A doula mess...need opinions... - Mothering Forums

 
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#1 of 19 Old 07-16-2007, 03:01 PM - Thread Starter
 
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I'm going to *try* to keep this (relatively) brief, but no promises...

I'm in the process of certifying, and accepted a few free clients. I since learned why this might be a bad idea, but it's already done. Don't need advice on that.
I met a potential client several months ago. Didn't have a great "feeling" about her--didn't feel like we "clicked." But (another bad idea on my part), I accepted her anyway. Figured I was in no position to be picky. Bad idea. She was very negative from the beginning, and our feelings on birth didn't really mesh. She told me at our first meeting that she wanted an epidural and didn't want a doula to try to "talk her out of it." I asked her what she envisioned my role to be at her birth, and she said, "Let me tell you what my husband did WRONG at our first birth: he couldn't get the ice chips in my mouth...and when I needed to throw up, he gave me something the size of a thimble to throw up in." I know, red flags. Warning signs. I didn't heed them.

Prenatals were a waste of time. She would ask me to meet her at a park where she was having a playgroup (despite me questioning if she really thought she could juggle our meeting with a playdate). We couldn't get through anything meaningful, because her 2-year-old was constantly throwing sand at someone, or running away, or whatever, plus her girlfriends were all there chiming in on everything I tried to bring up. I brought my 14-year-old nephew along to watch my own 2-year-old, because I knew I would not be able to have a decent conversation with him there, otherwise. I made a point of telling her I would bring him so that I could focus on our conversation. We never made a birth plan. She didn't want any information regarding epidurals or narcotics. I offered to research things if she needed information. She didn't. She continued to invite me to her playgroup, which I politely declined for this-reason-or-that. When I asked her birth-related questions, she might give me a short answer and then get distracted and tell me some impertinent story.

Long story short(er): she was very critical, got upset when I went on vacation 4 weeks before her EDD (she was sure she'd have the baby while I was gone, but didn't). She sends me occasional e-mails saying "are you in or are you out?" or "Are you still interested, because I'm having this baby this week." Then she tells me she's being induced in a week if she hasn't gone into labor (this is still TEN DAYS before her EDD). I asked why. She says because the baby is "big." She kept giving me these "outs," I thought: "Are we still on?" "Are you still interested?" And I finally decided that a) maybe she was *trying* to get me to back out, and b)maybe I shouldn't be attending her birth. I don't take my attendance at another woman's birth lightly, and if I feel so unsure of my role at a birth like hers (NOT, NOT, NOT just because she wants an epidural, but because we have very different views on birth, and she wasn't willing to talk to me enough to give me a clear picture of hers). So I told her that I had concerns about attending her birth. She freaked out, told me this was a "slap in the face" and that my decision to become a doula was "a poor one." I asked her to meet me to talk about it; she wouldn't. So I thanked her for giving me her perspective on everything, and said I'd like to do the same for her. I explained how I had perceived things, and said that perhaps I had misunderstood her. I was absolutely not at all accusatory, and was clear in telling her that I was not trying to correct her or invalidate her point of view. She is now telling me she's sending all of our e-mail exchanges to ALACE, and telling everyone she knows about her horrible experience with me, et cetera.

Honestly: am I missing something here? I feel like the only BIG mistake I made here was accepting her as a client--and a free one at that. I'm so sorry it went this way, and I regret that she's so upset with me, but I don't know what else I could have done.

If a client--whom you feel is not taking responsibility for her own birth and who declines information from you, sends you rude e-mails, and whom you generally know you cannot please AND who is setting herself up for a potentially rough birth experience by being induced early without medical indication--asks you if you're still "interested" three weeks before her EDD...is it okay to raise questions like this that may lead to you not working with her, even this close to her due date? Or should I have said, "Of course I'm still interested, and attended her induction and watched TV while she "labored" with her epidural, and just suck it all up because I already made the mistake of accepting her? What would YOU do? I guess I also felt like I was protecting myself, because I swear this is the kind of thing where she doesn't want to hear why the induction might be a bad idea, but she probably DOES want to sue everyone in a 5 mile radius if things don't go as smoothly as she'd like, even if she makes choices to lead herself there. Anyway...not sure if I'm asking a question or just venting. I really would like to hear from someone if you have a suggestion for how I should have handled this differently (like I said, beyond the point of having taken her on at all).

Yeah, sorry...I didn't keep it brief at all.
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#2 of 19 Old 07-16-2007, 03:30 PM
 
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Well, if you have any concerns as far as ALACE, give them a call and speak to Susan Cassel. She's wonderful and will help you process this situation so that you can avoid something like this in the future. And help other doulas avoid this type of situation! Or know how to get out.

Now, I think it's absolutely fine to skip this woman's birth. She doesn't seem to want you... she just seems to want a slave, someone to complain to, etc etc. She's not interested in her birth or her body. She sounds like a bully and a User Agree Violation, and that you feel she would want to sue is a HUGE red flag! Someone who is sue-happy, well, she's just blaming everyone else for her lack of decisions.

I had a client somewhat like this, and she didn't call me when she went into labor; she ended up with a c-s and called me later. I offered to come to the hospital and she said she'd rather I visit when she got home; I called her several times and she never returned my calls.

I think you've learned your lesson by now. I wouldn't worry about this woman fwd'ing your emails or telling everyone about you -- she doesn't sound very well-balanced. She might not even call you when she goes for an induction.
And ends up with a c-s.

I'm sorry you've had to deal with this.

ETA: If she starts bullying YOU, stop answering her calls. You don't deserve that.

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#3 of 19 Old 07-17-2007, 12:05 PM
 
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Well if she had been my client, I would have done the same that you did - the information-attempts, etc. I think wondering if she was trying to un-hire you were also very attentive and not un-founded. The fact that she freaked out sounds more like her personality issues than something you did wrong (in my opinion).

I do however feel that as a doula, if my client WANTS an epidural, it's my job to get her one no matter how I personally feel about it. Not everyone would probably agree on that, but my job is not to figure out a way for them to have the most natural birth if they are informed and truly don't want that. The informed part is certainly a huge key though.

If ALACE brings anything up, you can more fully explain the situation, but I don't think it will cause you any trouble. You handled things maturely, I would not worry.

I have had experiences like yours - it taught me to ask, always and often, in our interview WHY they want a doula. One couple told me pretty much they wanted me to babysit their children. I told them at that point that I did not feel comfortable doing that for them but gave them numbers of other people they could try.

I have accepted situations I have not been comfortable even after getting more than 20 births... I just want to help and get myself in sticky situations sometimes. Being honest feels like I'm being mean sometimes... it's a co-interview you know? Just as they can say "No thanks", so can you. But it's hard to learn how to say that.

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#4 of 19 Old 07-17-2007, 01:13 PM - Thread Starter
 
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Thanks for your input. I told her that I was happy to discuss this at any time with her, but that I wasn't going to trade insults with her, nor was I going to continue to try to justify myself to her. She wrote me once since--more "I'm going to tell every expectant mother and friend of mine how horrible you are" kind of stuff, and I didn't respond. I really will be happy to discuss this with her if she decides she ready to talk about it calmly, but until then, I'm finished with it.

Just so I'm clear--I NEVER tried to talk her out of having an epidural, and I NEVER would have tried to prevent her from having one if I had attended her birth. My problem with the situation was THAT she wanted an epidural, but her unwillingness to be informed (about *anything,* not just epidurals), and her general attitude towards people (such as her poor husband who didn't choose a large enough bin for her to throw up in). When you couple a lack of information with an unwillingness to take responsibility for one's own choices, and throw a severely critical disposition in the mix, I felt like I was being set up for a disaster.

Anyway, I appreciate the support--and I'd love to hear from someone who thought I was way out-of-line, too. This woman kept telling me, "I told my friend who's a doula about this, and she 'frowned' on your behavior." Or, "My friend who's a doula said that you are entirely in the wrong and that I should report all of this to ALACE." I really wish I could talk to this "friend who's a doula," not to debate her, but because I would really like to hear her opinion--if she really thinks I'm way off-base here, and isn't just trying to be a supportive friend. Oh, and if she really exists. Also, this client has misquoted me *to* me, so I can only imagine how she might be representing me to someone who *doesn't* know what's really gone on. But, any way...if you think I'm totally wrong here, I'd love to hear from you, too.
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#5 of 19 Old 07-17-2007, 03:05 PM
 
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Don't be afraid of her "reporting" you to ALACE; I would encourage it in this instance. Allow ALACE to step in and help you extricate yourself from this woman's focus.

FWIW, not everyone hires a doula to "save" them from themselves or the hospital staff. Sometimes they want an epidural and they want you to hold the emesis basin or the ice chip cup. Forget how boring this will be for you over the course of a day and remember how relieved her husband will be not to have to deal with the complaints of his performance at the birth of his baby.

Finally, did you have a contract with her even though she was free? If you didn't make sure the end of the spoken contract is documented and send her a copy of it and invite her to speak to ALACE. As a midwife in the two states I have licenses I have to inform my clients where they can write/call if they have a complaint about me, it should be no different for a doula who is using a doula organization for her training. It may help you with this woman in the end.
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#6 of 19 Old 07-17-2007, 05:10 PM
 
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Couple points:

Hard lessons we all learn -

trust your gut and don't take the client you get hinky vibes from. It almost never works out!

never do free births - I did one for $20 once (my cost of babysitting when dh had to go to work just before I was done with birth) but still charged something. No one values that which is too easily gotten.

Contract, contract, contract -don't accept a client who hasn't signed a contract that you go over WITH them that states your on call time. I don't do more than two weeks before and two weeks after a due date (those are my guaranteed call weeks, if you go before or after that and I can make it great). I have a twin couple now for whom I modified to be on call for a month before and not at all after due date (docs will induce if she doesn't go by then) because she is likely to go in that range.

