Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

No Doula in the Name of Privacy? Oh Come On! September 26, 2009

This comment was recently left by a reader named Jessica under one of my older posts.  Since I read every comment that is posted on my blog I happened to stumble upon it this morning.  When I read it I couldn’t help but think “I Hear Ya Sister!!!”and felt that it was so well stated that it needed to be its own post!  I know that there are quite a few doulas out there that read my blog and I just wanted to take this opportunity and give a shout out to them all and say thank you for all you try to do to educate women before they get to me on L&D!  Unfortunately, they don’t all listen but I hope you know that there is at least one L&D nurse out there that appreciates your efforts, both before and during labor!!!

 

For all you expecting moms out there please check out DONA’s website to learn a bit more about what a doula is, how you can find one, the effects a doula can have on your birth outcome and experience, and how a doula can advocate for you!

 

And just for the record, there is NOTHING private about a hospital birth experience.  Even in the most well meaning hospitals with the most well meaning birth attendant and the most well meaning nurse(s).  Albeit some women’s hospital births might be more private than others and I personally have had the priviledge to be a part of a few totally amazing hospital births.  But to not hire a doula for your hospital birth (especially at a university hospital!) because you want a “private” experience is a very VERY naive and misguided idea!  I am not saying that to hurt anyone’s feelings and I am certainly not judging anyone out there who decided not to hire a doula for one reason or another.  I am just telling it like it is.  Some food for thought…

 

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Hi NursingBirth!

I am a certifying doula and have recently had an interview with a perspective client. She is 36wks pregnant with her first. She was strongly considering a doula, but everyone else in her family was on the fence, and pushing a “private” birth experience. However, they are planning a delivery at a university hospital, she has yet to see the same health care provider throughout her prenatal care, she has no idea which one will be at the birth, or if it will even be someone she has met. They are planning a natural birth. She assured me that the hospital she is birthing at offers a multitude of birth options, including water birth, birth ball, position changes, etc… and the childbirth education from the hospital has given them confidence in their ability to get what they want from this birth. After much “deliberation” they decided that they were not going to hire a doula, based solely on their confidence in the hospital to give them what they want, and their desire for privacy. While I can completely respect their privacy request, I fail to see how birthing in a university hospital will give her much if any privacy…AND if she doesn’t even know who will be her health care provider at the birth…how is she confident that the hospital will give her what she needs? I wish there was some way to help open her naive eyes to the reality of birth in hospitals today. Her chances of getting to work with a mother friendly doc that understands and respects natural birth have got to be low! Reading your blog was comforting (because I know there are others who struggle with this) and depressing(because we have to struggle with this). I don’t want to have her hire me for her VBAC next time around. I want her to have the birth she desires now. I realize there isn’t much I can do for her at this point, which is why I am here, leaving my frustration with a bunch of like minded individuals. I am hoping things will go well for her and in the mean time, I’ve let her know that I am and will be available until the baby is born. just in case. Thanks for the space to rant.

  

Sincerely,

Jessica

  

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Jessica, you can rant here anytime!!!  I Hear Ya Sister!  Loud and clear!!

 

And now I leave you with one of my FAVORITE Monty Python skits of all time.  I have seen it a million times but it is still as hilarious (and eerily true) each time I see it.  Notice how the doctor invites in an army of people to watch.  It often feels like that where I work no matter what I do!!!

 

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28 Responses to “No Doula in the Name of Privacy? Oh Come On!”

  1. enjoybirth Says:

    Thanks for the thanks. 🙂 I am a doula and love my job. I would agree, there is nothing much private about hospital birth.

    I think having a doula actually increases your chance of having more privacy. I have had nurses at some of the births I have attended pretty much leave us alone, because they knew mom had a doula. (They would come in and do their jobs still, but very unobtrusively.) A few have even commented after that they left mom alone because she had a doula. As all my clients are my Hypnobabies students, the peace and quiet is appreciated.

