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Doula Ethics (actual situation, need help)

949 Views 9 Replies 8 Participants Last post by  birthgreeter
Hi everyone,

I attended a birth about 5 weeks ago, which was co-doula'd, with another very qualified doula. We chose to work with this client because the mom could not afford doula care, and we both believe that if a mom wants a doula, she should have a doula at her birth. We met her together, for the first time, at a local coffee shop, and her partner was there. At some point before we even got the meeting underway, her partner left. I remember wondering if he felt ganged up on by three women. Didn't know what was in store for us.

The couple came to us on a Friday, when the mom was scheduled to have a cesarean birth on the following Monday. She was due any day to have her baby, so we agreed to work with her and her partner to help her have the type of birth she wanted to have.

When we got the call that she was in labor, we came to be with her. Her partner was there with us, and he was coming in and out of the hospital room. We both dropped hints to him (without drawing it to moms attention) that we normally share with the partner how important it is that he stays with the mom consistantly. Really, for every minute that passed in the birth, the father was becoming more and more out of control, and the birth atmosphere was no longer the bubble we created. He was making comments towards both of us, that were inappropriate, and offering to give US, the DOULAS, massages while we worked. I have accepted offers of massages before, but I was having terrible urges to leave, because I could see this situation was getting worse, and neither would mom tell dad to leave, nor would dad calm down enough for the mom to get comfortable and relax into her contractions. At some point, we hinted to dad to take a break. When he did, he went out and smoked pot, came back in even more strung out and disrupting. He was having trouble breathing, he was telling us that he didn't think he was ready for this (fatherhood), all while we were desperately working with the mother to help her accomplish her goals.

The hospital staff was becoming more concerned, but they didn't ask him to leave, and we asked mom if she was needed him to eat dinner or whatever (gently hinting that we thought she might settle more into the birth if she had some time without her needy partner).

As you probably guessed, the mother ended up with a cesarean birth, and it was the first cesarean birth I have been in involved in since I started attending births as a doula in 2001. I have been processing this birth since it happened, and especially in the beginning, I wondered what I had done wrong (blaming myself) and how I could have possibly have turned this around. Since then, the mother told us that she couldn't even visualize having a vaginal birth, not before she was pregnant, not during her labor and especially after her birth. I felt so terrible. I'm not one of those doulas that shows up to a birth and make no suggestions or try to help the mom change the outcome. I have always met with my clients in advance (well in advance most times) and know them very closely, know where they live, have done prenatal visits with them, know which books they have read, know how they really feel about giving birth ect, ect. So this birth, and the cesarean section at this birth, just left me feeling overwhelmed. I attended the DONA workshop recently and got some closure on this particular birth, in the best possible way I could...talking with Debbie Young the president of DONA.

I know I had trouble processing this birth because of the behaviour of the father, the complacency of the mother and the cesarean birth that followed. I had spoken many times to my doula partner who seemed to be dealing well with the birth...UNTIL yesterday.

Our moms partner contacted her saying that he wanted to payback to us for helping, for being there ect, and that since he didn't have money....
he'd like to do some massages on her.

We both know that this man doesn't want just massages, and we were taken under again by how to deal with this. She has made it very clear that she doesn't want the massages, but he has called twice. We both don't want the mother to have no one to turn to, with a partner like this, I assume that he has done this to all too many of her friends, and ultimately isolated her.

She is a mother, who may very likely need further support, even though our support has ended (after 2 weeks postpartum). My co-doula friend is leary about cutting contact off from this family, but does not know how to deal with the partners advances.

I have talked this over with an attorney friend of mine, who has given me some very clear things we can try (wait till he calls again and tell him that we don't want any more contact with him, that the services for the family have finished, and if mother wants to call, it is alright, but if he calls again, we will tell the mother about his advances on both of us at the birth, and on my co-doula yesterday).

My worst fear is that the mother will be cut off from the only type of support she has. As a doula, helping out by doing a birth pro-bono, that I did only to benefit the mother and child, but always welcome the benefits to the father too.

I need to know how to proceed, if at all, so that we can from now on only be concerned with the mothers need, and not the fathers.

While I could have avoided this all together by only taking on a mom who I have gotten to know well, gotten to know her partner well ect, but these issues I have coped with finally, I just really need help on how to end this without isolating the mother any further.

Thanks everyone!
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Oh my, what a really tough situation.

You have gotten some good advice from the lawyer, and I can only emphasize that when it comes to a guy like that you really MUST be very very clear about boundaries and consequences. It is the only way to attain some distance from him and the unpleasantness he generates by his spaced out, self-involved, boundariless, needy energy. If he is smoking a lot of pot, then he is NOT in reality, not going to be easily reachable, because the pot-fantasy will be very potent in his mind--and so much more pleasing to him than actually attending to anyone else's needs, preferences, etc.

It's a sad, infuriating situation...and this mom is complicit in it. You would like to help, but it's obvious that he is sucking attention and energy his way. But part of this difficulty is that she IS complicit; this is the contract she has entered into with him and with her own life.

I think you're going to focus on taking care of yourself here, and really reach for detachment. Remind yourself that this mom IS making her choices, and is fully capable of making different ones at any moment. Remember that only she can save herself; trust that she has the strength, wisdom and ability to claim her power and to realize her wish for real love and support.

