06 June, 2011

Don't Be A Negative Nancy

The other day, I had the displeasure of getting into an argument with someone...a friend of my husband's....over doulas. She is a nurse. She went to nursing school, and as far as I am aware, she is currently working as a nurse somewhere over in the Midwest.

Before I go any further in my little rant, I need to make something clear. Just because I am a doula and a natural birth advocate does not mean I am anti-nurse/doctor/medicine. I have a lot of respect for doctors and nurses. They have worked very hard to get where they are. I do not think that medical interventions are always unnecessary. The majority? Maybe. Even half the time? Quite possibly. I am obviously speaking of pregnancy and childbirth only) But I am very thankful that we live in a day and age where we have the tools necessary for emergencies. I am of the opinion that doctors have turned childbirth into a completely medicalized process, treating it as a disease instead of something natural. And however I may feel about some nurses and doctors on a personal level (for instance, I am not a big fan of the head nurse and OB who attended Ophelia's birth) does not carry over into how I feel about nurses and doctors on a professional level. And while I'm on the subject, I am a natural birth advocate, and I believe that if a woman is making an informed choice on her terms instead of a doctors, she has the right to make whatever choice she desires. I personally want women to be informed about what they do to their bodies.

That being said....this is what started the whole debacle:
I have never seen a doula around here. Interesting. We the nurses do all of the before and after teaching and are very hands on through the delivery process. We also have lactation consultants (also nurses) come in and will go to women's homes. So I am not really seeing the point unless it's a home birth.

Phew. Is anyone else irritated by this statement? Or is it just me? As a woman who has given birth two times myself, and has many, many friends who have given birth, I just would like to call bullshit. For the record, the woman I am discussing has never been pregnant or given birth. Lets see...with my first baby, no nurse explained to me what was going on before or during labor. They just told me to do things...."pee in this cup"..."put this on"...."lay like this". Hands on? No. With my second birth, no nurse did anything "hands on"....unless you consider hands on putting an EFM on my stomach, asking me when I wanted to get my epidural, then making snarky comments when I said I wanted a natural childbirth. Then ignoring my requests after Ophelia was born. Yup. Hands.On. Also, I am unsure of any LC who is staffed at a hospital who makes house calls...though maybe there are some...who knows.

We make recommendations, advocate for the patient based on our medical knowledge that we went to college for, not just by taking a course.

I personally, have never had a nurse advocate for me. I have had them make snarky, condescending comments, but not make recommendations based on what I want, or advocate for me in any way.  I know they are out there. I do. I know a couple of women who are nurses and who are caring and compassionate women, and I would assume that personality carries over into their career. With that being said, I have seen very few labor and delivery nurses advocate for a patient. I've read a blog of a L&D nurse and she talks about how difficult it is to advocate for a patient.  (I cannot find the blog right now, but I'm looking, I swear.) I can understand why it would be difficult to advocate for laboring women. Every other place in a hospital is filled with people who are sick, have diseases, or are dying. Except the Labor & Delivery ward. L&D is just filled with mommies having babies, which they have been doing for thousands and thousands of years. As I stated earlier, I believe that childbirth is over-medicalized. According to the CDC the cesarean rate was 32%, which, according to the WHO, should only be 10-15%....which means about half of all the c-sections performed each year are unnecessary.

For the record, I am not sure where in a hospital this nurse works.

We are the patients' advocates and have the medical knowledge to back it up. Any nurse without a backbone to stand up for their patient doesn't need to be a nurse! We don't work for or have to answer to the drs. I have many times told drs what my patient wants or doesn't want. Now I see shy doulas are used so little, lack of medical knowledge.

Again, I personally have never had a nurse advocate for me. A lot of mama's I know who have delivered in a hospital  have disliked at least one of their nurses, if not the majority of their nursing staff. I have read stories of L&D nurses all but being forced to perform unnecessary interventions or procedures on patients that those patients do not want. I have read stories of doctors who do not care what the patient, support person (husband), or nurse says, and do whatever they want anyway. Doulas may not have gone to school for 4 years. Doulas may not be able to give medical advice.

I would LOVE to know where you get your evidence based research. Googling something don't count. Any one or two studies with a handful of participants isn't grounds for evidence based. Do your research on evidence based practice. In layman terms it means MULTIPLE studies were done to show the best, most effective and safest way to do something. Get on CINHL and then talk to me about evidence based research. Good luck in educating yourself. I am pretty sure drs and nurses view birth as something natural.

To me, this is not only an attack on my job but an attack on me personally.  I have read numerous books and studies about labor and childbirth. I know the deal. I know what is necessary and when, and what is not. I have not witnessed many OB/GYNs who practice evidence based care (though that does not mean they aren't out there). I personally do not believe that doctors view birth as "something natural" but a problem they can fix...I know my attending OB at Ophelia's birth didn't...the look on her face when I told her I wasn't moving and was going to push instead made it very apparent that she had never seen a natural childbirth before. I'm a lot of nurses view birth as natural, but that doesn't mean anything in the grand scheme of things. Nurses are nurses, plain and simple. They are overworked and underpaid and have a lot of shit to do on their shifts. They have more patients than they can handle sometimes. They do their best. I truly believe that nurses want to do what is best for their patient...but it doesn't always happen. While technically nurses are not employed by the doctors, they ultimately fall under doctor rule, and often times have to do things that they aren't comfortable with. Not listening to a doctor can have its consequences when you have to work with them on an almost daily basis.