    Pushing tends to be a very public time, which seems so odd. But you have the baby nurse, the labor nurse, the OB as the minimum. I like to turn on the Pushing Your Baby Out CD on out loud, it helps keep the room a bit calmer. It reminds everyone why they are there. To welcome a baby into the world.

    I have been at a couple births where the nurses and OBs are chatting about dates they had, quitting smoking…. all sort of inappropriate things to be discussing at the birth of a baby!

    • NursingBirth Says:

      Enjoy birth,

      You write, “I have been at a couple births where the nurses and OBs are chatting about dates they had, quitting smoking…. all sort of inappropriate things to be discussing at the birth of a baby!”

      I have been at births like that too. I have always found it really really awkward! I try to just focus my energy on the mom and her team and sometimes I give the “shush!” look but still, its really awkward and unnecessary!

  2. Microbiologychick Says:

    The discussion about privacy brings up a funny story. I had a friend in graduate school who had attended a small, private, Christian college. She told me about a biology class she had where the professor received a call saying his wife was in labor. Instead of canceling class, the professor walked the students to his house (a few blocks from the school) and proceeded to give a lesson on the biology of what was happening while the students watched the homebirth.

  3. Sarah Says:

    I just heard yesterday that one of the doctors in the sketch was actually a doctor!

  4. Audrey Says:

    I hope things turn out well for the mom who turned down the doula!

    I’m 37 weeks pregnant, and giving birth at a great hospital (NOT a university hospital). I have wonderful midwives who work at the hospital, and the hospital is extremely supportive of natural birth. The midwife on call (there are 3 in the office) will be with me the whole time, and things in my birth plan are already routine for them. I’m fully confident in my ability to have a peaceful natural VBAC at this hospital (previous c-section was at a different hospital 2 years ago). But I have a doula, just in case! 🙂 Better safe than sorry!

    I’m fully confident that my doula will help me have the birth I want, and help keep the unwanted visitors out. There are so many reasons I have a doula this time, I wish I had gotten one last time! My family thinks having a doula is useless, but they have never had one and don’t know how amazing they are!

  5. Ted Says:

    I would be interested to hear how her experience at the hospital goes.

  6. wb Says:

    With nothing but respect for Jessica, perhaps a sub-issue here is the need to find a doula that you (and your spouse) click with so that they don’t feel like an intrusion at all. If it feels like the doula would be intrusive, perhaps this is a sign that the personalities are not a good match. I had a doula for our birth, and while she is a friend, I didn’t feel like she helped the labor or was supportive much at all, and I was really disappointed by the experience. Next time, I’ll look harder for a better match of personalities and styles and try to better communicate what I want from the doula relationship. I think it is important to interview a number of doulas (ditto for health care professionals, but that’s another topic). It is also possible that this mama-to-be needs a cave and would be better served by having a home birth or being supported by a really close friend who has also given birth naturally. Perhaps for her the key would be to stress staying home as long as possible to have her “private” labor for as long as possible.

  7. briome Says:

    I like a cave too….. the less people the better for me! (yes I had a HBAC with my second) but I know some people really need that person just for them…like a Doula

    Linked! http://icanwesternmd.blogspot.com/2009/09/get-doulaeven-if-you-wish-for-privacy.html

  8. Jill Says:

    THat was one of the biggest perks of my homebirth…no entourage of strangers wandering in and out looking up my hoo-ha! 😉

    I love that skit…amazing how it continues to ring true even 30 years after. The Monty Python boys (can I still call them boys even though they are old men now??) are BRILLIANT!

