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repercussions of doula's redefining the word "advocate" - Page 3

post #41 of 69
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Originally Posted by sapphire_chan View Post
I would've thought this would be more the role of a CBE. Oh wait, you are one of those as well. Okay, so your thoughts on those two roles? What about people who are "only" doulas?
Doulas have to be both. There is a lot of prenatal discusssion between doulas and their clients about what to expect during their birth. I've had the opportunity to be a doula who does shift work at a hospital and I haven't pursued it. I don't like the idea of not having prenatal contact with moms and just meeting them in labor.
Quote:
Originally Posted by sapphire_chan View Post
(By the way, I hope you aren't feeling picked on, one of the dangers of making articulate and well-thought out posts is that I'll pounce on you to get your knowledge and input. If you seemed clueless I wouldn't be reading your posts so carefully to get you to clarify stuff.)
A little bit, but I'm enjoying the lively discussion.
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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.
Exactly. I hate being an advocate. It seems so confrontational to me. The last birth I attended as a doula was so much less stressful on me because the CNM and the nurse respected the mom's wishes. I wish that every birth could be like that. Its especially sad from someone such as myself who had a birth at home. I didn't UC but my midwives were on my territory and I was in charge of the birth. To be a mom in a hospital is so very different. I'm not saying that hospital births can't be great, but I wish every mom could have a birth like I did. That's the reason I became a doula in the first place. To help moms have great births.
post #42 of 69
Quote:
Originally Posted by sapphire_chan View Post
I would've thought this would be more the role of a CBE. Oh wait, you are one of those as well. Okay, so your thoughts on those two roles? What about people who are "only" doulas?

(By the way, I hope you aren't feeling picked on, one of the dangers of making articulate and well-thought out posts is that I'll pounce on you to get your knowledge and input. If you seemed clueless I wouldn't be reading your posts so carefully to get you to clarify stuff.)

Honestly, any good doula (absent CBE credentials) in my opinion should be able to provide the information I outlined there. I provided it long before I became a CBE, maybe it's what led me to BE a CBE though, wanting to give more.

I don't feel picked on. I cut my online teeth on debate boards, so I'm used to needing to defend or be questioned on my position.
post #43 of 69
Quote:
Originally Posted by April422 View Post
I can't say that the above bolded is my experience as a birthing woman or as a doula. Sure there are providers like that where I am, I'm sure it happens, but I'm not sure it's the rule and more an exception.

If a woman has not consented to a vaginal exam and one is being forced on her, I'd speak up. "I hear her declining a vaginal exam. (client) do you want the (dr/nurse/midwife) to stop?"

I think that our power as doulas is most effective if used prenatally. Help our clients find providers whose birthing philosophy most closely matches her. Education her about her options, her "rights". I cover the right to refuse, anything. No means no. Absent of a court order they can not force treatment or exams upon a woman. I wouldn't be adverse to mentioning that I hear the refusal, and my clients are aware of what "battery" means in a medical setting and the power of using that word.
So... Can I come live where you live then?

I'm sorry, but although your options there seem to be quite wonderful, reality is that in many many places, doctors WONT listen to their clients, even if it has been laid out very plainly in front of them beforehand. They will continue offering drugs, and doing vaginal exams without asking. If they get caught during, then they just say "ohh it's just a quick one, I'm almost done." I don't think it's as much the exception in other places as you'd like to believe.

I live in a place where we are having a huge doctor and midwife shortage. If you've been lucky enough to find ONE provider, you don't switch. You have to call for a midwife before 6 weeks or you are pretty much guaranteed not to get one. And even then- I've heard some horror stories about a few of the midwives, but when it's your only option, what do you do? I have a client right now who is working with apparently one of the best obgyn's in the city as far as natural delivery. Yet my 27 week pregnant client was told last week that since her placenta MAY not have formed properly, she's automatically being diagnosed with IUGR, preeclampsia, and they want to induce her in July. She's not due til September, and they don't even want to wait to tmake the decision. This is what the BEST gets you in my city. No wonder I want to UC.

Quote:
To be quite honest, I don't want to be an advocate in the dictionary sense. To me, speaking for a woman means taking away HER voice. I can't do that. I'm more than happy to help her communicate her plans and desires but there are ways to do that without removing her voice.
But we've gone over this, and while you may have been able to speak- many women aren't. They aren't not talking because they figure their doula will speak for them- they're not speaking because their brainhas physically shut off the portion required for speech. They are dealing with labor, which they should be.