For the record, googling stuff DOES count as long as you are getting your information from reliable resources. Just for the record.

I was so angry. I still am a little irritated. Not only was what I want to do with my life (right now) attacked, but I felt personally attacked as well. Have I gone to 4  years of nursing school? No. I haven't....not yet anyway. But I never claimed to know everything. I know a lot more than a lot of pregnant women about the body, labor and childbirth, but I do not know everything. Being a doula means you are continually learning...just like being a nurse or a doctor. Can I give medical recommendations? No I can't. But I can give my clients the information that I know that has been published by doctors, midwives and other professionals. I'm not saying a doula is for everyone either. I'm not bashing women as a whole or the choices they make. I feel that every woman has the right to do whatever she wants to do to her body, which is also why I'm Pro-Choice. If a woman gets pregnant, and decides right off the bat that they don't want to feel any pain at all, I will make try to make sure that they understand the risks and benefits, but I will not belittle them for getting an epidural...it's not my place at all. I will birth how I feel is best for me and you will do the same.

The nurse that this happened with....I would never feel comfortable having her as my nurse, which is my right as a patient. I have personal issues (aside from this whole thing) with this person that I will not get into, but it is frustrating when someone basically says your job is obsolete and makes cracks about how educated you are (or aren't). And it makes me hurt for the pregnant women. Some hospitals (I know of at least one in Ohio -- and that's almost a different post in and of itself...and is mostly the fault of doulas overstepping their boundaries and trying to play doctor) that have banned doulas all together. Having a doula at a hospital birth has been proven to cause less stress on mom and have less interventions take place, both of which are needed at hospitals.

I feel like I'm making myself look like I'm digging on nurses. I'm not. As I said earlier, I have a great deal of respect for nurses. The nurses I know have worked long and hard, missing out on spending time with their families, to get where they are. And I respect that greatly. I know what is in store for me when I go to nursing school. What I am digging on is ignorance and what I perceive as woman on woman hating. It happens a lot in the birthing community because everyone feels like their way is the best way and that women who do differently are putting them down (for instance, scheduled c-sections vs. natural childbirth, formula vs. breast, etc.). I try to get my point across without telling anyone they are "doing it wrong", but before you start talking shit, please understand that there are many women who don't believe the same thing you do. The attitude this person had (which was very defensive) made it seem like she thought doulas were out to take her job. Which is absolutely not what doulas are trying to do. I don't sit back and talk shit about things I know nothing about. I would hope that other women would educate themselves (just because you go to nursing school doesn't mean they teach you about doulas or you know e-ver-y-thing) before they bash other women. And just because you (the collective 'you') think something is unimportant, does not mean that others feel the same. Doulas have always been a very important part of childbirth. They may not have always been as popular as they used to be, but they have always been important. Having that support is very important to have...whether if be from a Doula, a spouse, a friend or relative, it's important.

I hope I've been able to convey my frustration in a pleasant manner. I tried not to talk shit, or go into 'bitch mode', and I hope I've accomplished that. I will say again, I truly respect nurses and what they do. They are a very important part of our lives. I am not trying to be the nurse when I go into the hospital to doula for someone. Nurses are nurses and I am a doula, and that's the way it will always be.

I don't want to go into this too much, but I attended a birth a little over a week ago. My first one. I was nervous as all hell, my palms were sweating as I walked into the labor room. I introduced myself to the nurses. I feel like I did an okay job. I wasn't too sure of myself, but mama was strong and she did wonderfully. Her little boy is adorable. I had no problems with any of the L&D staff. It was an amazing first experience. As I left the little family to get to know each other, I teared up a little bit as I started my car. Nothing horrible happened, mama and daddy were enjoying their new son and I didn't feel like stabbing any nurses or doctors. That's how it should be. It won't always be that way, but that's how it should be.

I really do hope I've gotten across my disgust for ignorance without coming off as a "know it all". I don't know it all. I don't claim to be something I'm not. I am just frustrated with the lack of understanding. It's frustrating to me to think that THIS is part of the reasons that doulas are looked down upon. Why we are not totally accepted in today's society. It makes me sad.  I hope I've not offended anyone either...my friends and family are very important to me, as well as my readers, and really, I don't want to offend anyone. If I wanted to offend you, I would try harder. Heh.

And thanks for reading all the way through if you made it this far. This was upsetting to me when it happened last week and writing about it has made me feel much better. My best friend told me that there will always be people who make these kinds of comments. And I am seriously thankful that I have more supportive people in my life than not. I hope that by being a good doula and a good person, I can change the minds of those who are "doula haters"....because every woman needs to feel comfortable while she's having a baby, and a doula-hating nurse and a doula do not mix.

No comments: