Hello everyone!
So recently I've been hearing about a very controversial doula organization called ProDoula. Now, as we all know, a doula is a woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born. Anyone can be a doula, however, traditional the women who become doula are very passionate about childbirth, birth/social justice, quality maternity care, and the right to choose. The whole point of a doula is to take modern maternity care and progressively move it forward towards decreased unnecessary medical cost, decreased unnecessary medical intervention, decreased cesarean rate, increased physiological births, increased satisfaction in childbirth, empowerment in birth experiences and confidence in the female body. Although ProDoula is training more women to be doulas so that there are more doulas in this country, they are missing two major key points about doula work: Accessibility and Affordability.
Lately there has been some debate on what a doula should charge as her fee for service. Personally, as a doula-in-training, even I have trouble setting even the smallest fee for myself because I know not a lot of people can afford many things. As a result, I just volunteer my time so that I can provide services to a large range of people, from the under-privileged to the wealthiest, because I believe that every woman deserves a doula no matter the circumstances. The doula profession does tend to be undervalued because, to be quite honest, you can't put a price on a special moment like childbirth. I feel like being a doula is all about making sure women are taken care of, they are happy, safe, more educated and empowered, and that should come from the heart. Yeah, a little money wouldn't hurt, I mean, you and your family got to eat right? However, if you want to be a doula, you have to understand that it is a very critical profession. You're at a very special time when you're with an expecting mom, so you need to be very passionate about it because it can be very taxing, physically and emotionally. I do not think it's the type of profession you go into as a way to "get rich" or make like $100K a year, so to make it about money and business instead of love and care is very insensitive. We're in a healthcare crisis where many people can't get access to care, let alone good quality care, as it is. Having a doula is a way to combat the accessibility and affordability issue we have in our healthcare system.
Of course, on the other hand there really isn't anything wrong with setting a fee so you can cover your costs from providing your services. You can make some pretty decent money here and there if you're really good at what you do. I think I just have a problem with making it all about the money. It's bad enough that the pharmaceutical companies and the insurances companies are making health care all about money instead of fundamental human rights. I know our country was built on capitalism, making it on your own, creating wealth on your own - it is very individualistic - and that is fine I guess. Everyone should try their hardest to progress and make something out of themselves, but just not at the cost of their health. Health should never be at the betting table or jeopardized for any reason. It's not some luxurious commodity.
ProDoula is treating doula work as a luxurious service that can only accommodate the women who can afford it. They do not believe that all women deserves a doula. Their logic behind all of this? Well, Randy Patterson, founder of ProDoula, was sick of working long hours as a doula basically for free while struggling to provide for her family. She did not think that it was a logical profession to have when you have a family to provide for and take care of. She loves doula work but it couldn't be a full time career unless she made good money out of it, so she did. Now, that is somewhat understandable. As a doula, you have to work crazy long hours (24+ if a woman is taking forever to give birth) and if you have a family, you have to seriously consider childcare, how to afford childcare, and how to provide for your family. Again, it is a very taxing job. It's a very noble and honorable job but very hard, so I get it. However, to say that not all women deserve doulas, that doulas are a luxurious service, and to be aggressive and competitive about fees for services is outrageous. It is disrupting the whole birth world and everything we are trying to do for women!!
Honestly, it's hard. If you really love this profession, you do not want to do anything else and you need to provide for yourself and/or your family, then yeah make a business out of it! It really is possible to do. Just make sure it is still coming from the heart. Don't follow the same philosophies that drive ProDoula's business. Our individualistic and capitalist culture is already ruining our health care system, don't let it ruin something as beautiful as childbirth. It's just not humane. Also, it's okay if it's not your main profession. You can just do it on the side because you love helping pregnant women and love witnessing the only miracle in life that happens every day. That is possible to. It can be very fulfilling. Personally, I am okay with having a separate career and doula'ing on the side for just some extra money. It's fun, I am happy and my clients are happy. That's all I need in life.
Check out the article on Buzzfeed about ProDoula and how it's ruining the birth world!
https://www.buzzfeed.com/katiejmbaker/doula-drama?utm_term=.camJMPB7K#.wcN54VvPd
Stay Strong, Stay Beautiful, Stay Empowered
Love,
Rosely
Wednesday, April 12, 2017
Sunday, April 2, 2017
Maternity care, Politics, and Science...
Hey everyone!
So, so far Pushed has been very mind broadening. For the most part, it has made me question everything about our health care and how competent the professionals in high-level positions really are.
By popular belief, doctors and officials are to be trusted. We hold them to the highest regard. And yet, they are the ones that are doing the most harm to us.
I believe in science, more than anything, so to hear of stories of the ACOG, scientists, and doctors conducting and believing in research studies that are not valid, reliable or safe is catastrophic. Scientists and doctors -- two professionals that uphold the principles of science; they are who they are because of empirically-evident, scientific truth. There is no arguing with science if it is done right; unbiased and with attention to detail.
What struck me the most was the Toronto epidemiologist Mary Hannah, MD -- A woman -- who led a randomized controlled trial on which birthing procedure was best for breech babies; vaginal birth or cesarean. Strike 1, unethical. Although randomized controlled experiments are the best way to have unbiased, valid and reliable result, jeopardizing the life of a mother and her child unnecessarily off of a flip of a coin is beyond unethical. Strike 2, the way the experiment was conducted was not entirely accurate or truthful. There was an unfair comparison between vaginal birth and cesarean. In this case, the vaginal births were not physiologically natural. They were monitored and very heavily managed. With the outcomes that Dr. Hannah had, of course it's true that a vaginal birth of a breeched baby is unsafe. None of the physicians were trained to safely handle a vaginal birth of a breeched baby. The way the results were framed, Dr. Hannah made it seem like cesarean births were better and safer than vaginal births, but cesareans have other complications that are not natural and cause greater harm in the long-run than vaginal births. But, of course the ACOG did not care. They ran with the results and made every woman go through major abdominal surgery without giving it a second glance. People questioned the validity and the structure of the study, they fought against it, they demanded a withdrawal of the study and demanded a better study that accurately represented childbirth. However, what did Dr. Hannah have to say about criticism? "The results of the study are the results, you don't withdraw them because somebody doesn't like them." Now, with that mindset, wouldn't you believe that the results of a better conducted observational study would be considered just as significant and valid? Apparently, according to the obstetric community, the answer is no. A physician recommended a redo of the study by making the study observational instead of a randomized controlled study. I believe this is a better choice because it is ethical and it gives an accurate representation of what generally happens in childbirth without altering it. The ACOG ignored it; deemed it inefficient. Another observational study was conducted by midwives Johnson and Betty-Anne Daviss about low-risk women planing midwife-attended home births in the US and Canada. The research showed that physiological births are safe and women are capable of having them with little to no intervention. Still, the obstetric community gave it no attention. So, by Dr. Hannah's ideology shouldn't the ACOG acknowledge the results and respect supporting evidence? I guess it's only okay to disregard results when it's convenient to officials in power. True science doesn't matter to them if it doesn't fit their beliefs. This just proves that the ACOG is biased. That is just disgraceful. You can't go above basic scientific evidence. Strike 3.
I am a firm believer in science. No matter what, observational and randomized controlled studies are both valid. I don't understand why in this case, observational research is "inefficient" when observational studies are used all the time, like in animal behavior research. That is just as valid as anything else.
How reliable is our healthcare if they are more tangled up in bureaucracy than in science?
That question will always haunt me....
So, so far Pushed has been very mind broadening. For the most part, it has made me question everything about our health care and how competent the professionals in high-level positions really are.
By popular belief, doctors and officials are to be trusted. We hold them to the highest regard. And yet, they are the ones that are doing the most harm to us.
I believe in science, more than anything, so to hear of stories of the ACOG, scientists, and doctors conducting and believing in research studies that are not valid, reliable or safe is catastrophic. Scientists and doctors -- two professionals that uphold the principles of science; they are who they are because of empirically-evident, scientific truth. There is no arguing with science if it is done right; unbiased and with attention to detail.
What struck me the most was the Toronto epidemiologist Mary Hannah, MD -- A woman -- who led a randomized controlled trial on which birthing procedure was best for breech babies; vaginal birth or cesarean. Strike 1, unethical. Although randomized controlled experiments are the best way to have unbiased, valid and reliable result, jeopardizing the life of a mother and her child unnecessarily off of a flip of a coin is beyond unethical. Strike 2, the way the experiment was conducted was not entirely accurate or truthful. There was an unfair comparison between vaginal birth and cesarean. In this case, the vaginal births were not physiologically natural. They were monitored and very heavily managed. With the outcomes that Dr. Hannah had, of course it's true that a vaginal birth of a breeched baby is unsafe. None of the physicians were trained to safely handle a vaginal birth of a breeched baby. The way the results were framed, Dr. Hannah made it seem like cesarean births were better and safer than vaginal births, but cesareans have other complications that are not natural and cause greater harm in the long-run than vaginal births. But, of course the ACOG did not care. They ran with the results and made every woman go through major abdominal surgery without giving it a second glance. People questioned the validity and the structure of the study, they fought against it, they demanded a withdrawal of the study and demanded a better study that accurately represented childbirth. However, what did Dr. Hannah have to say about criticism? "The results of the study are the results, you don't withdraw them because somebody doesn't like them." Now, with that mindset, wouldn't you believe that the results of a better conducted observational study would be considered just as significant and valid? Apparently, according to the obstetric community, the answer is no. A physician recommended a redo of the study by making the study observational instead of a randomized controlled study. I believe this is a better choice because it is ethical and it gives an accurate representation of what generally happens in childbirth without altering it. The ACOG ignored it; deemed it inefficient. Another observational study was conducted by midwives Johnson and Betty-Anne Daviss about low-risk women planing midwife-attended home births in the US and Canada. The research showed that physiological births are safe and women are capable of having them with little to no intervention. Still, the obstetric community gave it no attention. So, by Dr. Hannah's ideology shouldn't the ACOG acknowledge the results and respect supporting evidence? I guess it's only okay to disregard results when it's convenient to officials in power. True science doesn't matter to them if it doesn't fit their beliefs. This just proves that the ACOG is biased. That is just disgraceful. You can't go above basic scientific evidence. Strike 3.
I am a firm believer in science. No matter what, observational and randomized controlled studies are both valid. I don't understand why in this case, observational research is "inefficient" when observational studies are used all the time, like in animal behavior research. That is just as valid as anything else.
How reliable is our healthcare if they are more tangled up in bureaucracy than in science?
That question will always haunt me....
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