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Wow. What a sad situation.

I think if I were faced with his advances I would NOT tell the mother. I think that is very much crossing the line. I would avoid his advances, unless they became excessive. I know it hurts to have him acting like this to you, but I feel it isn't your (or your doula partner's) place to tell this woman. I have a few reasons that I think this:

A. You really don't know her that well- how do you know she would even believe you. Since she is still with this guy she probably has some major blinders on. She may feel you are lying, and example B will ensue.

B. She does need you and your partner- even if the support has ended- she has those memories of having your support, and those are very valuable. If you told her this I believe you would tarnish her memories of her birth and ruin her trust in you two, which really would be horrible, and she doesn't deserve that.

C. Maybe she knows, and does not care, or has no options? Many women stay with men who stray, for a miriad of reasons. It's more common then you'ld think, especially after a child is added to the mix. If she already knows (which seems likely) then it will only bring more pain to her, plus she will then feel judged by you to do something, AND example B would still apply.

There are other examples, and many reasons not to tell. But to me the bottom line is that it isn't your job (or even your ethical duty) to tell her. It really is a private matter, something you really have no idea how she would feel about, or if she already knows.

Furter I am amazed that this if your firest cesarean birth since starting 7 yrs ago. Go you!
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If he calls again refuse his offers, and tell him his partner should call if she has any concerns. Thanks, take care, hang up!
That is it.
How enmeshed in peoples lives do you want to be. This is her chosen partner, she knows his bullshit. If this mom needs further help she will get it.

Unless you're working in a volunteer program, it is Never a good idea to not charge some type of fee or barter for your professional services.
rats...had a long reply but got deleted.

here goes again (in an abridged form due to time)

have clear boundaries as best you can now. trust yourself, your gut, your inner voice.

try to have closure with the mom. my thought was to send her/drop off a list of resources within the community for new moms.

know that your issues with the fact that it was c-birth and all of the issues with the dad are really separate issues, which are both completely valid.

know that your presence in the laboring room and at birth brought consistency, calm and warmth to the mother. you were helpful to the mother during her birth. imagine what it would have been like if you had not been there.

one idea i had, if you are comfortable, is to have a conversation with the attending nurse (if you had a connection). it might be nice to know that other's had similar thoughts about the situation.

have peace that this will all resolve in time. in the mean time take care of yourself and do something physical to attend to your needs (warm bath, walk in nature, yoga class).
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Thanks for your comments. I have thought of all of these things, and I still don't feel I have a clear path, except to break contact with the mom (she can still contact later if she needs). I personally would not want to be the one who told her about her partner. And like one of you said, she could be perfectly fine with it, or accepts it as part of what she has to accept?

Either way, the partner needs to leave my partner and me alone, for good.
I'll think it over, and let you all know what I do.

Thanks again for your thoughts and hugs!
Not a doula but, I think you and your partnet need to make it very clear to the father that his advances are not welcome and that you are there to support the mother only, period. Maybe if he knows that you two are on to him and you do not appreciate it he will stop.

You can't tip toe aroung this type of thing, you have to be very direct and say exactly what you mean, otherwise they just don't get it.
Tell him you are not interested. Tell him mom can call if she needs anything. Hang up. Don't answer his calls.

I guess this istuation does not seem like a big deal to me. It sounds like a mom who was planning a c-section got one and has no regrets about her birth thus far. Fine. This is not on you.

Her partner is not your style and was not prepapred for the birth and has been inappropriate since (is he a massge therapist?). Him smoking p[ot does not strike me as a big deal personally if it was fine with mom. I don't smoke and would never want my partner to but as a doula, it is Not My Birth so I don't stress it if mom doesn't stress it. It is a bummer that mom seemed to not be able to relax into labor but this may not really be so much about the baby daddy since you acknowledge that mom very even thought she would birth vaginally and that mental block strikes me as huge.

Anyhow, not to be unsupportive, but to me it does not seem like anything too intense is happening. If dad calls, don't take the call or tell him you are busy and not to call again. This does nto cut mom out (and you are really not seeing her much anymore at this point anyhow). Does she not have any other support?

I hope you find some peace about this issue. Sorry it is so troubling to you. I hope my words are read as my perspective and not as a way to diminish how you feel, since I want to both honor your feelings and suggest that perhaps what is happening is not as bad as you might feel. A section is okay. A dad who is a mess at the birth is ok (that is an issue for mom not you). A dad who is inappropriate just needs to be put back in his place.
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Thanks for your response Meagan. Let me say again, that it is not me who is getting the post-birth advances. I have very strong boundaries, and I have not trouble letting anyone know when they have crossed over unwanted.

My doula friend is younger than me, and we are just trying to work out some ways to deal with this situation that will work for her, and still remain open to the mother.

I think we have come up with some great ideas here, and I have passed all of that on to the doula, and we have processed alot, and learned alot.

Thanks so much, and I really do appreciate your thoughts.

You have received good advice.

Keep in mind that even though you say he might be this mothers only support right now, he is obviously not a good and proper support for her, so do not feel guilty for saying anything to him that may cause in any way- for him to 'not' be there for her...
If he was out of the picture, she would have other support thru family or friends or if not - you could suggest to her different groups for that support...
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