Inclusive

At one birth I attended over the weekend, I saw about five nurses, three OB-GYN doctors, and probably around 10 OB-GYN residents (i.e. Meredith Grey at the beginning of Grey’s Anatomy). It wasn’t until the end of the birth that something happened and I was FLOORED about how one resident did something totally tiny to include me as a part of the team. If you’ve ever been in a patient’s room in a hospital, you’ll see that there are these giant white boards that list information about the patient, any big medical concerns or preferences and the team caring for them. In labor rooms, there’s usually a spot for the support person and baby name as well.

Doulas Are Much More Present in Labor Rooms

Nurses typically update these religiously as things change or the care team switches over. I was never listed on this board- as a support person or a part of the care team. It didn’t really bother me, everyone was still very kind and new people would always introduce themselves.

But then, towards the end of the labor, one of the residents- meaning one of the doctors in training that typically does not update the board- went and added me to it as a member of the care team. And doulas truly are part of the care team, but that tiny act felt so significant to me.

It made me feel really hopeful for future OB-GYNs getting their training now. Doulas are much more present in the labor rooms than ever before and it makes me excited that we are being better integrated in the team.

Postpartum Essentials - a line art drawing of a baby being cradled with a parent's hand on their head with a very light pink background with peach water color circles and gold glitter accents

With this story fresh in my mind, I wanted to share a few other things that care teams in hospitals can do to help create welcoming environments to be supportive so we can all best serve our clients. 

1.  Include the doulas on the care team list! 

2.  Introduce yourself to the doula in the room and make sure anyone being supervised does as well. 

3.  Include doulas in the discussions. This is more of a process that is done through body language than anything else.

Doulas shouldn’t be the ones responding to questions/asking questions for the most part, but as a background advocate or helpful reminder of preferences the family has.

Keeping open body language to include the doula in the conversation is such a kind and simple way to be inclusive.

4.  Allow doulas in the room during epidurals. Some hospitals will only allow one support person in the room during epidurals. This means that sometimes doulas are asked to leave.

However, many times that epidurals are being given are during active labor when a laboring person not only needs support to get through contractions, but needs support to hold still through the contraction.

A doula can provide that support without compromising the procedure. Trust me, we’ve done this before. 

5.  Allow doulas in the operating room. Hospital policies vary on whether or not doulas are allowed in. Some allow it, and some don’t, but many don’t have a set policy and leave it up to the anesthesiologist.

This is a particularly hard policy for many reasons. If it’s a planned c-section, the parents might not know whether or not they should hire a doula if they don’t even know they’ll be let in the room. If it’s an unplanned c-section, then there must have been some complications leading up to that decision, a time when parents frequently need more emotional support. 

6.  Clear and accessible protocols. It would be so immensely helpful if I could look up policies hospitals have around different labor situations (ex: birthing in the tub, walking epidurals, etc.) on their website. In the large metro area where I live, there are so many hospitals and birth centers within my 20 mile range that I can attend births at. Frequently, I can rely on the information I have from the last time I was at that hospital, but if it’s a new hospital for me, or if I haven’t been there in a while, it would be great to be able to look up their policies. It helps me to best serve my clients, which is a benefit to the hospital as well. 

Hospitals Can Lead the Way in Supportive Care

I truly love being a doula for hospital births. I get to work with amazing doctors and nurses and see some incredible knowledge, tricks, and teaching of the next generation of doctors as well. I have had wonderful experiences in many of the hospital births.

I think it is wonderful that we come together to support a family to bring a life into the world and we are doing it in different ways, and it works beautifully. I think that these few suggestions can help with improving the environment and help us to all serve our families well. 

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