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In a now viral story, the International Caesarean Awareness Network (ICAN) in Huntsville, AL and Exposing the Silence announced that an OB / GYN in Huntsville, AL will no longer allow women to have doulas at birth .
People are outraged and rightly so.
Doulas are trained professionals who are hired to provide support to women and families during pregnancy, childbirth and the postpartum period.
According to this picture, the new policy of Dr. Edith Aguayo, Obstetrics and Gynecology for all women, states the following:
"Please, report to us if you are engaging a doula during your pregnancy, because Dr. Aguayo has decided not to collaborate with doulas or other lay support." We hope that this strengthens the relationship between your doctor, your hospital care team and yourself. Please, do not hesitate to discuss any questions or concerns at your appointment. "
Motherly contacted the office but they declined to comment on this article.
But the question goes far beyond this office. For starters, this policy does not take into account factual research that overwhelmingly demonstrates the impact of doulas. Women with doulas have shorter jobs, with fewer interventions (including fewer cesareans) and are more satisfied with their experience at birth.
Doulas can also play a key role in improving the disproportionate rates of maternal morbidity and mortality among black women in the United States.
The American College of Obstetricians and Gynecologists (ACOG) is supportive of the use of doulas and writes in a 2018 position statement that "evidence suggests that in addition to regular nursing care, individual and ongoing emotional support provided by support staff, such as doula, are associated with better outcomes for working women. "
And, this new policy does not seem to reflect that of the Crestwood Medical Center, the hospital where Dr. Aguayo attends childbirth. According to their website, the doulas are welcome. "Share your birth plan with us If you have specific requests or opinions about your care, we'll be happy to help you get things done." The Crestwood Medical Center Maternity Center also welcomes coaches and doulas. "
All of these factors make it difficult to understand the reasoning behind Mr. Aguayo's decision.
But it is not really my intention to reprimand this obstetrician or her cabinet for this decision. Negative critics are flocking. They know that people are angry, and I'm sure the Crestwood Medical Center is too. Women for whom this policy does not work will transfer their care if they are able, and the doctor and the hospital can make a commercial decision as to whether this policy is worth it.
My concern is about the culture that brought us here.
The culture of birth in this country sends continually to women the message that they are not responsible for their birth, that birth belongs in some way to caregivers or hospitals and not to women.
We need permission for our desired support team to be present.
That we must tolerate abuse during work.
We must not trust our self – knowledge and our intuition because, obviously, someone else knows what is best for our body.
This is evident in the way small policies like this are sneaking in, and blatantly in the way that there are huge disparities in maternal outcomes.
So, although I am not interested in addressing this particular practice, I am very interested in addressing the people who are giving birth. If it's you, here's what I want you to know:
Attending your birth is a privilege and an honor. There is this moment just before the birth of a baby (though a baby is born), that everything is always happening with the muffled anticipation of a world about to change. It's such a powerful moment that it can not be described, but only felt – and mom, you are at the heart of its power. Being in your presence right now is a gift, and I'm sorry if you've ever felt the opposite.
Please, know that this is your body, your baby and your birth. Nobody can ever take it off. Listen to your health care team because their job is to protect you. But listen to yourself too. Your intuition is so wise. If that tells you that you need a doula, find a provider who welcomes them. If this tells you that something is wrong, hold down the call button until someone is paying attention.
You own your birth. Please no less than the world tells you the opposite.
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