Don't worry about who she will tell etc. Her doula friend is her friend, she isn't likely to not affirm friends feelings and isn't of course getting the entire story straight.

From your description I think you handled it well.

Personally I don't take clients who want an epidural. Now plenty of mothers might eventually need or want to go that route and I don't judge that and have even agreed outright it was a good choice at the time, but I don't enjoy working with those who have
no excitement about the journey and want to avoid all of the challenge of birth. Its just a personal thing. If a mama wants that I know 6 doulas who are happy to take her money and feed her ice chips or watch TV with her. I like the process of labor and the challenge of working with mothers who want to challenge themselves. Just be clear about what you want and refer out those you don't feel you would be a good doula for.
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#7 of 19 Old 07-17-2007, 07:04 PM
 
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Originally Posted by redpajama View Post
This woman kept telling me, "I told my friend who's a doula about this, and she 'frowned' on your behavior." Or, "My friend who's a doula said that you are entirely in the wrong and that I should report all of this to ALACE."
What behavior of yours, real or imagined, is she referring to? I do think I get the drift but maybe you could be more precise.

I'm sorry this happened to you.
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#8 of 19 Old 07-17-2007, 07:26 PM
 
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She sounds like a drama queen and a control freak and nothing would make her happy.

Anyone who believes her about you isn't worth having as a client.

I have doula training, though I've never done a birth, but I *am* a business person (self-employed writer/researcher) and I have cut off numerous clients for similar reasons, and some go on about how they're going to "ruin" my reputation by telling everyone how "unprofessional" I am.

I have ALWAYS met someone, later, that these people have indeed spoken to, and I am always told that the cut-off client isn't worth worrying about and isn't respected in the field.

You did the right thing. In fact, it's good that you had this experience *early* in your career so that you can move forward with more wisdom.
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#9 of 19 Old 07-17-2007, 10:13 PM
 
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I think you can chalk this learning experience up as further proof that no good deed goes unpunished

Seriously, I think your only mistake was investing so much time and effort in this client. Bending over backwards to "help" someone who isn't willing to help themselves is never helpful in the long run.

I think the advice to not worry about what she says about you is right on. You don't want to work with her friends anyway.

I wonder why her doula friend can't attend?

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#10 of 19 Old 07-17-2007, 10:44 PM - Thread Starter
 
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Originally Posted by pigpokey View Post
What behavior of yours, real or imagined, is she referring to? I do think I get the drift but maybe you could be more precise.

I'm sorry this happened to you.
What *really happened* that I suppose someone could take issue with...I raised my concerns with her (after I felt prompted by her repeatedly asking "Are you still interested?" when I'd given no indication to the contrary) sort of late-in-the-game (3 weeks before her EDD).

Based on what she wrote in an e-mail to me, I think she would tell her friend that I "questioned her decision to have an epidural." I can't imagine HOW, because I was careful not to even bring the epidural issue up until things had already gone bad and I was trying to help her sort through what had happened. And when I *did* bring it up later, I reiterated ad nauseum that the epidural itself absolutely was not the issue. But she later said in an e-mail, "Doulas are supposed to be supportive, not question a woman's decisions." So I would say she obviously *felt* that I was making an issue of that.

Other than that...I don't know. She did rell me I was "rude and unprofessional," but I really, sincerely think she was just angry. I was so careful about everything I said to her in the end (because, like I said, she struck me as the type who would be eager to sue/slander. I never sent an e-mail in the end without having my husband read it first, specifically looking for things that might be misconstrued as judgemental or offensive. Instead of accusing her of anything, I did a lot of, "Perhaps I misunderstood you, but I had the impression that..." I saved absolutely every e-mail we exchanged and have read back through them...I really don't think I came across as rude. Or unprofessional.

But...that's all I can think of that she would object to.
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#11 of 19 Old 07-17-2007, 11:53 PM
 
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I think the only thing I'd further suggest is not to rely on email for primary communication with clients. I don't mind it for appointment confirmations or changes, or links to websites, but when it comes to personal communication being on the phone or in person is usually best so that emotion or inflection can't be injected into the written word where it wasn't intended.
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#12 of 19 Old 07-18-2007, 12:13 AM
 
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Yup. If you saved the emails, I'd call the ALACE office and talk to them about what's going on, just to see what they say about the whole thing. I think they'll be more than happy to take a look at what you wrote and give constructive help!

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#13 of 19 Old 07-18-2007, 02:20 PM
 
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Originally Posted by redpajama View Post
But, any way...if you think I'm totally wrong here, I'd love to hear from you, too.
I don't think you're totally wrong here. I do, however, have a different perspective than has already been discussed on this thread, and I think it would be beneficial to this particular instance and other instances if I were to share my thoughts.



Yes....wow. What a mess.

I am not quite able to discern if this woman is still your client.

But if she is your client, PITA or not, as her doula, your role is to support her.

It is too bad she has a negative attitude and seems overly critical. But as an extremely removed observer of this situation, I can see some indications that there can be a positive outcome for this "mess."