A mother should have every opportunity to use her own voice first. But if she can't, then we need to be able to step in.

I wanted to thank the original poster here as yu've given me a LOT to think about with what I want to be providing in my care. I was very worried prior to this about certifying and 'following the rules', and I think I"m leaning much more now towards not worrying about it. Do I want to belong to an organization which tells me I can't talk to doctors and nurses for the client when she needs? I don't know....
post #44 of 69
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Originally Posted by jeninejessica View Post
I wanted to thank the original poster here as yu've given me a LOT to think about with what I want to be providing in my care. I was very worried prior to this about certifying and 'following the rules', and I think I"m leaning much more now towards not worrying about it. Do I want to belong to an organization which tells me I can't talk to doctors and nurses for the client when she needs? I don't know....
I think if I were training as a doula, I'd rather be a pre-birth CBE for the family and act as a coach for the DP during labor. If you can't be an advocate, back the person who can be an advocate.
post #45 of 69
Quote:
Originally Posted by jeninejessica View Post
I was very worried prior to this about certifying and 'following the rules', and I think I"m leaning much more now towards not worrying about it. Do I want to belong to an organization which tells me I can't talk to doctors and nurses for the client when she needs? I don't know....
Me too! I let my cert lapse, and maybe it's for the best. Not that I'm an active doula anyway, but I at the births that I did attend I was uber worried about towing the line and following the rules.




About the woman's voice issue. I think labor/birth isn't too much the time for worrying about stealing a woman's voice. If she obtained information and expressed opinions prior to labor that IS her voice. As long as the advocate acts as the woman herself would then there's no stealing going on--it's pure support. Her voice remains intact, it's just that birth sometimes necessitates that it be channeled through another.
post #46 of 69
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Originally Posted by Synchro246 View Post

About the woman's voice issue. I think labor/birth isn't too much the time for worrying about stealing a woman's voice. If she obtained information and expressed opinions prior to labor that IS her voice. As long as the advocate acts as the woman herself would then there's no stealing going on--it's pure support. Her voice remains intact, it's just that birth sometimes necessitates that it be channeled through another.
Bravo for this!!!

I have been frustrated by this issue since I realized that my doula wasn't there for me in the way she had presented herself to me when we agreed she'd be my doula. And then I considered becoming a doula. I felt strongly that I needed a spokesperson or a voice that is somtimes "channeled through another" as you put it. I was very disillusioned when I discovered that if I were to become a doula I would be prohibited from being that spokesperson which I know is so desperately needed, as it was in my case. In the last few weeks, I've been getting into it with doulas on this topic and have been very frustrated by the responses I've heard.

Jennica, thank you for bringing this conversation here. I'm glad its being discussed.
post #47 of 69
Quote:
Originally Posted by sapphire_chan View Post
I think if I were training as a doula, I'd rather be a pre-birth CBE for the family and act as a coach for the DP during labor. If you can't be an advocate, back the person who can be an advocate.
Isn't that what doulas do?

Since I can't directly advocate for clients, I help the partner be her voice if that is their preference. I can cue him/her to say something, I can remind him/her of her wishes and let him/her handle the staff if she doesn't want to.

But really, the bottom line here is that in the hospital setting, the ultimate acceptance or refusal of any procedure or intervention must come from mom and mom alone. Absent a medical POA.
post #48 of 69
Quote:
Originally Posted by Synchro246 View Post
Me too! I let my cert lapse, and maybe it's for the best. Not that I'm an active doula anyway, but I at the births that I did attend I was uber worried about towing the line and following the rules.

About the woman's voice issue. I think labor/birth isn't too much the time for worrying about stealing a woman's voice. If she obtained information and expressed opinions prior to labor that IS her voice. As long as the advocate acts as the woman herself would then there's no stealing going on--it's pure support. Her voice remains intact, it's just that birth sometimes necessitates that it be channeled through another.
I'm certified, and I can't say I've ever been worried about crossing the line, and I can say I've walked a fine line or two in my time, but not when it comes to speaking for women.

I really want to honor those of you who say you can't speak up in labor. However, my experiences don't lead me to the same conclusions. Not just my own births, but the countless births I've attended as a doula hasn't led to me see women as fragile things that can't be spoken to or can't speak for themselves in labor. Maybe it's the population I work with (doubt it as they're as varied as the women here) or maybe it's that most of the providers I work with are gentle, respectful and wait for appropriate moments to speak to a laboring woman when a decision must be made.

The whole other side of this "can't think, can't speak" thing that counfounds me is that I'm hired to help women cope, to utilize the tricks and comfort measures I've learned and developed over the years. Doing this work requires that I speak to mom. It requires that I gain her consent to touch her, tell her how I"m going to touch her, and why I think it might help. Sure, we use as few words as possible and there's no long lecture on what I'm doing, but a "I'm going to come around behind you and try a counterpressure point on your back, is that ok?" (Mom nods or says yes) I approach her and touch her and ask "How does that feel?" (she replies better or worse or asks for more pressure or less or asks me to stop) <insert here speaking is done between contractions not during contractions>

It's the same dance I see with a client and a provider. Enter the room, wait till a contraction is over, speak to the woman and wait for a response.

I really don't want to come across as invalidating the experiences of those who say they can't focus that way in labor. I just haven't seen or experienced a woman totally incapable of speaking for herself in labor. 90% of my clients give birth without pain medication, so it's not like I've only experienced numbed out moms who are disconnected from their bodies during labor because of epidurals.
post #49 of 69
Quote:
Originally Posted by April422 View Post

I really don't want to come across as invalidating the experiences of those who say they can't focus that way in labor. I just haven't seen or experienced a woman totally incapable of speaking for herself in labor. 90% of my clients give birth without pain medication, so it's not like I've only experienced numbed out moms who are disconnected from their bodies during labor because of epidurals.
I think it's Heisenberg's uncertainty principle at work. Being in a totally safe space that allowed me to labor as nature intended; allowed me to be totally out of it. When I was in a space where I needed to be a social being (hospital) I was. I participated actively in my care. I did still deal with contractions and I coped, but my ability to cope was diminished. It may have not seemed that way, but it was. I was on Pit for 14 hours (after 36+ hours of natural labor) before I gave up and asked for an epidural, but it really DID affect the process. I wouldn't have known that until after experiencing totally secluded labor at home.
post #50 of 69
Quote:
Originally Posted by Synchro246 View Post
I think it's Heisenberg's uncertainty principle at work. Being in a totally safe space that allowed me to labor as nature intended; allowed me to be totally out of it. When I was in a space where I needed to be a social being (hospital) I was. I participated actively in my care. I did still deal with contractions and I coped, but my ability to cope was diminished. It may have not seemed that way, but it was. I was on Pit for 14 hours (after 36+ hours of natural labor) before I gave up and asked for an epidural, but it really DID affect the process. I wouldn't have known that until after experiencing totally secluded labor at home.

I think I said previously that I've attended home and birth center births I'm not a hospital only doula. I still haven't experienced a situation where a mom couldn't speak for herself if she needed to.
post #51 of 69
Quote:
Originally Posted by April422 View Post
I think I said previously that I've attended home and birth center births I'm not a hospital only doula. I still haven't experienced a situation where a mom couldn't speak for herself if she needed to.
I don't think it has anything with being specifically at home, in a BC or, or in a hossy. I know I didn't go into this un-reachable state of mind with my first at all. I labored at home for 36 hours. I had my two best friends and my mom (to whom I am very bonded). Any time they would so much as speak, even across the house--what should be out of range of hearing--I told them to shut up.
I guess it was inaccurate for me to say that "being in a safe place" was why i could check out. I was in a safe place both times, so there must have been something else at play preventing me from traveling to laborland with my first.


Ok, I did a little brain experiment thinking about my out-of-it birth from the perspective of an outsider. I do think that they would probably agree with you. I could speak for myself. I did make decisions about whether or not to do a couple things.
It DID break me from the process. I would wake up, come out (to a degree) and participate. I was NOT in the same, sacred, labor-space for this interaction. I think that the ammt of interaction required from a naturally un-interventive HCP is probably less consequential to the process than is the type of interaction required by a more active HCP.
I know that I could not have done what I did if I were in a hospital advocating for myself. The experience would have been more intense. I can almost guarantee.
post #52 of 69
Quote:
Originally Posted by Synchro246 View Post

Ok, I did a little brain experiment thinking about my out-of-it birth from the perspective of an outsider. I do think that they would probably agree with you. I could speak for myself. I did make decisions about whether or not to do a couple things.
It DID break me from the process. I would wake up, come out (to a degree) and participate. I was NOT in the same, sacred, labor-space for this interaction. I think that the ammt of interaction required from a naturally un-interventive HCP is probably less consequential to the process than is the type of interaction required by a more active HCP.
I know that I could not have done what I did if I were in a hospital advocating for myself. The experience would have been more intense. I can almost guarantee.