  9. It is funny how it wasn’t even doctors and different nurses coming in! I was really lucky to have an awesome OB who came out to attend my birth, even though he wasn’t on call. So I only saw one doctor and two or three nurses. But at least three or four different lab techs wandered in, because they needed a sample, and then they needed a sample to cross reference that sample, and then someone had forgotten to mention that they’d already gotten the first sample, and then they lost the second sample–

    All this while I was gritting my teeth during contractions and the nurse and my husband were trying to jam towels between my legs to sop all the amniotic fluid. Not exactly how I like to present myself to strangers 🙂

    And I’m pretty sure a cafeteria manager strolled in too, not realizing that I wasn’t postpartum yet and hadn’t even had a chance to eat a meal to take the meal survey.

  10. Manda Says:

    I am 27 wks and planning a hospital VBAC. I am interviewing a doula on Monday. My sister had a baby last January and I was talking to her about the possibility of my getting a doula and she said to me – Just remember what an INTIMATE experience my birth was – and would you really want a stranger in there helping you? And to make sure our personalities really matched. I kind of laugh to myself now, because OBVIOUSLY my sis does NOT remember that besides her DH, our mom, and I there was a nurse, the OB and 3 student doctors in the room! And, those are just the people I remember! I had to stand on the couch and hold the camera over my head in order to get her birth pictures!! It was a *very* intimate experience indeed! LOL

    I do agree wholeheartedly about making sure that our personalities match the doula and that I need one who has the same birth philosophies as I do!

    • NursingBirth Says:

      Manda, that is wild! The funny thing is that many mothers dont understand that if they have a doula, the doula is going to be the only person with her that is NOT a stranger (except her OB/midwife, that is of course if the mother is lucky enough to have one of the ones she met at the office actually attend her birth!) As awesome as I like to think I am as a nurse, I am still 100% a stranger to all of my patients.

  11. Joy Says:

    That is definitely one thing I am not looking forward to- an entourage of nurses/attendants/whoever at the birth. I think there were five nurses along with the OB while I was delivering. Three of which were the post-partum nurses (to take baby and do Apgar and all the wonderful after-birth stuff to baby). I felt violated and everyone was just staring like I was the greatest show on earth! It made me feel like a freak. It didn’t make birth feel intimate and beautiful.

    Anyway, I’m actually going to have my MIL be my “doula”. She doesn’t have formal training but she has attended many births and has been told so many times she’d make an amazing doula. We’re going to chat this week about my birth plan and preferences for birth. We’ll see how it goes!

    BTW- I gave my doctor my birth plan and he has notes written all over it. I’ll be 37 weeks on Tuesday and he has yet to tell me what his little notes say. When he first saw my BP he told me, “Nothing seems out of the ordinary! I’m pretty sure all of this is just fine.” It doesn’t seem like it’s going to be fine if he’s scribbled all over it and hasn’t discussed it with me.

    I don’t want to get all anal about the BP but at the same time I really want communication and to know what to expect!

    P.S. Can I fight the IV? Apparently it is hospital policy to have it. I have a major problem with having THINGS on me or attached to me. It makes my skin crawl- I’m very sensitive to touch. ACOG released a statement saying fluids were okay during labor now so I show my doctor (an ACOG affiliate) the article. I say, “Can I have fluids in labor and avoid the IV? I’m willing to do a Heplock if having access to a vein is mandatory.” His answer was yes. But that’s where I saw his little notes all over my paper- on the space where I said I want fluids by mouth, not IV. UGH!

    Sorry, I’m rambling. I’m getting really irritated and nervous and anxious about this birth now and just wish I was having her at home.

  12. Krista Says:

    This is an interesting subject. I hear what you all are saying and I realize it does sound silly to want privacy when there are nurses, doctors, students, etc coming and going out of your room. However, I don’t think we should discount Jessica’s desire for privacy. To be honest, when my youngest was born I don’t have any memories or recollection of some of the nurses, attendants and/or students (yes, I was at a university hospital…yuck!) that were there toward the end of my labor. I was so far into laborland that my only memories are of my husband, my friend (and doula), my midwife and I was aware that my mom was in the room, although she was more of an observer than anything. Even though there could have been 20 other people (seriously, who knows? I have no idea how many were actually there) it felt like a just 5 of us there. It felt intimate and small. So, it may not be just who (in reality) will be in the room, but who will be in the mama’s inner circle…..who will she be leaning on. Some women want only their husband and hopefully he’s up for the challenge, but I do think that we shouldn’t judge harshly a woman who doesn’t want to add someone to that inner circle…..and I agree with the person who said maybe it wasn’t a good match with the doula and she just didn’t want to hurt any feelings.

