Tuesday, July 17, 2012

in defense of doulas

I have a lot of hopes and dreams for this birth, the biggest of which (aside from a healthy baby) is that I am satisfied with the provision of my care and my experience afterwards. My wishes for pain management or intervention or how we'll cook the placenta can be disregarded. I simply want to experience my labor and birth presently and have no regrets (or PTSD) afterwards. So, we hired a doula.

A lot of people may not know what a doula is (a professional, non-clinical birth attendant, typically a female, who provides emotional and physical support during labor and delivery), but a lot of people have questioned our decision to hire one for this birth. Frequently people have interjected on Mitch's behalf, suggesting that I'm attempting to replace him by hiring an anti-establishment she-warrior who would gladly lop of the arm of any health professional who dares approach with a needle or scalpel. This is not so.

First, this was a decision we arrived at after what I recall to be a pretty brief discussion. We both acknowledged that this was a new and exciting experience, but that we really had no idea what we were doing or what to expect. We both hope for an optimal start for our baby, and we realized that within our existing healthcare system, it might be difficult to receive the continuity of care we desired. Doulas fill in these gaps.

Second, Mitch chose our doula. We interviewed several, and he fell in love with a two-woman doula team, one of whom will attend our birth. After all, he's still going to be doing most of the support work, and he wanted to choose someone who complemented him well and made him feel confident in his ability to support me during labor. Their job is not to replace him, but to support him as he supports me. If you hire a good doula, she'll know this and act accordingly.

Third, doulas (good ones) leave their own preconceptions about birth at the door. If I want an epidural, she will support me through that. If I demand that someone rip this baby out of me with forceps, she is supposed to hold my hand and tell me what a good job I'm doing. If I decide that I want my baby to be born to the song "Lady" by Styx, she will be standing by the iPod speakers ready to push play. Although there are some doulas who refuse to care for women with certain intentions (I know one who wouldn't take clients who intended to circumcize their baby boys), most are accepting of all women and their desires for labor and delivery.

Lastly, with all the benefits associated with doula care (i.e. shorter labor, reduced oxytocin use, reduced C-section rates, reduced episiotomy rates, increased breastfeeding initiation and duration, decreased postpartum depression, etc.), why the hell wouldn't we want one? No seriously, I'd love to know.

I can give you citations if you like; I happen to be writing my thesis on the matter, but really it should suffice to say that this is something that we both decided, and Mitch doesn't need anyone to defend his honor. I know I'm scary, but he's quite capable of telling me what he wants or doesn't want. Plus, he tells me I've been a box of kittens this whole pregnancy.

Also for your viewing pleasure, my most favorite interpretation of this song on one of my most favorite shows of all time, Freaks and Geeks. You can chew the awkwardness it's so thick. Thank you Jason Segel.

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