I totally agree that women shouldn't be put into the position to come out of their labor land (as they define and experience it) the way that it happens in most hospitals with "things" coming at them from all directions. But I believe that it is best if that woman speaks for herself, or she has her partner or family member speak for her where appropriate. I just don't think it's the doula's role, nor should it be.

A big part of what I do as a doula is help clients evaluate and change, if necessary, providers to one who is most in alignment with their own birth philosophy. IMO this minimizes all the un-necesary interruptions that can distract a woman from her labor's rhythm.

I wish women were given the respect to birth freely, but until that happens, as a doula I can't be their voice. So far, so good.
post #53 of 69
Quote:
Originally Posted by April422 View Post
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 think that we do women a HUGE disservice by assuming that they're poor little helpless things in labor and can't make necessary decisions. Just imagine if the OB world decided such, what an uproar "that" would cause!
I had an exam that I screamed thru. Saying 'stop, no, get out....etc'. This was by a midwife no less. When she finally finished I broke down crying. She walked out of the room as if what just happened was completely normal. So yes, it happens. And I would bet alot more then you are assuming.

I agree that women should be given a voice. In fact, I beleive that their voice should be the only one that truely matters. Noone ever said laboring women are poor and helpless. But in a typical hospital setting, they are simply patients. Their voice is not heard.

Alot of women ask for epidurals during transition. It is not allways because they truely want one. But because they want to be heard. They want someone so understand how much pain they are in. Even women birthing at home ask for pain reliefe. I think should be something that doulas talk about with their clients before hand. I know alot of doulas do, and they set up a code word. If I would have had a coed word during my labor, I wouldn't have used it, even though I was screaming for and epi. I just wanted to be listened to. For someone to take me seriously.
post #54 of 69
Quote:
Originally Posted by April422 View Post
A big part of what I do as a doula is help clients evaluate and change, if necessary, providers to one who is most in alignment with their own birth philosophy. IMO this minimizes all the un-necesary interruptions that can distract a woman from her labor's rhythm.

I wish women were given the respect to birth freely, but until that happens, as a doula I can't be their voice. So far, so good.
But for many women this IS NOT an option! Simply finding a better provider isn't as easy as you make it sound for all women.

Quote:
Not just my own births, but the countless births I've attended as a doula hasn't led to me see women as fragile things that can't be spoken to or can't speak for themselves in labor.
Nobody said women were fragile things that can't be spoken to... what we're saying is that many women (albeit not ones you've seen), find that they cannot speak during labor, or during contractions. They are doing what they can to cope with their labors in a productive way, and having to answer questions and come out of their space to talk, is simply not possible. We're not talking about moms being too afraid or too nervous to say something, we're talking about a physical inability to speak.

Should I punish a woman by not standing up for her because she is coping on her own by going into her own space and can't come out to tell her doctor "no please don't ____"? She's doing the best she can, dealing in a deep state of meditation, concentration, etc, and sometimes that takes all that you have, you simply don't have enough left to use your words.


MamaB21- *hugs* I've heard too many of those stories. It's not fair.
post #55 of 69
Thread Starter 
Quote:
Originally Posted by April422 View Post
I really don't want to come across as invalidating the experiences of those who say they can't focus that way in labor. I just haven't seen or experienced a woman totally incapable of speaking for herself in labor. 90% of my clients give birth without pain medication, so it's not like I've only experienced numbed out moms who are disconnected from their bodies during labor because of epidurals.
The thing is, you CAN speak, but you can NOT advocate for yourself. There is a very distinct difference. If somebody breaks into your labor land and demands, "I'm going to give you an exam now", you can say "no, I don't want one." However, most women can't say, "don't you remember doc in the discussions we had prenatally that we agreed that I would only get vaginal exams when I asked for one. Perhaps you should read over my birth plan again to remind yourself of my wishes." Now, the first sentence doesn't sound too convincing to many providers because they quickly counter with, "it will be really quick" or "we just need to see how things are progressing" or some other phrase that is supposed to reassure the woman that it is okay to allow this procedure. The second phrase would likely stop the provider from what he is about to do, or at least give him pause while further communications happen to determine what his next move will be. The very reason women need an advocate is that providers know that they can not advocate for themselves and they take advantage of this vulnerability in order to accomplish their own agenda. They know very well that if there is any negative response to their intention to perform a procedure, it will not take much to convince a woman to go along with the procedure. Perhaps you have had clients that can say, "no, I don't want that" and amazingly every provider you have worked with just says, "okay then" and turns and walks out of the room. However, if you ever had a provider challenge your client after she already did speak up for herself, then you might see that she truly can not advocate for herself while in labor.
post #56 of 69
Quote:
Originally Posted by April422 View Post
hasn't led to me see women as fragile things that can't be spoken to or can't speak for themselves in labor.
If this is how you're interpreting that, you still aren't understanding the issue I have with women having to speak for themselves in labor. They have already expressed what they want. They should not have to deal with people trying to push things on them that they have already declined--vaginal exams, epidurals. They should not have to fight to get things they've already requested--changing positions, having silence or at least a minimum of talking.

