Sometimes as doulas, I think we actually need doulas too. Not in the same way as a mother in labor would, but often I think those of us who do this kind of work need support. Especially when we attend births that are difficult for various reasons.
The last few days I've found myself supporting one of my partners through a rough client situation. Its hard to stand by and watch people make decisions you don't understand or agree with. Yes, its not our job as doulas to decide how births should go for our clients. We 'simply provide information and then support choices.'
That's easy to say sometimes.
My partner watched her client pretty much force out a baby that was not ready to be born. An attempted induction (because her OB was going on vacation as of today) with Cervidil on Wednesday morning failed. It did not ripen her cervix or start labor. An second induction attempt with Pitocin failed. Her labor stopped after they took her off it. With her waters still intact, this woman had every chance to go home and let her baby come whenher baby wasready... to breathe on his or her own. Her doula, my partner, told her 'your baby is not ready to come yet'. I'm hearing her baby saying 'Mommy... I'm fine in here. I need to stay in a bit longer. Can you let me?"
But mom would not go home.
Mom and Dad asked my partner, who'd been to the hospital three times now with this couple what the risks were of Cytotec. This is a drug approved by the FDA to use in treating ulcers. It is not, I repeat... NOT intended or approved for the use of labor induction. It says so right on the label. But OB"s are using this pill, inserted directly into the vagina (which means that once it is administered it cannot be stopped in the way that Cervidil or Pitocin can if mom or baby is in trouble) to force babies to be born. Or at least to attempt the forcing. Cytotec's risks include ' maternal or fetal death, uterine rupture, and severe vaginal bleeding and shock.'
"Cytotec® is a drug that was not tested in the laboratory to determine its safety before doctors starting using it as an agent to induce labor, and its manufacturer recommends against its use in inducing labor. Instead, it was and is tested in real life labor and delivery, and unwitting mothers are the guinea pigs. In some cases, Cytotec® imposes risks that far outweigh the benefits of a delivery that takes place at a convenient time."
My partner referred this couple to the resources to make an informed choice about the usage of this drug. They were shocked and said 'no!' They chose the Pitocin route instead, along with its many risks.
Fast forward a bunch of hours. Mom won't go home. My partner does not know what to do to support this family. She's not in labor. We support women in labor.
Telling them, the couple, to talk and figure out what they are going to do, my partner leaves the room with some other family members. The couple talks. Dad comes out and informs my partner that 'She wants to try the Cytotec.'
I'm on the phone, as I've been with my partner on and off of a few days now, and I'm calling it. This will be a cesarean section... an unnececarean ... by the time the sun is up.
At 2 am they were told that the baby was not handling the induction attempt, and was in distress. She was sectioned at 5 am. What hopsital lets a baby 'in distess' wait till 5 am to be sectioned? None, because there was no distress. But now we have a primip mom with a primary cesarean section and a baby who wasn't ready to be born.
It's awesome being a doula. But let's face it. It's hard being a doula too. My partner did her job as best as she could. She supplied them information and they made their choices. She never supported her in labor... because she was never really in labor. But Mom accepted an induction because her doctor had a vacation, and because she just wanted that baby out, and you often get what you get when you make the choices you do. She didn't want a section, but she got one.
Me? I'm glad my partner called me. I'm glad she let me let her talk and vent and throw out questions (when there weren't any answers) and debrief her experience with me. Gods know I've needed to do the same a few times.
I can't imagine being a 'lone doula'. I appreciate my partners and doula sisters more than I can say. Sometimes they are the only ones who understand and the only ones that can relate.
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I can't say enough how important I think your service is to women. I don't even know if they had doulas when I was having my kids and if they did, there probably were none in my small town. Probably still aren't.
ReplyDeleteI'm no expert on any of this but have given birth four times so I do have experience in the birthing process. And I understand how hard it would be to watch people make choices that may not be best for them. I do think though that the support that you and your colleagues give is wonderful and keep your eye on the prize so to speak. It's like when I was teaching school. You may not be able to reach each and every child, but you can try your best and touch some lives along the way.
Keep up the good work, both you and your friend!
Lori :)