Controversial. It is even more controversial when the Spanish Penal Code bans intrusiveness in the regulated professions.
Doulas, which might not ring your bell, is the new self-called profession which is raising so much debate about their competences and duties.
Canibalism, nursing intrusiveness, familiar apartheid, doctors' demonization, risky health behaviours for the mother... It is not the description of a horror serial movie, it is the description made by the Spanish Nursing College Organization referring to the Doulas' work.
First of all let's be fair and let them explain themselves. What does appear on the website of some random Doulas? They claim what it follows: "We Doulas, are women, mainly mothers, that accompany other women in their path to maternity. Our main duty is to give support, either physic or emotional, during pregnancy, birth and puerperium".
Doesn't it sound great? Wait, you need to check what's going next. They want to prevent the frustations of births that weren't as succesful as pregnants expected like "mistreatment for the usage of aggresive practices on the mother or on the baby" or "guilty feelings in caesaria or other interventions cases".
What do they want to prevent? The use of a caesarea in a risky birth? The use of episiotomy if it is mandatory? Are they professionally acredited for stating something like this regarding that they lack any kind of study?
The report on Doulas issued by the Spanish Nursing College Organization is pretty clear. Their activities surpass the competences which are exclusive to midwives, endangering mother's and babies' lives.
The College Organization state that some of them promote canibalism by advicing the mother to cook and eath their own placenta, ban the presence of the father in the delivery room, prevent the mothers to check their pregnancy status by not attending the gynaecologist... And some more aberrations.
The truth is that their activities are not taught by any college or institute, it is not regulated either at a state or european level. It is just their beliefs and pure ignorance which lead mothers to believe their words and take up risky habits which endanger their pregnancy.
So I would like to know what's the opinion of my dear medical students fellows. Do you think these activities are intruding the nursing and medical profession? Do you think this activity should be banned by the authorities? Do you think this endangers the mothers' and babies' lives?
Let the debate begin!
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Thank you, Jordi for bring us this interesting issue which appears many times in all the national media.
ReplyDeleteFirst, I would like to say that I'm agree with the opinion of the Spanish Nursing College Organization about this topic. I think Doulas can be more dangerous than beneficial just because they assume a role for which they haven't been formed.
The mother which takes on a Doula, trusts her for everything concerning the pregnancy, delivery and puerperium. Sometimes, the birth goes well, and doesn't last too long, but other times could last too long or even appear complications that need a real doctor which has been specialised in obstetrics. We are talking about health and lives, and I believe there are not reason to let our lives or our children's lives in the Doulas hands because of these risky situations that come with the delivery.
In the other hand, in my opinion, if the Doulas only provide physical or emotional support and do not interfere with the medical aspect of delivery, take on a Doulas will be a good option but only as a complement, not as a substitute.
In conclusion, a beneficial solution for everyone could be regulate these practices and if anyone notices that a Doula "crosses the line", he or she should inform to the authorities in order to take the convenient actions regarding those situations that had endangered mother and child.
Hi Jordi!
ReplyDeleteYes, I think that Doulas are a huge danger to pregnant women. There are many risks that can occurr during a labour and it is very important to have knowledge and materials to save the situation. Of course that they should be banned, it's very important to preserve women and babies' health and if we let Doulas continue with their activity, maternal mortality could grow more and more.
Hey Jordi!
ReplyDeleteWell, about your questions, I think that Doulas' activities are intruding in nursing and medical profession because they try to take part in some of the work of nursing and medicine without any knowledge. This brings many risks to the baby and mother's live.
On the other hand I think that doctors and nurses have no time to give support to the pregnants, especially on the emotional suport area. So for this part, I think that they do a good work/job if they don't take part on the pregnant's decisions.
Interesting choice for debate. Nowadays we see that more and more people are trying to pursue alternative paths whether it’s because it’s healthier or safer (or at least they think so!).
ReplyDeleteThe truth is that, in the case of childbirth, I believe parents lost trust in hospitals and the medical system. Like the case of vaccination, people take the bad news and bad experiences and take them as the truth or as the rule of what generally happens. So, they take the alternative option of believing someone who claims that will stay by their side at all moments, turning it into a more personalized experience.
I agree with Cristina when she says that this kind of activity should be regulated and watched closely. I don’t believe that ignoring or forbidding it is the answer, because the danger for both mother and child are real and higher than people may think.
In conclusion, I think doulas may offer a more personalized care for the moms to be, but without ever trespassing the technical work of doctors and nurses.
I have never heard about these women!
ReplyDeleteFirst of all, I don't think this should be called a profession because a profession needs extensive training and specific knowledge. I will call it an occupation.
