Originally Posted by April422
In 8 years as a doula i have to say in hospital, home and birth center clients I've never had a woman who couldn't refuse a vaginal exam, even if by simply closing her legs.
I've given birth myself, and I've never found myself unable to answer questions asked of me between contractions. I was able to decline vaginal exams, AROM, medication, etc. It didn't take much engagement of my rational brain at all.
But you do recognize that not all women labor the same, right? Each individual woman has different reactions to labor, and to pain. Your reaction was how it works for you, but it doesn't mean that other women will be able to refuse exams, close their legs, or answer questions between contractions.
For your statement above to work, we have to first assume that the provider asks before they start an exam, or will stop the exam once the mother says no. We then have to assume that the mother is able to hear and respond to questions while in labor. We also have to assume that there is down time between contractions where these conversations can occur. We also have to assume that the act of closing ones legs is "simple" during labor, and that a woman will even think to do it. We also must assume that when she closes her legs, they will not be forced back open.
Also, the situation you seem to be describing isn't even an "advocate" situation. You seem to be describing a situation where a very calm respectful provider asks a woman, in between contractions, if she would like a vaginal exam. She says no, or yes, and everything proceeds as planned. What does a doula do if her client tells her in advance that she wants no exams at all, or that she only wants exams when she asks for them, and then a provider comes in the room, slips on a glove, and proceeds to start the exam while telling the client, "I'm just gonna see how things are going here." What if her client says, "no, I don't want one" and the provider proceeds anyway? This is where a true advocate is needed, and this is a very typical hospital experience for birthing women. How can she close her legs without risking the exam becoming more uncomfortable? How can she say no to something that has already begun, that is already a violation of her wishes? If a doula at this point says to her client, "is this what you want" and her client says "no", what good does that do? What if her client becomes confused, or wants to protect herself from the shame, so she says, "it's fine".
I don't think any of us have the answers to these questions, but I wish that someone did. I wish that doulas really were advocates and weren't just labeled as such. I wish that all women could think logically and argue on their own behalf during labor, but some of us just can't do that.