I dont see how that letter can be any sort of inspiration. Its tragic that this writer had a traumatising Caesarean and thought that her doula could have prevented it, however it is most certainly not something I would include in a doula training package and I dont think its a great reminder of anything. I dont think any doula lacks sympathy for their caesarean clients and will do anything they can to prevent an unneccessary ceasarean.
This letter comes from a place of birth trauma, fear and horror, and it seems as though this woman feels her doula let her get wheeled away to the OR for no reason. No one knows why this woman feels this way. What is the context? Is the woman suffering from PPD? Did the doula do a lousy job? What is the emotional state of the woman and relationship between woman and doula?
I do not think this is a reasonable representation of a normal post caesarean reaction to a doula's role in the whole thing.
I do everything I can to prevent unneccesary caesarean, but I realize that what I can do is limited. What I will not do: "you will throw yourself bodily in front of the train to save her" because guess what, that is not going to "save her".
I am not fighting either. I dont need to be reminded what I am 'fighting for' because I dont fight. I am not combative with doctors, nurses, or clients. I consider that I effect positive change through information and demonstration, but there is no way I am going to go off on a doctor for me thinking a section isnt neccessary, or that he caused it because 1) I am not a doctor, even if I were a midwife I am not a doctor, and 2) because fighting is definitely not the solution to repairing the wounds in maternity care.
I want to have a good relationship with doctors even if I dont agree with their practice all the time. I want to be respected in the hospitals and have nurses and docs happy to see me when I enter the room, because a combatative doula is not doing their job to help the woman because tension and anger has no positive effect on birth.
The next thing to consider is that there are risks involved in everything, and whether the options are vast or not, each woman is making a choice, on some level, about what risks she is willing to make.
She is choosing to give birth in the hospital which carries the risk of unneccesary or increased medical intervention, which may inevidably lead to caesarean section.
She is choosing not to give birth at home. Even if access to midwifery care is limited or non existant there is a choice with risks. The risks being that it could be illegal, or more expensive that she could afford.
She could UC but find that too risky in that there is no medical support, or whatever.
They may not be informed decisions, they may not be decisions out of a wide array of delightful options, however they are her choices. you are not responsible for them. She chose to get a doula, which is great but she needs to recognize what that means and doesn't mean, and to realize that because she is giving birth in a hospital there is a risk of intervention, which she may decline if she so chooses and at no point may/will her doula, make decisions for her, nor is a doula her doctor, therefore the doula is NOT responsible for the resulting caesarean or fourth degree tear, or whatever it may be.
A bit of a rant because that letter kind of got under my skin. We cannot take on the tragedies of our clients in an unhealthy way. We can mourn for them, we can be sad, or feel bad, but we are not to feel guilty or responsible for the choices of our clients.
I know the idea of choice will really make people mad because I know women have so few options, especially where I am from but inevidably they are decisions with risks. Each decision. If a woman is not willing to take any chance of unneccessary caesarean she should UC.