier to become an IBCLC if you have a medical (nursing) background.

Also, I have found - just in the doula world- that this is a big emphasis on "staying on scope" and not doing anything outside what the certifying body has agreed is acceptable doula practice. So there is a struggle between moms who say they were disappointed in their doula because she did not advocate when the doc gave them an episiotomy...and doulas who say it is "not their job" to speak up against the doctor.

You also hear of doulas who HAVE spoken up on behalf of their clients who are then banned from the hospital or - as you posted - getting chewed out by the doctor. This is something I am struggling with right now, because I want to advocate for my birth clients. I don't think a woman in the middle of second stage labor is in any position to advocate for herself - esp when she can't really see what is going on "down there."

[paquerette]

There is a difference between what LC's are required to do by their certifying body and what you're allowed to do. The LC is in more of a position of telling the mother what she should or should not do. You're in a position of telling the mother that she could do A, B, or C, presenting her with facts about each of those options, and asking her what she'd like. You're not giving medical advice.

If a doctor dares to call you at home and harass you about something, I think I would file harassment charges!

[mamallama]

The other thing to consider is that most LC's work for the hospital. Her job depends on her maintaining awareness of her place in the hierarchy.

As a self employed doula, you'll have quite a bit more leeway.