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Birth Doula Support at UAB hospital? Why not:

1/6/2016

8 Comments

 
Picture
"Only with trust, faith, and support can a woman allow the birth experience to enlighten and empower her." ~ Penny Simkin

BirthWise in Birmingham, as a group of doulas serving mothers in Birmingham, Anniston and Tuscaloosa, have decided to stop providing labor support at UAB hospital. We would like to explain why:
 
BirthWise doulas pledge to uphold the DONA Code of Ethics and Standards of Practice governing a doula’s behavior, ethics and scope of practice. DONA is the oldest and most recognized doula certifying organization nationally, and has developed this code and these standards to assure doulas behave in a professional manner and provide the best services possible. If a client, OB, nurse or hospital should have a complaint about a doula’s actions, DONA has a grievance procedure in place.
As doulas, we believe a woman has the right and competence to choose the members of her labor support team.  This includes the right to hire the doula of her choice, based on her personal priorities and preferences. It also includes the right to bring her doula with her to the hospital to provide continuous labor support. 
Furthermore, BirthWise doulas enter into a contractual agreement (here's our contract) with our clients. We are not employed by a hospital or particular provider.  Research has shown that the benefits of doula support on maternal/fetal outcomes and satisfaction are greatest when doulas work independently of hospitals (Continuous Support for Women During Childbirth and see more research about doulas here).  We believe that we are able to establish trust and provide the best support for our clients when we work independently.
 
UAB has recently instituted a policy requiring doulas and doula clients to sign UAB documents that were drafted without doula input. All patients are now being asked to sign “Information for Patients and Families Regarding Doulas”, and all doulas must sign a “Doula Partnership Agreement". The “Doula Partnership Agreement” is essentially a contract between the doula and the hospital that was created without the input of doulas or doula clients. Being required to sign this agreement conflicts with our doula-client contract, infringes on our ability to practice our profession according to the full scope of our practice, and therefore prevents us from providing the best care possible for our clients.
 
We believe these documents come between ourselves and our doula clients. They create an environment of distrust, rather than one of mutual respect and collaboration between doulas and hospital staff.
 
Therefore, regretfully, as long as UAB’s regulatory policy remains in place, we cannot, in good conscience, provide labor support at UAB hospital.
 
Birmingham is fortunate to have many options for pregnancy and birth. Among these there are many who recognize the positive emotional and clinical impact a doula can have before, during, and after birth. We would be happy to point you to a provider or facility that recognizes the patient's right to choose her own birth team without interfering in the contractual relationship with the doula she chooses. 


8 Comments
Ashley
1/7/2016 09:07:37 pm

I read the agreement they want you to sign and I am very confused why any doula would have a problem signing it. The things they listed are very reasonable and should be the way doulas practice anyway.

Reply
Katie Short
1/8/2016 04:23:05 am

Forcing a woman into unnecessary and unwanted interventions is not part of how a doula should practice. This document says that there are non-negotiable interventions that a doula cannot support her client in avoiding. But the main thing being stated here is that a doula should only be in a partnership with her client, and with no other person who has an interest in the birth. In simply entering into such a partnership, they undermine their own reputation and integrity in the eyes of their clients. It creates a secondary interest for the doula, someone else who must be pleased with her job. That means she can't be fully focused on the mother, she must concern herself with this contract and what the hospital considers acceptable speech. And presumably, if a doula is deemed to have done something against the contract, she will not be permitted to practice there, which means she's a half step away from being a hospital employee the minute she signs this form. As the article states, women do better with doulas who are not hospital employees.

Reply
Lea link
1/8/2016 06:51:45 am

Spot on!!

Gena link
1/26/2016 05:40:21 pm

The doula's main concern is the the well being of her client, she shouldn't have her loyalties playing against one another.

Lea Garner link
1/8/2016 06:50:27 am

Hmmm... Is it publicly available?

Reply
dalia
3/1/2016 11:24:27 am

Lea, I have linked the document in the body of the blog. I am happy to email you a copy of you want. Email me at birthpower@bellsouth.net. Any mother who works with an OB at UAB and says she is having a doula is supposed to have a copy handed to her. I don't know that they have it posted publicly anywhere. But you could call and ask for a copy if you want.

Leah Kay
11/23/2016 07:44:43 pm

I could not agree more. I am confused why a doula would think this is too much to ask. They are a guest in the hospital. It is not their place of work and the hospital owes them nothing. They will not be held accountable either if something goes wrong with the delivery. If an agreement is too much to ask they can stick to home deliveries where they have all full control and more responsibility if the pt or baby has a bad outcome. I think some doulas are great but others seem to forget their role.

Reply
Dalia
1/8/2016 03:56:56 pm

There are parts of the document from UAB that are reasonable. However, DONA (doula certifying organization) has a Code of Ethics and Standard of Practice that spells out doula behavior. It is the job of certifying organizations to describe the doula role and scope of practice, not hospitals. A mother has the right to choose the doula she wants w/o the hospital getting in the middle of this contractual relationship. Hospitals already have the power to remove anyone who behaves out of line (including doulas). To improve doula/hospital cooperation and improve birth outcomes and family's experiences in birth there needs to be training for doulas and for hospital staff and direct communication. That is what is going on at Brookwood, RMC, St. V and Princeton. We asked UAB to do an orientation for doulas and offered to dialogue with nurses. UAB was not interested.

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