Since I read this post I wanted to know a bit more about Doulas and I searched for some webpages on the Internet. The idea is not that bad: a doula could be a friend who has already been pregnant and can support you and give advice in anything about the process. I have read their "Ethical Code" which explains, among other points, that:
- They are not medical personnel, so: they do not diagnose, do not recommend any treatment or drug, do not attend any labor and do not perform an examination. They cannot slow down the doctors' and nurses' work.
Reading this I want to believe that they will always be faithful to their "Ethical Code" and never intrude in the medical assistance. In addition, they could help reducing the number of consultations for irrelevant or not-so-important issues that may overload the medical aid.
I do not think they should be banned but their activity should be controlled and regulated. And I also think that they do not endanger the mothers' and babies' lives. Women are free to choose where do they get their assistance and even today some of them don't want to go to the doctor and have their childbirth as natural as possible. However, I strongly recommend to pay attention to the gynaecologist advices!
Thanks for bringing us this interesting topic, Jordi!
Throughout history there have always been midwives and these had no training. However there have been many advances in medicine and this has improved labor conditions and health of the mother and the baby.
ReplyDeleteI understand that there are people who want a natural childbirth as much as possible, but always under the supervision of a professional. Throughout pregnancy there may be a variety of complications so you always have to have a medical traking. Do not go to the gynecologist can have serious consequences that could have been solved easily by doctors. During pregnancy must be controlled constants of the mother to prevent any problem that without this control could have serious consequences.
At the time of delivery I think that the best place is the hospital. It is true that it is not the most beautiful place in the world and it sounds much better to have the baby in the comfort of a house. However, although one of the justifications they give is that childbirth is a natural process that has been done over a lifetime, can cause many problems during this. Today is very rare for a woman to die during childbirth and this is thanks to the progress that has occurred in medicine.
In my opinion the doulas should not be the only person responsable during the pregnancy and the childbirth of a woman and even less knowing that they are person who does not have the necessary training to act faced with any complications. I think that they could be a good support during pregnancy but they should have prohibited to deny the medical assistance.
First at all, I would like to say that it is a very controversial issue and I think that everyone can freely decide what to do. I would like to thanks Jordi for start this interesting debate and give us the opportunity to think about this problem.
ReplyDeleteIn my opinion, each job requires a previous training and in this point I agree with the Spanish Nursing College Organization . Midwives are prepared to assist pregnant women during pregnancy and labour, they know what kind of problems can appear and how to face them.
However, Doulas practice a job for which they aren’t trained. So, I strongly believe if Doulas expect to replace nurses’ work, we would be talking about intrusion. Nevertheless, I agree with the idea of giving emotional support to pregnant women. During pregnancy, labour and puerperium many women feel sad and alone, so in this point the task of Doulas can be very useful and important. Moreover, first-time parents are confused and they need someone who help them to take care of the baby.
I think that the practice of a profession by an unauthorized person must be banned. So for me, the best solution is to regulateDoulas’s activities. They would be punishif they interfere into doctors and nurses’ work, but they can have an important role giving support and teaching first-time parents.
I completely agree with all of you on the formation issue. They cannot at any cost interfere with the medical or nursing practice because it could endanger their health.
ReplyDeleteIf it was only physical or emotional support there would not be any problem, as Gemma, Cristina or Adela said, but as it is not controlled by the Administration or any college it arises serious debates about their real duties behind the houses' walls.
As Gemma, Carlota, Margarita and Adela said, Doulas should be carefully watched and then, demonstrate if their work intrudes the nursing or medical profession.
Margarita, I understand that there is some kind of mistrust on the hospitals when things don't go as good as expected, but this cannot force them to take dangerous paths which lead nowhere.
About your opinion Adrià, that is the key of the matter. The problem is that they don't have a collectively accepted etichal code. It's just a random text written by a random Doula. If this lines are violated by any of those women, nothing happens. Also, referring to reducing the consultations for irrelevant issues, I don't think they are the ones to determine that issue, if the pregnant thinks it is important enough to consultate, they must attend the doctor. Doulas are not qualified to do so. Women are free to choose wherever they want to have birth, but always with the presence of a midwife as Isabel supported on her opinion.
I strongly support your point of view Isabel, hospitals are the safest environment in which a woman can have her delivery. It is for this matter that the childbirth mortality rate has gone down so drastically for the last decades in Occident.
I think that we all agree on the essential: determining whether this occupation is intruding other's professions or not and regulating it properly to assist pregnants in the emotional field.
It has been a great debate with you my dear folks, I appreciate every word you dropped here. If you are interested on more insighful research, contact me because we could talk about this more deeply and, why not, taking a step forward in this field in our Health Science's Campus of the University of Lleida.