This, to me, is not about decisions made during the birth, it is about protecting the woman from having to remake decisions that she has already made so that she can get on with the work of giving birth.

It's not about being 'fragile' it's about not having to deal with the irritation of oxytocin reducing, adrenalin increasing BS.

And I have changed to a provider who will respect my wishes in this 100%--ME.
post #57 of 69
Quote:
Originally Posted by sapphire_chan View Post
If this is how you're interpreting that, you still aren't understanding the issue I have with women having to speak for themselves in labor. They have already expressed what they want. They should not have to deal with people trying to push things on them that they have already declined--vaginal exams, epidurals. They should not have to fight to get things they've already requested--changing positions, having silence or at least a minimum of talking.

This, to me, is not about decisions made during the birth, it is about protecting the woman from having to remake decisions that she has already made so that she can get on with the work of giving birth.

It's not about being 'fragile' it's about not having to deal with the irritation of oxytocin reducing, adrenalin increasing BS.

And I have changed to a provider who will respect my wishes in this 100%--ME.
This is a good point.

I just wanted to add, that women are usually extreemly happy directly after their birth, reguardless of how the birth whent. They are overjoyed to have their new baby, and are far from being able to process the birth. So this is what the doula sees. Most doulas have one follow up with the mom, and then are told to cut off ties with her. In the few weeks after the birth, the mom may still have not processed the birth. Or, she may be upset with sertain aspects of it, and feels like she can't talk about it or bring it up with her doula. So the assumption that women are speaking up for themselves in labor, is just that, an assumption. I will give an example of something that is completely common.

Doc comes into the room and sais to mom, "Your labor is stalling out, we would like to break your water."

Mom, "no, I don't want you to."

Doc, "okay, I will allow you to labor for one more hour, if you haven't progressed when I get back, we will have to break your water."

Mom is left in fear, and anxiety, and pressure to progress, so of course mom doesn't progress.

Doc comes back and starts vaginal exam without asking in the middle of a contraction. He sais, "well, looks like you haven't progressed I'm going to go ahead and just break your water here for you."

Mom is upset, but doesn't 'stop' it because she was told it has to be done. Meanwhile, the doula and other onlookers see this as her choice, since the doc originally complied with her, and then it was 'necessary' to do otherwise later. The rest of the labor goes beautifully, and all of moms wishes are met. Mom doesn't focus on this one thing until months later when she realizes how upset she is that her wishes weren't respected. Meanwhile, doula has seen 2 or 3 other clients by then, completely believing that mom was happy and content with her labor.

Just because women in labor 'appear' to be able to talk and give answers, I would be willing to bet that at least some of the time, those answers are scripted, knee jerk reactions to being bullied into doing something they didn't want to do in the first place.
post #58 of 69
Quote:
Originally Posted by MammaB21 View Post
I will give an example of something that is completely common.

Doc comes into the room and sais to mom, "Your labor is stalling out, we would like to break your water."

Mom, "no, I don't want you to."

Doc, "okay, I will allow you to labor for one more hour, if you haven't progressed when I get back, we will have to break your water."

Mom is left in fear, and anxiety, and pressure to progress, so of course mom doesn't progress.

Doc comes back and starts vaginal exam without asking in the middle of a contraction. He sais, "well, looks like you haven't progressed I'm going to go ahead and just break your water here for you."
This is exactly the situation I was in, but I wasn't the mom who consented to it. Instead I found my voice and used it, refused again, tried to negotiate, and got totally out of labor land, had all sorts of stress hormones come into my body. And the result is that the midwife got frustrated and impatient with me, and pulled out the heavy handed tricks of "you need to be drugged and you don't have a choice about it." And then it was after more "advocating for myself" and using all of the brain power and negotiating skills I possessed, I was then told that all of my options had been taken away and I needed to leave the hospital right then, no more discussion allowed. It was those manipulative techniques, and all the stress I felt trying to fight for my bodily integrity and my wishes to be respected that is the root cause of the PTSD that I experienced.

So was I capable of speaking up for myself, yes. It interfered with not only my birth process, but also my mental health, the attachment to my child, my transition to motherhood and my marital relationship. All because my doula was required that I advocate myself and speak up using my voice when she had told me before hand that that was what she was going to do.

Based on my experience and my desire to become a doula, women may be capable of advocating for themselves in labor and reaffirming the decisions they made previously with thier providers, but they shouldn't have to do that. They should be respected enough to have their providers treat them in kind and supportive ways and since OBs and midwives are frequently not good at this, it falls to the doula to stand as the laboring woman's advocate. Especially since that's one of the reasons she was hired in the first place!
post #59 of 69
I am not sure if anyone actually read what I posted (in a link) before about choice.
I will just respond with a few statements to thinks I saw mentioned before.

I believe that a lot of the most important doula work is done prenatally.
Part of that is discussing the persons care provider and what they have discussed about the birth, the clients expectations and assumptions about birth, how they might deal with conflict or interventions in the birth room, and risk assesment: the decisions they have made and the risks of them.
This brings me to a point about choice, which I think is very relevant to this discussion.
I live in an area where midwives have to be employed by birthing centres which are funded by the government. They only meet about 10% of their demand. Therefore 90% of women are turned away by midwives.
There are illegal midwives. There are family doctors, and there are OBs.
Family doctors are hard to get, legal midwives are almost impossible to get. A good OB may be hard to find but they are out there. There are several hospitals and some are better than the others.
The choices arent vast or fantastic but there ARE choices. Women have choices, and they do assess the risk of each and assume the risks of their choice.
Therefore a woman may seem to have no choice but to give birth in a hospital because she didnt get in at a birthing centre. However she has the choice to have an illegal midwive, a UC, or a hospital birth, or to relocate to an area with better access to care for their birth(my mom stayed with relatives 3 hrs away from her home during her pregnancy with me to avoid a caesarean).
Now if a woman is not willing to assume the risks of a UC or an illegally assisted birth she is willing to assume the risks of a hospital birth.
This understanding is an important part of prenatal preparation for problems. If she is 100% unwilling to consent to unneccesary intervention at any time she needs to reconsider having a birth at a hospital. Is it fair? No. Is it ideal? No way! Is it reality? yes. We are functioning in a broken system and we need to empower ourselves to make decisions that we can live with. Clients also need to know that they absolutely have the right to refuse anything, but what they will have to go through to have that happen in a hospital and that if they go in with their fists up they are going to wind up with a battle.
what is each woman willing to sacrifice/deal with for the intervention free birth? Fighting with the doctor or nurse or midwife? or taking the risk of having an out of hospital birth/unassisted birth etc?

So I equip my clients to know what they might face, and let them know that they can refuse or accept anything and that I will support that but they have to be the one to accept or deny it, not me. I will reframe questions to make more sense to my clients (and I will not ask them in a contraction-and will tell a doc to wait for a contraction to pass), and if a doctor ignores the wishes then will I be more forward in a more 'advocational' manner. But the responses come from my clients. This has not posed any problems for me so far and as a result of the fact that I am obviously not answering for my clients but asking for their opinion docs respect me and have never accused me of witholding epidural or interfering. Is it interfering with the birth process? Yes. Birthing in a hospital is, in essence and some manner, interfereing with the birth process. This is reality. If we want no interference we should go home to our bathrooms turn of the lights and birth by ourselves.

Hope I expressed that well. I have no illusions of the birthing system and its pretty damn bad here but there is still choice. There is always choice, and weighing of postitives and negatives etc.
post #60 of 69
That was expressed well, thanks

Do you happen to have a handout or similiar about patients having the right to refuse? I'm in Canada also, and while I know that they can refuse, it's often hard to convey that idea to a client, especially when they've been socialized to believe that doctors know best, and if the doctor says so, then they have to go along.
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Mothering › Mothering Forums › Pregnancy and Birth › Birth and Beyond › repercussions of doula's redefining the word "advocate"