tag:blogger.com,1999:blog-5686997867572223504.post211800274659675103..comments2023-10-02T06:42:39.541-04:00Comments on musings of a montreal doula: Patient Interest or Witch Hunt?Anonymoushttp://www.blogger.com/profile/06059951273542374898noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-5686997867572223504.post-90597872411865263852010-06-05T22:08:03.869-04:002010-06-05T22:08:03.869-04:00Hi there,
This is an excellent question. Because...Hi there,<br /><br />This is an excellent question. Because doulas are non-clinical professionals, supporting our clients in non-clinical ways, there is no liscensure. We don't diagnose, treat, assess, or guide anyone to one choice or another. We outline information gleaned from many sources and empower a woman to make her choice given her circumstances and mindset.<br /><br />Organizations exist, such as Doulas of North America, ALACE, CAPPA, MotherWit, etc., which have basic standards of practice. When I train my doulas, I have them sign a contract saying they understand the scope of doula practice I present. I don't certify people whom I feel are not suitable for the job. But this doesn't mean that doulas who are uncertified are bad banananas. Some have good reasons to choose not to certify. A doula can still go out and work whether or not she's certified or not, as there is no governing board. <br /><br />I am wary of there being a governing board, as our work with people is so personal. I enjoy that doula work is one of those grassroots professions. I worry that standardization would take away some of our autonomy and make us too sheep-y and hospital yes-women. Yet there is still the issue of accountability for bad banana behaviour.<br /><br />Bad bananas usually don't last in pratice long. They get bad reps. If a doctor says to her patient, "I've worked with that doula, and let me tell you some stories about them...let me refer you to another who is consistently good" that will influence a potential client. We all make mistakes in practice sometimes, but that doesn't normally damage a rep...it's consistent boundary breaking, rude behaviour to hospital staff, and perhaps even assuming some clinical care.<br /> A good doula will meet her clients in advance of being hired and ensure her role is clear.<br />If a doula is not a trained and experienced clinician and makes things like cervical dilation checks, fetal heart monitoring, and "accidental" homebirth part of her repertoire, she is endangering her client. If she wishes to do these things, midwifery is a better career for her. A midwife can totally be a doula, but a doula, unless she actually is a midwife, can't peform midwifery skills which are geared towards monitoring the health of the mother and baby. <br />The best thing for a parent to be to do is doula shop. They should meet a few to see who clicks with them, who they feel are open to whatever their needs are, and who people speak well of. Experienced doulas are usually in the field that long because they've been accepted by medical staff and have developed a good reputation through word of mouth. Ask for references!Anonymoushttps://www.blogger.com/profile/06059951273542374898noreply@blogger.comtag:blogger.com,1999:blog-5686997867572223504.post-73273233926033193372010-06-05T18:45:05.746-04:002010-06-05T18:45:05.746-04:00I am a friend of someone your helped recently. The...I am a friend of someone your helped recently. The whole notion of a doula was very foreign to me. And while I still don't quite get it completely, and have many questions about your role and influence. I must admit, I wouldn't mind having a "doula-like" advocate when I go into just a simple walk-in clinic. <br /><br />When a person is vulnerable *(illness, preganancy or just emotionally tired) having someone to deal with the tedious realities of our social structures would definitely be a plus.<br />I think the most important aspect of this situation you have decribed is, as you have clearly stated, that essentially the parents have willingly and intentionally requested your presence and intervention. This in and of itself makes your role just as important is not more important than anyone else in the room.<br /><br />Having said that, I do have one important question. Even if a doula is good natured or well intentioned, who can actually hold the doula accountable for her actions and behavious in the room? sure the parents can evaluate the experience in regads to their desires having been met or not butprofessionally, who can call to account that "bad banana?"Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5686997867572223504.post-23198766230919285242010-06-05T13:09:08.866-04:002010-06-05T13:09:08.866-04:00Bravo for this information!Bravo for this information!Danielle Arnold-McKennyhttps://www.blogger.com/profile/00606657569365450105noreply@blogger.comtag:blogger.com,1999:blog-5686997867572223504.post-83990405985707576822010-06-04T18:29:49.550-04:002010-06-04T18:29:49.550-04:00Absolutely, Nicole. This is exactly what needs to...Absolutely, Nicole. This is exactly what needs to happen here. Hospital staff should most definitely be protected from true bad doula behaviour (not to mention their patients), but not at the expense of all doulas. We actually need a lot more protection, as we're not part of some big system. I don't object to a policy, but one that allows our work to flourish and thrive. There will always be a potential for tension, as our philosophies are often so different, but we make so much more headway by being diplomatic and gentle, teaching the efficacy of our support with good happy outcomes, rather than ramming our information down their throats. If we're trying to lecture staff on their "mistakes", who's supporting the parents? We CAN make this work.Anonymoushttps://www.blogger.com/profile/06059951273542374898noreply@blogger.comtag:blogger.com,1999:blog-5686997867572223504.post-30506567450562617842010-06-04T10:16:51.050-04:002010-06-04T10:16:51.050-04:00Lesley - I agree with everything that you have sai...Lesley - I agree with everything that you have said. This is a fine line - if you refuse to give information on yourself, you seem defensive - but being placed in a position like this, there is every right to feel and react defensively. <br /><br />Perhaps a good bridge to begin building would be for you to contact the powers that be and offer your insight, helping them to write up a firm policy on what is within a doulas scope of practice and what is not, so that they can more easily differentiate between a personality issue vs an ethical issue vs a medical issue, were the bad banana situation to rear it's head. <br /><br />Similar to when policies and laws are put in place governing midwifery within different states, we can either fight these policies and laws, or we can work with the powers that be to make them the most conducive to our profession, removing any hostility that may be motivating these steps.Nicole Dhttps://www.blogger.com/profile/00221401549139626688noreply@blogger.comtag:blogger.com,1999:blog-5686997867572223504.post-35597102850041585752010-06-04T09:36:22.581-04:002010-06-04T09:36:22.581-04:00Bravo Lesley! This has been my point for YEARS! ...Bravo Lesley! This has been my point for YEARS! I think there are less bad behaving doulas and more anti-doula behaviors through misinterpreted <br />reasoning by both hospital staff and other doulas!<br />Thank you for your post!!!Traceyhttps://www.blogger.com/profile/03078147650729680018noreply@blogger.com