Quote:
Originally Posted by redpajama View Post
She told me at our first meeting that she wanted an epidural and didn't want a doula to try to "talk her out of it." I asked her what she envisioned my role to be at her birth, and she said, "Let me tell you what my husband did WRONG at our first birth: he couldn't get the ice chips in my mouth...and when I needed to throw up, he gave me something the size of a thimble to throw up in." I know, red flags. Warning signs. I didn't heed them.
I read this and see a pregnant woman who is scared of pain, wants an epidural, and does want a birth support person.

I read this and see a woman who did not feel supported by her own husband last time, who couldn't even offer her the most basic of comforts. What a letdown. What a dissapointing birth--if she was unable to even throw up in comfort.

This is her second baby....she's been around the block, and she is willing to risk choosing a doula with an agenda (whether you have one or not--SHE thinks you do, because the first words out of her mouth are "don't talk me out of the epidural" which suggests she assumed you would talk her out of the epidural) to help her get the birth she desparately wants.

She has the common misfortune of having hired a care provider that will induce her for a "big" baby--we all know what a crappy boat that is to be in. She seems quite desparate for someone--you, the doula--to be there, to help her. Her husband didn't help her. Her care provider does not thouroughly expain risks or benefits of induction (and maybe she doesn't want to hear it anyway.) But could she have a free doula who will show up and give her ice chips?

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Originally Posted by redpajama View Post
Prenatals were a waste of time. She would ask me to meet her at a park where she was having a playgroup (despite me questioning if she really thought she could juggle our meeting with a playdate).
Were they a waste of time for her? Were they a chance for her to feel like, hey, my doula will show up and be with me at my park? Maybe that is all she needed.

Quote:
Originally Posted by redpajama View Post
We couldn't get through anything meaningful, because her 2-year-old was constantly throwing sand at someone, or running away, or whatever, plus her girlfriends were all there chiming in on everything I tried to bring up.
That must have been frustrating for you, because by your personal standards to be a good doula to this woman, it meant you needed to get through that which was meaningful for you, and for you that it meant the meeting needed to be without her girlfriends.

But is that what the woman, your client, wanted? Perhaps she felt that her meaningful communications (i.e., her desire for an epidural and wish to not be talked out of it, and her desire for a doula to fulfill the support roles her husband failed to do last time) were effectively communicated, sand-throwing 2-year olds or girlfriends-chiming-in notwithstanding.

I chose doula certification through DONA, because I agree with DONA's philosophy, including the points made in their Birth Doula Position Paper.

http://www.dona.org/publications/pos...aper_birth.php
Quote:
The doula’s goal is to help the woman have a safe and satisfying childbirth as the woman defines it.
From what you have shared here, your woman has clearly defined her concept of a safe and satisfying birth. It is not the same as yours.

Quote:
Originally Posted by redpajama View Post
She didn't want any information regarding epidurals or narcotics. I offered to research things if she needed information. She didn't. She continued to invite me to her playgroup, which I politely declined for this-reason-or-that.
She has a right to refuse information. Her desire for epidural medication is within the scope of 'standard of care' for maternity services and we cannot call Child Protective Services on her. She contiued to invite you to the playgroup--WHY why why? Because she WANTED to see YOU.

Because you are her doula.

She may be a giant jerk and lack tact and seem reckless with her desire for her epidural....but she is a loyal tactless jerk. She senses a connection with you, even if you do not agree with her choices, and even if you regret establishing the connection with her.

Quote:
Originally Posted by redpajama View Post
Long story short(er): she was very critical, got upset when I went on vacation 4 weeks before her EDD (she was sure she'd have the baby while I was gone, but didn't). She sends me occasional e-mails saying "are you in or are you out?" or "Are you still interested, because I'm having this baby this week." Then she tells me she's being induced in a week if she hasn't gone into labor (this is still TEN DAYS before her EDD). I asked why. She says because the baby is "big." She kept giving me these "outs," I thought: "Are we still on?" "Are you still interested?"
I do not interpret her constant questioning as giving you "outs"....it seems like she wants to know: ARE YOU GOING TO BE THERE FOR HER? You chose to not attend her playgroup. She was upset when you were on vacation (instead of thrilled you'd be out of her life) and she doesn't even know if you're interested in being with her.


Quote:
Originally Posted by redpajama View Post
...I feel so unsure of my role at a birth like hers (NOT, NOT, NOT just because she wants an epidural, but because we have very different views on birth, and she wasn't willing to talk to me enough to give me a clear picture of hers). So I told her that I had concerns about attending her birth.
This is important information. As a brand-new doula, you have every right to be unsure of yourself, esp. when contemplating attending a birth that will challenge your core value system.

I understand this. Furthermore, it is personal to me. There is a reason that 3 out of my 4 certification births were homebirths. And now, finally, after having attended 6 births total, none of them medicated, I can begin to contemplate assiting a woman in a hospital who chooses epidural anesthesia.

