Sunday, February 22, 2009

A Doula's Reflection

(picture not from actual birth)

My client gave birth to an early, but healthy little girl at 6:30 am on Saturday morning. Every birth has been so different for me, and I relish in every raw emotional moment. They called me Friday evening to say that her water had broken. My personal stopwatch began, because I knew that this baby would be born one way or another 24 hours from now. Even though my client wanted to stay at home longer, the hospital insisted she come in right away. I drove to the hospital lost in thought, predicting all the possible scenarios. My clients were already upset because of the on-call doctor's attitude on the phone. I knew their emotions would be high, and there were many different ways a birth could unfold with a less than cooperative doctor.

When I got there, the doctor was finishing up her review of medical information when she told my client she would have six hours to progress before she would "suggest" Pitocin augmentation. My client looked at me with fearful eyes because it was not the path she wished for her birth. The doctor felt aggravated by her look so she repeated the six hours and left the room while slamming the door. The nurse and I comforted the now crying mother-to-be, reminding her that she had six hours, and not to worry until then.

Her labor got stronger, and with only a half hour until the "six hour mark," she made the progress they were looking for. My client and her baby had worked together to make the birth their own. Not much longer after that she was ready to push. A first time mom just breezed through active labor in only two hours! She was strong, and determined to work through every contraction, letting her daughter come out on her own, and in her own time. Then the birth...and the return of the doctor. While she was no longer slamming doors, she clearly had the "tough doctor" persona down pat. She commanded that the room understand that she was the one in charge. As the nurse said "she is not the hand-holder" type.

After speaking with my client it was clear that she was thoroughly ecstatic with her new bundle of joy, and the way she made it through labor and birth unmedicated, but her story still remained slightly tainted to her. The doctor's lack of all nurturing ability left my client feeling let down, because she was not happy with the one who was fortunate enough to physically bring her baby into the world. She was even more thankful that I was there, and that she had a supportive nurse, but personal violations still resonated. I feel terrible for any woman to have her birth story tainted in such a way. I am sad that while this doctor may have been an excellent physician, she misses the mark on what a laboring woman needs most. The doctor even gave her an episiotomy without her permission, not even saying she was getting ready to do it. While I have seen this before, I have never had a client truly believe in her heart that it was done "out of spite". I doubt the doctor did it out of spite, but it truly hurts my soul that my client believes she did.

I am not the first, and will not be the last person who will point out the deficiencies in hospital care. I agree that hospitals are necessary and imperative when complications arise with a birth, but it doesn't mean the quality of service should resemble swiss cheese. As a keeper of the birth memories, I will try and make sure that my client only remembers her amazing hard work, the support of her husband, and her beautiful little girl. Nobody deserves to have their birth memories tarnished by someone that is not truly invested in the emotional well being of the mother.

No comments: