Scapegoats and Birth Teams

Dear Nurse -

"I don't like doulas. Just in case my actions didn't make it obvious enough, let me spell it out for you - 'your presence isn't welcome. You complicate my job and my relationship with the doctor."

I'm sorry that you have been bullied by the hospital contractors enough that you feel the need to treat doulas like that. I get it, I do. A doula's presence can sometimes make your job harder, no matter how hard we try to make it easier.

A doula's presence should allow you more freedom to focus on the details of your job - like charting, other rooms where women don't have additional support, and supporting mom in the medical aspect of her care. A doula should be able to focus her attention on physically and emotionally supporting mom during her labor, changing out linens, helping mom to the bathroom, helping her into different positions, cleaning up her messes, and getting her fluids and nourishment.

Sometimes, though, our presence can complicate your position. Sometimes, when we see a medical provider attempting to coerce mom into interventions or medications for the sake of the providers comfort, schedule, or personal bias, we might have to put on our advocacy and educator hats. This can place you between that proverbial rock and hard place.

Please remember though, we aren't the bad guys. Bad policies, medical advice for the doctor's best interests, and convenience sake are the culprits for the position that you are in. A doctor who bullies mom most likely also bullies nurse when nurse doesn't follow through with their orders - even if it is mom's refusal of those orders that made it so that you cannot fulfill those orders.

But let's call a spade a spade, shall we?
The provider wants you to do xyz to mom. Mom asks educated questions about xyz, and you repeat what you have been told to repeat; that it's 'necessary and non-negotiable'. I remind mom of her rights as a consumer and patient and offer, while attempting to include you in the conversation, other possible options.  
You update doc that mom has opted for abc and will be forgoing xyz. Doctor doesn't like this answer and puts the pressure on you to 'finish the job' that he wanted you to do in the first place. You are put in a hard place. It would've been so much easier if I wasn't there so that you could do xyz. 
Whose fault is this awkwardness really? Mom's for being a proactive partner in her own healthcare? Your's for not assaulting mom to complete what mom has refused? Mine for educating her so that she can have the best chance at achieving a birthing experience that is both safe and fulfilling? Or the provider's for attempting to manipulate both you and the mother?

Your anger and frustration is misplaced. I get it, it's hard to properly place blame when the blame rests on someone who can make or break your career. But to remain silent when you're being mistreated by your superiors is simply enabling them to continue mistreating you. And displacing that blame onto my shoulders only perpetuates the cycle of mistreatment. In essence, doulas become the scapegoat for your dissatisfaction for the way you are treated by your boss.

Did you know that a doula would be happy to back you up if you were to report a provider for mistreatment? Did you know that a mom would have your back in an instant if you had hers? And did you know that, if we began to demand more ethical treatment on all levels of healthcare, and worked together instead of offering up scapegoats for sacrifice, we could really make a difference?

So make your statement earlier or a little more honest and a little less enabling... "Cole, your presence complicates things. I was taking it out on you earlier because it's difficult to stand up to this doctor. Having an educated patient with a solid support team that advocates for her options ticks this doctor off... and he takes it out on me."

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