Monday, September 15, 2008

Where is this all coming from?

Many of my recent posts were prompted by a thought process that Rixa started me on when she posted a blog about doulas making a difference in the birth outcomes of women. She expressed her reservations that doulas may unintentionally support the status quo in our maternity care system.

This is my response to her post, and what started me on thinking about what an "organized effort" to promote change in the maternity care system would look like.

On August 20, at 9:58 pm I wrote:
In the last few months, I've been having a crisis of faith in doulas which has kept me away from going through the certification process.

From a first time mom who then came into the birth community, I learned that doulas tend to represent themselves as advocates and spokespeople for laboring women. But then the same doulas turn around and change the definition of advocate into something that doesn't mean what is being heard when a pregnant couple hears "advocate."

I also know that I am one of those mothers who found a doula as a no confidence vote in the hosptial. And while I avoided the cesarean, my plan backfired when I experienced PTSD after being forced repeatedly to find my voice in order to speak up for myself like Jen said. I did that and it was like trying to stave off a freight train that was trying to barrel down on me. And Jen is right, it is the responsibility of DOULAS (not mothers!) to correct the misconception that they aren't there to be advocates or spokespeople.

In addition to all of that, I do believe that doulas are contributing to the status quo of what is happening to women during birth. I see them spending more time trying to make women "more educated" when all that ends up happening is that those women go into the situation that is stacked against them. Doulas should be mounting organized efforts against hospitals and maternity care providers that change the face of birth in hospitals so in time it will become what we know is the true face of birth is supposed to be.

I see the efforts to make those changes being kept separate from the work of doula-ing. I've heard doulas say "when I'm older, I'll take on the system but now I'm going to focus on the individual family." While I understand where they are coming from, I strongly think that most doulas have the responsibility to do both: care for their individual familes and take on the system. As they do that work, women will join them.

This is also a time to say that when I do see doula efforts to take on the system, it is very disjointed and in little pockets. While that is the way grassroots changes come about, its important to connect those pockets and getting them to work together. It is that organized effort that is needed now.

To see the posts I've written aspects of what an organized effort would look like go to:
Birth "Think-Tank"
Legal Rights to Informed Consent in Birth
Framing Birth As Public Health, Reproductive Rights Social Issue
Speaking of Frames

Stay tune as my vision and ideas coalesce themselves, and how the organizations that I volunteer for (The Coalition for Improving Maternity Services and Solace for Mothers) fit into that vision.

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