Are Doulas and Childbirth Educators Invalidated in Rochester, NY?

by consciousmidwifery | April 21, 2008 at 08:55 am

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       Are Doulas and Childbirth Educators Invalidated In Rochester, New York?
What happens when a trained independent doula or childbirth educator is invalidated? To
understand why this is happening we need to understand what doulas and childbirth educators offer
their communities as well as define invalidation.
        Doulas are trained a variety of ways, their training is ethical, with no known associated risks for
the childbearing family who utilizes their services. Doulas are the closest thing pregnant and laboring
women get in the 21st century aside from a good midwife, to ethical, compassionate care. Focused attention on the laboring women and her partner/family during childbirth is what we are trained to provide. Well worth the average fee, doulas pamper, promote normalcy, provide advocacy, support, and provide technical knowledge. If women wish to avoid cesareans, wish to birth after a cesarean, wish to maintain dignity during birth, and truly desire birth to be celebrated, a doula is the way to go.
       Doulas are independent contractors, not affiliated with any one hospital. Training is specialized to
support normal, safe birth. Additionally, some doulas participate in Advanced Doula Training such as
www.womenofservice.org. Along with doula services, Rochester has several trained childbirth educators who practice independent of hospital settings. If families want full information, with completeness about normal birth, along with education about what can go wrong during birth, in addition to learning ways to avoid assembly line birthing, the judicious choice is an independent educator, doulas at birth, and continuing education for families. These three vitally important ingredients, mixed together combine to provide Rochester women with tools and resources necessary to look forward to an optimal birth outcome. Everyone wants an optimal outcome, which is a healthy mother, healthy newborn, and a positive birthing experience.
       Currently, there are rumors of several area obstetrical practices participating in restraint of trade by suggesting they will ditch clients if they choose childbirth education outside the hospital setting. Area obstetricians are often-times disrespectful of, belittling of, and verbally abusive toward patients who wish to hire doulas or other care providers. This is invalidation, and no care provider should be
promoting the spread of invalidation for women in our communities. One is forced to ask why this
occurs in such a progressive society.
       In the book “Nasty People” the author states “Invalidation is a general term...to describe one
person injuring or trying to injure another”. He goes on to state “Destroying a person's capability to be
happy for a whole lifetime is probably worse than any physical damage one person can do to another”.
This is happening in Rochester, NY. For many women, feelings of isolation, abandonement, and
invalidation contribute for years to post partum depression. Remorse and shock, along with massive
denial, has paralyzed countless women over the course of their mothering years which should be met
with energy, joy and strength. I have personally witnessed one obstetrician demean his client and her doula during the pushing stage of her labor by yelling at her for giving birth on her hands and knees. Striding into the room in his white coat, in the middle of a contraction was the bellow “What the hell is going on in here?” As if this particular doctor had never seen normal birth, or caught a baby in this position. The particular individual made it all about him, not the family waiting to embrace a new soul. I have seen an obstetrician refuse to do a procedure that would encourage normal delivery in favor of a surgical delivery that in all probability was not medically justified. I have seen obstetricians roll their eyes at birth plans, doulas, and midwives. Invalidation comes in many forms, it comes by way of belittling a woman's hopes and celebration for her unique birthing process, it can be from a superior and angry tone an MD takes when a women in labor asks valid questions about any one provider's
recommendations, it can come in the form of control, verbal assaults, by suggesting they are
trustworthy and collegial only to find out the person in whom you placed your trust is out to destroy
your self-esteem, birth plans, even the most strong of us can be reduced to tears when someone is
engaged in invalidating behavior.
       Exposing invalidation seems to be one way to wake up our community to this subtle form of abuse. This invalidation has more than once, injured and damaged women emotionally and mentally while giving birth. The business matters of birth have become rigid and inflexible instead of focused on
serving women in our community with warmth and generosity. Unfortunately, hospitals that suggest
they have homelike centers called birthing centers within the hospital itself, do not promote normal
birth, but frequently promote pain relief that is un-asked for, wearing a laboring mother down when she is at her most vulnerable rather than using ethical doula services which research shows reduces the need for epidural or other pain relief measures. The bottom line ought to be, service to women during their childbearing years with respect and never to serve any one care provider's purposes other than optimal outcomes in childbirth. Women giving birth are not machines to be managed, or library books when it comes to due dates. To reach optimal care in our city, women need liberation - options.
As a doula, I don't want to waste my time dealing with absurd opposition to the type of care I
provide because a physician in a place of power feels invalidated due to self-esteem issues. Doulas are adaptable on hospital turf, but can doctors adapt to patients who want this type of care in collegial
collaboration? Right now, its marginal at best.
       One office practice is telling their patients they won't work with them if they choose independent
childbirth classes. There is no law against educating one's self via independent classes outside of any
given hospital. It seems to be restraint of trade more than anything else. Restraint of trade, is defined as "Contracts or combinations that tend to, or are designed, to eliminate or stifle competition, create
monopoly of artificially maintain prices, or otherwise hamper or obstruct the course of trade as it
would be carried on if it were left to the control of natural economic forces” .

This means if a women wants a natural birth, or wishes in depth education and chooses a care provider, or course of childbirth education that is not aligned with her current provider's choice of education, the provider is attempting to control how she receives her education and how possibly, she will birth. What can citizen's do? Research doulas, and types of childbirth classes locally. Get educated, read the research and remind yourself that it is your body, and you need to understand the options available. It is never too late to change care providers, and according to one blogger, when your physician says “ “trust me” remind them that trust must be earned, it is not an inherent right derived simply from their title”.
Another long term solution to avoiding invalidation of normal birth, are grants and funding for area hospitals to implement full up hospital doula programs hiring community doulas for shift work, who would be available 24/7 for women who request this option. Doulas must be compensated adequately for the long hours of care they give. Hospital doulas like being on call, and taking 24 hour call three times a week is not unheard of. This solution is certainly one in which the community could truly observe the 'wisdom of Solomon' at work. People will be drawn to hospitals with this kind of care, they will have satisfied women and families, because we work hard to promote positive outcomes and memories, fulfilled families walk away wanting to come back for health related reasons and to birth again, but only when their physical, emotional, and mental health are validated by the entire birthing team and patients have flexible options.

Conscious Midwife