    That said, in a hospital setting a woman *does* need someone to advocate for her. Maybe her husband is willing to do that, but doulas are a great option to fill that role!

  13. EG Says:

    I hired a doula for my July VBAC attempt. After 40 hours of active labor I wound up with a repeat c-section (devastating, but that’s a different story), but I don’t think I would have lasted 40 hours without her.

    Anyway, I think the privacy concern is funny having done this twice, but I understand how a first-timer would have the concern.

    Of course the reality is that people you have never seen before and won’t even be introduced to will see the entirety of you. And you won’t care. You might not even know they’re there. They’ll see you pee the bed, vomit, maybe poop, and possibly curse at your husband or baby or doctor.

    At the end of my 40 hours, as I was being wheeled to the OR, I heard someone say to my husband, “I have a nurse practicioner student here. Would it be okay…?” I yelled from my bed, “I don’t care!” All I cared about at that point was a quick and effective spinal block.

    Joy, you have the right to refuse any medical care. With my VBAC attempt I compromised with the Heplock. And if I’d gotten to the hospital earlier in labor, I would’ve avoided continuous fetal monitoring, too, unless they could’ve gotten the wireless to work. I’m with you – I don’t like being tethered. And I’m convinced that’s a large part of the reason I wound up with my first c-section. I guess I’d just advise doing it in a polite way and not come in defensive. You want the nurses to be your advocates!

  14. Megan Says:

    The absurd idea of “privacy” at a hospital idea reminds me of the related idea that the 2-day hospital stay is a good time to “rest”. Oh, sure. I got so much sleep between 9pm and 1am – being woken up separately every 30 min by: the nurse who came in to check my vitals, the separate nurse who came in to check the baby’s vitals, the manager who brought a folder of paperwork I needed to sign tomorrow, the cafeteria worker who picked up my tray, the sanitation worker who emptied the trash, the nurse who came to pick up my baby for midnight rounds in the nursery… etc. Its really a comedy in there.

  15. Erin Says:

    This isn’t so much about the specific post, but more an observation I just realized! I stumbled across this blog in July and voraciously read it – I’m 24 and not planning on having a child for a good long while but I always like to be well-researched. Oddly enough about the same time I ran across this blog, I also started watching “Baby Story” on TLC on my days off.

    Today I realized how many of these episodes feature inductions or c-sections! It’s insane and after reading your blog entries I find myself really using the episodes as a way to check my own thoughts on the issue. I’m appalled at how restricted the motion of the mother is and in the few un-induced labors I’ve seen it really seems like a lot of what you describe is happening in these birth situations. It’s a huge eye opener.

    I’m pretty darn sure that when it’s time for my husband and I to start a family I’ll be looking for a good midwife and birthing center. I’m kind of a type A personality and I’m thinking being ignored or restrained for hours and hours will NOT help me have a good experience – I like having as much control as possible. 😉

    Thank you for providing this resource!!

  16. Joy Says:

    EG- thanks!!! I’m proud to say that I took things a step further. Last night I became very upset and distraught about my current health care with my doctor. So I did some searching and found a midwife group. I called them today and they take late transfers! My first appointment with them is Wednesday. They are low/no intervention, water birth, father-assisted birth, no IVs unless needed, VBACs (though I’ve never had a c-section), etc.

    I’m in heaven and feel SO MUCH BETTER. I actually feel like I could sleep tonight (I didn’t sleep at all last night from stressing out).