That is my baggage. And my baggage seems a bit similar to your baggage. But it's not your client's baggage. Really, all you have to do is hold her hand, support her choices, and fulfil your role as DOULA:

mother to the mother
slave to the mother
support for the mother

Quote:
Originally Posted by redpajama View Post
Honestly: am I missing something here? I feel like the only BIG mistake I made here was accepting her as a client--and a free one at that. I'm so sorry it went this way, and I regret that she's so upset with me, but I don't know what else I could have done.
When you know better, you do better. It's okay to make mistakes--it doesn't mean they're always easy to live with.

Quote:
Originally Posted by redpajama View Post
If a client--whom you feel is not taking responsibility for her own birth and who declines information from you, sends you rude e-mails, and whom you generally know you cannot please AND who is setting herself up for a potentially rough birth experience by being induced early without medical indication--asks you if you're still "interested" three weeks before her EDD...is it okay to raise questions like this that may lead to you not working with her, even this close to her due date?
Questioning and introspection is always good for a person to do. But should you dump her? In contrast to your opinion, I see that she is taking responsibility for her birth, because she has chosen a method of pain relief. She has also reflected on her previous birth experience, and has indicated that her huband's actions were not satisfactory, and that you can help her achieve a more satisfying birth experience by fulfiling that role.


Quote:
Originally Posted by redpajama View Post
Or should I have said, "Of course I'm still interested, and attended her induction and watched TV while she "labored" with her epidural, and just suck it all up because I already made the mistake of accepting her?
Yes. I think you should do that. You did make the "mistake" of accepting her. But I cannot help but wonder: what will her birth teach YOU? Her choices are sooooooo out of your comfort zone, you cannot stand the idea of watching her "labor"....and that is how over 80% of women in the United States choose to "labor".

Also, you may be attending a cesarean birth, when you serve this woman, because an induction for a "big" baby before the start of natural active labor increases the risks of cesarean. 30.2% of women in 2005 experienced cesarean surgery, and for sure, some of those women had doulas. In my lifetime as a doula, I know I will be involved in a cesarean birth. What could this woman's birth teach you?

Certification births are difficult. You are finding your way as a doula. What kind of doula will you be? Natural-birth only? will you have amazing rebozzo skills someday? will you be like my DONA doula trainer, who can and will doula ANY birth scenario ANY time?

When it all boils down, you can't change this woman, protect this woman, birth for this woman, or anything....sounds like your job is to tolerate this woman, and do your best to be a doula for her: hold her hands when she has to sit hunched over for her epidural placement. Comfort her, if she experiences violent shaking from the meds. Reassure her, when her labor stalls from the epidural and she now needs Pit. Give her ice chips, if she is not allowed to eat with her epidural. Let her know that you care--women need that, when their MW or OB is out of the room for most of the labor, when the RN has other patients to attend to.

Furthermore, once the baby is born, your doula role continues as you help the mother initiate breastfeeding, and you help the mother review this monumental birth experience.

Sitting in the room while she watches TV is easy to do--and she will always remember her doula was there (or wasn't there) and was supportive or her choices (or was so disgusted with her choices that she wouldn't even attend.)

Best of luck as you find your way as a doula. I hope you are able to find a choice that resonates with your values--and I hope to hear the outcome of this "doula mess"!
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#14 of 19 Old 07-18-2007, 03:11 PM - Thread Starter
 
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tinyshoes--I am so appreciative of your willingness to respond to my post so thoroughly; it really is very nice of you to take the time to do that. And I appreciate, like I said, hearing a different perspective on all of this.

