I was recently given an idea for a great topic on introducing the idea of Doula what their role is during birth. For years as a labor and delivery nurse, I cringed when I seen Doulas come in with patients. In many of the hospitals, I worked in it was an ongoing joke to call a birth plan, a “written c-section plan”. We criticized Doulas and felt like they just got in our way. I am not saying that all nurses are this way, but I was taught these biases for many years. I was trained that we do what the doctors ordered, and everything I did I honestly thought was what was best for my patient. I am a highly-skilled labor nurse, when it comes to interpreting fetal monitoring, placing internal monitors, knowing different medication and so much more in the hospital birthing world. I was and still am very proud of my skills, and I believe that there are times when these medical skills have saved the lives of mothers and babies.
In recent years though I began to study physiologic birth and how amazing the women’s body actually is. Those women I thought were crazy for wanting a low intervention unmedicated birth, actually had something quite amazing, they had a strength and a belief that has become a thing of the past. They understood their body’s true abilities. As I have researched and began to understand the process of labor and understood the female body, I realized that many of the interventions were unnecessary and many times may have been the leading cause of many unnecessary interventions, and unplanned or emergency c-sections. This caused me to rethink my ideas about unmedicated, natural low intervention childbirth, and how Doulas fit into helping achieve this.
As labor nurses, we are not able to be at a patient’s side continuously providing support and comfort. Many of us were not taught comfort measure techniques or upright birthing positions. For many years I thought women had to deliver on her back, or I had to monitor fetal heart tones continuously to make sure the baby was doing ok.
I believe that in order for nurses and Doulas to come together more nurses need to be taught about physiologic birth and understand, that it really isn’t crazy, it is a beautiful thing and a very safe and natural process. And Doulas need to understand that labor nurses that are pushy about following doctors’ orders are not evil spawns trying to sabotage a women’s birth, we truly believe that we are doing what is best for our patients because that is the way we were trained.
I am in a Facebook group called “Labor and Delivery nurses rock” and I am very pleased to find that many nurses are talking about different methods to assist women to have a successful vaginal delivery, and many of them are asking for ideas and ways to support and advocate for their patients. We still have a long way to go in the birthing world, but I am very pleased to see some local hospitals taking initiatives to teach their nurse about comfort measures and physiologic birth. Mercy hospital in St. Louis recently paid for 20 of their nurses to attend an Evidence Based Birth Workshop called “Comfort Measures for Labor and Delivery Nurses”. I was so overjoyed to see how these nurses were eager to learn, and shared so many stories with me.
So, I think we are headed in the right direction, I think we just need to come together and talk to each as nurses and Doulas and practitioners and see how we can support and understand each other.