    • NursingBirth Says:

      Joy, I am SO PROUD of you! It takes a lot of courage to switch birth attendants late in your pregnancy! But I know you have been battling with this for awhile. I am so happy that you followed your heart and instincts! Good luck!!!!

      • Joy Says:

        Thank you!!! No seriously… thank YOU! And to all the other wonderful L&D nurses and midwives who have the guts to have blogs that help women get this information. If I hadn’t have found your blog and others I would probably be having a c-section in an OR in the next few weeks. You can read more details about my switch on my most recent blog post, too! Again, thank you!!! Your private email to me about delayed cord clamping (and the ridiculous claim my doctor made) has echoed in my heart and head for the past few weeks and I finally decided enough was ENOUGH!

  17. Kelly Says:

    I’m 32 weeks, expecting my second child, and working for a VBAC. I have hired a doula, and just completed 12 weeks of natural childbirth classes. I know my husband and I are much more prepared and educated this time around, and have a much better idea of what we want, and not just what we don’t want- and WHY. But having a doula is a MUST for me, I want someone else “in my corner”, “on my side”. My doula is not a stranger, I’ve been meeting with her regularly during my pregnancy, and even if a mom chooses to hire a doula late in pregnancy, there is still time to get to know each other before labor. Your partner and your doula can do wonderful things to HELP keep your hospital birth experience as private as possible. Perhaps the mom who isn’t hiring a doula for her first birth really does need to look at homebirth…? But I can’t help but agree with the doula who wrote originally- that she wants to help the mom’s FIRST birth experience be everything she wants it to be. OBs, midwives, and nurses all come and go during your hospital stay. You can not count on an OB/midwife/nurse to be with you constantly, to encourage you constantly. If that is what you expect of your hospital birth team- you should talk about it ahead of time, ask and make sure! It’s easy to assume so much, or be naive about so much with your first birth! And that’s normal! But when your hospital birth team is looking out for “your best interests”, their priorities might NOT be the same as yours. Your doula is looking out for you, and the priorities YOU have decided on, and with her experience can help you make the best decisions when your situation changes unexpectedly.
    In my opinion, anyone risked out of using midwives and forced to see an OB (due to VBAC, or other health issue) should absolutely consider a doula! A trained labor coach -DOULA- (or two, if your partner is also trained!) can make all the difference!

  18. […] Doulas talk about how they do or don’t invade on couple’s privacy during labor […]

  19. Kira Says:

    Hi there,
    Awesome website. I found it while I was searching the internet to answer the question “Do you poop when you give birth?” And…my question was answered. But I was also looking in to the internet regarding privacy as well, while a woman is giving birth. I know it is not a glamouros affair, but I think if a woman has more privacy, she feels more comfortable. I haven’t had a baby yet, but my partner and I are thinking about it, here….so soon it might happen. Well, my sister told me when she had her first child, she was actually feeling pretty good. I mean, she was having contractions and then after awhile she ended up getting an epidural because she wanted to rest. When she started to push, the only people in the room were her mother in law and our mother and the nurse. And my sister said she felt really good, and very peaceful. But then her baby pooped in her stomach ( I have no idea what they call that) and people started to barge in the room, and telling my sister “Come on you gotta push now!” And that is when my sister said she started to feel intense pain, and really didn’t want to push anymore, and also she didn’t understand why the room was filled with people. So, needles to say, my sister when she gets pregnant again, is looking into homebirth or going to a birthing center. Another, comment I wanted to make was in regards to my mother. My mother’s experience with having me and my sister were two very different experiences. All I have to say is my mom can HANDLE THE PAIN. So, my mom had me here in America, and she had my sister in Finland. She told us that here in America everyone and their mother’s, father’s and their grandkids were in the delivery room when she was delivering me. But when she had my sister in Finland all the people in the room was the midwife and nurse. Nobody else. So, my question is, can we request that we don’t have all these individuals coming and going into the room? Sorry so long.


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