To clarify: This woman is no longer a client. Ultimately, that was her decision. When I raised questions about my role at her birth--basically saying I didn't feel that we had had adequate conversations regarding what *she* wanted for her birth in general, or from me in particular--she responded by saying that it was a "slap in the face" and that she no longer felt comfortable asking me to be at the birth. I *don't* think I was perceived as a "doula with an agenda,"--she told me she didn't want to be talked out of her epidural in the context of why she didn't hire another doula (that, and that her fee was "outrageous"). Because she made this so clear at our first meeting, I never specifically offered her information regarding the epidural--I offered her some printed information more generally, and also asked if there was anything I could help her research/look into.
When she responded to me (by e-mail) saying that she didn't feel comfortable asking me to be there any more, she sort of went through our whole working relationship and recapped everything from her perspective. I responded by saying, essentially, "Hey, look--perhaps I misunderstood you, and perhaps I've been misunderstood. Let me do the same for you (recapping the course of events from *my* perspective) so you can see that we genuinely miscommunicated. Then, if you'd like, I will clear some time in my schedule right away for us to get together and talk, and I am perfectly willing and able to put this behind us so I can be as helpful to you as possible." Then I went through, like I said, and sort of said, "Here's how I misunderstood what you said here, now I can see that perhaps you meant it this way," et cetera. That's when she called me unprofessional and rude, and really went off about how I shouldn't be a doula, and I shouldn't question her choices, and whatever.
I totally see where you're coming from, and I appreciate your perspective. I guess I just feel like this really fell apart when I just raised concerns about our working relationship (in other words, not feeling like I'd been given a clear picture, from her, of what she expected during her birth). I didn't anticipate that at all. When she responded to my next e-mail with so much anger and whatever, I sort of felt like it was no longer salvagable.
I really don't feel like I "dumped" her--but I feel like I raised the questions and concerns that led to her dumping me. As far as whether or not she was offering me "outs" by asking me again and again whether or not I was "in" or "interested" or whatever...I believe now that, obviously, she was not--or she wouldn't have been so upset when I started to hedge a little bit. But this kind of approach to me also typifies my impression of her--that she can't be pleased. I never gave her any reason to doubt that I would make every reasonable effort to be at her birth. I didn't put conditions on my attendance, other than, I suppose, taking a vacation 4 weeks before her EDD. She knew from the beginning that I would be "on call" beginning two weeks before her EDD, but I guess she expected me to change my plans once I heard that she was "going to go early." But I never said, "I'll *try* to be there" or anything like that. I was always clearly commited, I think. So the repeated questioning almost felt critical or suggestive to me. I took it as suggestive--"Are you SURE you want to come to my birth? Because you could always NOT (and save me the confrontation of telling you not to come)"--but if it wasn't a "hint," then it still feels very critical. Like she didn't trust me the first (several) time(s) I told her I would attend her birth. Like she didn't think enough of me to trust that I would notify her if something big changed and I planned not to be there. That's insulting. But more than insulting, I think it's foreshadowing. I really had a bad feeling that if there was any negative outcome here--and I'm not even referencing a "big" negative outcome...I'm talking about an unwanted perenial tear or her epidural not working or something...I sincerely wouldn't be surprised if she named me in a lawsuit. I'm not attending her birth--probably won't know when the birth occurs or anything else (although I am actually attending another birth at the same hospital tonight or tomorrow, and her induction was scheduled for Friday so, with my luck, I'll probably run into her), but I seriously have it in the back of my head that if something goes wrong, she'll try to link it to the stress I caused her or something and still blame me. Hard to qualify, and I hate to say she's "that kind of person," but I just have a pretty strong feeling that she's...well..."that kind of person."
Anyway, I really do appreciate your response, and I can see entirely where you're coming from. I'm certainly learning a lot through this experience. I guess I'm still sort of looking back on it unsure at which point I really went wrong--not that I *didn't* go wrong, I'm just not sure where this began to unravel.
Thanks, again.
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#15 of 19 Old 07-18-2007, 09:06 PM
 
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Maybe it is just me, but I have a slightly differing opinion than several of the people that have already posted. First of all I think that unless you let this woman know certain things she has no way of knowing that isn't how doulas do business. First of all you agreed to meet her in the park for playdates where you would bring your child, and to me it sounds like you did this a few times. Perhaps this woman just doesn't understand your role (or hers) in this situation. If you bring your child to the park and agree to meet her there while a playdate with a bunch of others is going on it is almost expected that they would all be involved in the discussions that you are having. I had a situation similar to this once when I was first starting. I was working with a teen mother who invited me to her house for a prenatal. When I got there a party was going on and she expected me to hold the prenatal during the party (drinking, smoking - real teenage party). At first I attempted to do so because I was new and wanted to make it as convenient for her as I could, but I quickly realized this wasn't going to work and that I had to insist on professionalism. If one doesn't insist on a client / professional relationship the mother may not know this is what is expected.

Like I said before too when one brings her child along - even if you bring someone to watch your child that changes the relationship as well.

It sounds to me like she didn't know what to expect of a doula and she wanted a friendly relationship of the woman who was going to be attending a very personal event in her life. This is pretty evident by the fact that she kept inviting you back.

I think before telling her that I couldn't be her doula I would have called her and said that we needed to meet alone (i.e. no kids, no friends, etc). Let her know at that meeting that perhaps you gave her the wrong impression of how doula prenatals are supposed to go. She was treating them like one would sit around and talk with her friends - like she probably does with those other woman in the playdates.

Then once you met I would have explained how the prenatals were going to go. I actually do this with EVERY single one of my clients. When I interview with them I explain what we will be going over during each prenatal, and often times when they schedule the prenatal I will let them know "okay, so at this prenatal we will be going over.... and talking about ....." so that they have a clear idea of what is going on. If my clients have children I will suggest that we find something to occupy them with, and if I know this is hard for the parents I have been known to bring a "project" for the child to do while we are talking.

The next thing that is important is that if a client wants an epidural it isn't my place to judge her decision, but instead to give her infomation (if she needs it) and to help her achieve the birth she wants. Not every client is going to want that natural birth. In my second prenatal I go over comfort options with them and I let them know that we go over this because sometimes situations arise that does not make getting that epidural immediately possible (i.e. anesthesiologist going to an emergency cesarean, etc). I also encourage them to practice these comfort techniques with me there so that we can have experience with what our roles will be. This gives the partner and the mother both the chance to talk about "hey I liked this" or "hey I would rather have my partner do that then you" , etc.

As far as her asking you whether you are out or not over and over again - perhaps she has issues with abandonment - this can be very real and very scary. Instead of feeling like she was trying to ditch you it would have been your place to ask her why she was concerned you might not be in. Perhaps her husband was a jerk to her and she is afraid that this birth will go the same way. Perhaps she has abandonment issues with her childhood - again the place of the doula to talk with her about this (in person and not through e-mails).

Also if issues arise I always suggest meeting with the client and talking face to face because with e-mails you cannot see expressions or hear inflection which can really impact a conversation.

I think it truly is the role of the doula to communicate well with her clients and if she has questions or concerns to bring them up and openly discuss them. After all these people are inviting you to a very personal and intimate event in their lives. For example, I had a client (very recently) who really struggled to hold a conversation with me on the phone, but when I would visit her house she would talk for hours and hours. At one point I couldn't figure it out and thought it was odd that she avoided my calls and would send an e-mail saying she got my message. I thought perhaps she didn't want me as her doula, so I sent her an e-mail back that asked if we could meet. When we did I discussed this with her openly and honestly and just found out that she doesn't have very good phone skills and the phone makes her nervous so together we strategized on how to fix that - we ended up e-mailing a lot and when needed would meet in person to help her avoid the phone situation that made her so nervous.

As a doula it is my place to make sure my clients know that they will get 100% honesty from me, and I let them know I expect the same from them. I also make sure that I set the ground rules for how I run my business and the meetings - meaning they will be held professionally - not during parties, not at the park and certainly not with my own children present. I also let them know what I go over standard with each client and above and beyond that I also let them know that I will help them with anything else that they have questions about, but I do set the basic rules. I let them know that I go over xyz so that I know all clients get the same information and then what they do with that information is up to them.

Sounds to me like you have a mother who doesn't know what to expect from her doula and as the doula you didn't set it up in a manner in which it is a professional relationship, but instead set it up as a friendly relationship.

Take this as a learning experience and now re-evaluate how you do things.
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#16 of 19 Old 07-19-2007, 11:07 AM - Thread Starter
 
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tlcdoula--I appreciate your perspective and your willingness to share it. I want to clarify a few things, but it's not at all to say that these things would (or should) change your opinion, and I think you raise some really good points with regard to things I could have done better to have prevented this situation from going bad.

First of all, I don't typically bring my son to interviews or prenatals with me; not at all. I do typically bring my daughter--or have typically brought her; she's getting a little older and more active and less content to just nurse/sleep in my arms during a meeting, so she probably won't continue to attend a lot of these meetings with me. When I arranged the prenatal appointment with this client, I told her that I had childcare readily available but would bring my nursing baby, if that was okay with her. She said, oh could you just meet me at the park; I'm going to be there for a playgroup anyway and you can just bring your son. I asked, "Do you really think you'll be able to juggle the playgroup with our meeting?" She did. So I told her ahead of time that I would be bringing someone along to keep an eye on my son for me, so that I could stay focused on our conversation. So I realize that it isn't terribly professional to bring my children along--I personally don't think my daughter is a problem (or at least was at the time), although I realize some people would disagree with even bringing her.

I guess your story about your experience with the teen mother is sort of what I would have *liked* to have seen happen. You said you "insisted on professionalism." When I tried to suggest meeting without the kids so that I could feel sure that we had had conversations I felt we should have--and I'll say again, I'm NOT talking about an epidural here--is when she became upset with me. It wasn't as if I weighed all of these different variables by myself, made a decision, and contacted her to tell her that I wouldn't be her doula anymore. I contacted her asking to get together without kids so that we could really talk about some things, and that's when she told *me* that she no longer felt comfortable asking me to attend her birth.
I think that I could have precluded a lot of this misunderstanding, perhaps, by discussing more of this in person or over the phone, as you suggested, rather than relying so heavily on e-mail for communication. On the other hand, though, I'm sort of glad for my own sake that I have a record of so much of the ongoing exchange between us. She's misrepresented me when addressing me in an e-mail--even though she and I both have a copy of what I actually said. I can only imagine that this would have been a much greater problem if there wasn't a record of it. She also denies having said things in person (whether she forgets, or...?) that I absolutely know beyond doubt that she said. So it's sort of tricky. The situation probably would have been less likely to have gone bad if I had conducted less of our communication through e-mail, but if it *had* still gone bad, I'd probably be in a worse place. I feel certain that if she felt she could further ruin my career (I don't think I'd be exaggerating to say "life") right now, she would. She's very angry, and she doesn't strike me as the kind of person who would let things simmer a little before she took action. I really think the fact that she and I both have copies of all of the e-mails that have been exchanged is really limiting her in just how far she can take this.
I also think I could have been more organized from the beginning, but that's part of the reason I've taken on these first births for free--because I'm learning through the process, too. When you said that you outline at your interview what you'll go over at each prenatal, I think that's a great idea and I will try to do the same with future clients. I honestly just didn't have a good feel yet for what we *would* be discussing at each prenatal (at the time of the interview, that is). But I can see how that may have prevented a lot of this misunderstanding as well.

As far as the epidural, I feel compelled to say one more time, the epidural
absolutely is not the issue here. It's so peripheral that I regret having mentioned it--here or to her. My issues ith this client were that I felt like she wasn't taking responsibility for her birth (not informing herself about things, saying a lot of "my doctor won't *let* me..." kinds of things, and not taking responsibility for her actions in general--with and without regard to her birth), and I felt like she didn't have respect for my time or my work. I may have been entirely wrong on both accounts, but those were the issues I wanted to resolve when I suggested that she and I get together and talk (and I hope it goes without saying that I didn't say, "Could we get together sometime to talk about your irresponsibility and lack of respect?"). I basically said that I was afraid there had been misguided and inadequate communication between us and that, as a result, I was feeling a little unsure of my role at her upcoming birth, and could we try to plan a time in the near future to get together and talk. In a subsequent message, I (mistakingly) mentioned the epidural--not the fact that she might have one, but her "give me the epidural in the parking lot" attitude, and how that left me uneasy about where I fit in with what she envisioned for her birth. But as soon as I even said the word "epidural"--even though I *thought* I uttered it carefully and with sufficient qualifiers, the conversation shifted to the epidural and why it wasn't my place to question her desire to have one. And I couldn't agree more. It is NOT my place to question her choice to have an epidural. But I think it *is* my place to question my usefulness at a given birth and not to attend a birth simply to earn another notch on my belt. And that's what I was trying to do.

Perhaps you summarized it well:

"Sounds to me like you have a mother who doesn't know what to expect from her doula and as the doula you didn't set it up in a manner in which it is a professional relationship, but instead set it up as a friendly relationship."

I think we miscommunicated from the beginning, and I--with as little experience as I was (am) coming from--assumed that because she was interviewing doulas and "hiring" me that she had a relatively good sense for what a doula does.
Although in this particular situation I still feel as though the biggest lesson I learned was in trusting my instincts when it comes to accepting clients. But I've also learned a lot about the importance of good communication (from the very beginning).

Thanks again for your input.
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#17 of 19 Old 07-19-2007, 02:09 PM
 
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I think was tlcdoula was trying to say too was that you could take the client more "in hand" in the beginning of the relationship. So it was not that you didn't try to steer the prenatal away from the playgroup, but rather that you did not set a boundary that this was not acceptable to you because you would not be able to serve her in the doula/client relationship in that setting and gather the information you needed. And you declined subsequent requests to go to the playgroup for various reasons but perhaps you should have insisted upon a proper prenatal at that point. Either the relationship would have dissolved in a more timely fashion, and left her much less angry, or perhaps it could have been negotiated.

So that perhaps was one of your roles in the problem, which in no way excuses her role in the situation. Or that any of your choices were easy and the right way to handle it cut and dried. Perhaps it would have exploded no matter what you did. Perhaps not being at her birth really saved you trouble.
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#18 of 19 Old 07-19-2007, 02:18 PM
 
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You have gotten some wonderful advice Susan as well as some thought provoking conversations. So now, take what is useful to you and incorporate it into your doula self. We live and learn and this definitely a process of learning. Take what you can from it to make you a better doula and don't beat yourself up.
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#19 of 19 Old 07-19-2007, 04:05 PM
 
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I know that someone else prior mentioned that you need to have a contract. Do you have a contract? This is the first thing I go over in when I am first contacted by a client. If the first contact is through email then I email it and let them know that if we set up a time to speak in person that we will go over it together in it's entirety. I am happy to send you mine if you want a suggestion of one. PM me.

And I agree with the prior post that you NEED to charge something. Maybe she had abandonment issues, maybe she was just uncomfortable with the fact that this whole arrangement was just a "handshake between friends". ya know? Also, make sure that the husband is present at least to one or two of the meetings. You are there for him also.

A suggestion......
1st meeting - go over contract. what you do, what their responsibilities to you are, payment, etc. if they hire you, set up another time to get together.

2nd meeting- (dad present here also) next meeting have them give you a birth plan (this is just a rough draft) discuss what they want, ask if they want any information on alternatives, if there are any given their situation.

3rd meeting- dad can be gone from this one, just chit chat for awhile and bond. then discuss the birth plan one more time to make sure you are clear as to what they want. then give them the instructions on when to call you.

Lastly, PLEASE don't think that you need to take every client. I know this was mentioned earlier, and I know that you realize that. But, don't be scared to say that you " will not work with someone who will not attend a birth class (for a primip)" or "will not be educated about her decisions regarding pain relief" (that doesn't mean that she still can't decide to get the epidural, but she has to at least get the handout on the risks, etc) That's your decision. You can say that in your first meeting and let them decide if they can live with that. It's just as reasonable to say that as to say that you won't work with someone over an hour away from you. It's just your personal boundary.

These are just my suggestions, please let me know if you want a copy of my contract. I'd be happy to share it.

Jessica Siczkowycz

Student CPM with Birthspirit Holistic Midwifery Services

Labor Doula

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Mommy to four amazing kiddos, married to the best husband ever

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