(Update from Summer 2008: The Summer edition of the magazine deleted all reference to doulas. Hooray!)
Cross posted from my MySpace journal:
This letter that I just wrote to the editor of "Smart Family" magazine says it all ... Grrr ...
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Dear Ms. R,
I picked up a copy of "Smart Family" at the grocery store yesterday and was excited to sit down and read through it last night before bed. Since I am expeciting a baby at the end of the summer, I immediately went to the first page that had the word "pregnancy" across the top. The following, on page 15, caught my eye:
doula: a trained and compassionate professional who provides support to the mother during labor and through the postpartum experience.
My first reaction was to toss the magazine in the trashcan, thinking it just another publication that has bought into the doula hype.
Doulas are not "trained" nor are they professionals. And many do not give any postpartum care.
Doula training is scant, at best, not even requiring a high school diploma. Many doula organizations do offer "certification" but that is deceptive as well, but I'll get to that in a moment.
The Flexner Report, for example, stipulates that a profession is based on a body of knowledge that can be learned and is refreshed and refined through research, and is taught through a process of highly specialized professional education. (from "Professional Nursing," fourth edition, by Kay Kittrell Chitty) A true profession requires a bachelor's degree at minimum and a license to practice.
Nurses, for example, are considered as being a member of a "semi-profession" since one can be an RN with only an Associate's degree. If a registered nurse, who does a vast majority of the floor work with patients, isn't a true professional, then how can one say that a doula, who has had no formal training, is? Being a doula is an occupation, nothing more.
Many, many people confuse not only the issue profession vs. occupation, but the issue of licensure vs. certification. When one reads propaganda such as the definition you printed above, they assume that doulas have some educational background in medicine and the birthing process and are recognized members of the healthcare team. This a dangerous assumption and should not be perpetuated by the publications we trust.
Licensure is a legal matter and is granted through a governing body, generally through the state. It gives permission to do something that is otherwise forbidden (think practicing medicine or law, dispensing drugs, driving a car, etc.). A certification, on the other hand, is a voluntary process and is granted through a private organization. It merely states that one has been recognized by the organiztion for reaching certain criteria. It does not carry legal status. Of even more importance, not one doula organization is accredited by The National Commission for Certifying Agencies.
The process of earning a certification through a doula organization does not even meet the standard of those in the automotive or construction industries, let alone those of the health care industry. (A complete list of accredited organizations can be found online at http://www.noca.org/NOCAMembersByOrganizationlistedbyoccupation/tabid/241/Default.aspx)
I also take issue with the term "compassionate," too. In theory, having a person with you and your partner during labor in delivery, a person who can help keep you calm and focused, is a good idea. The problem is that many doulas have an agenda that is staunchly against medical interventions of any kind. They use scare tactics to get their clients to do what they want in an effort to further the "nature" movement. Suein Hwang, a reporter for The Wall Street Journal, wrote a story in January 2004 that broke the doula hype, and made a lot of doula organizations mad in the process. The story, "As 'Doulas' Enter Delivery Rooms, Conflicts Arise Hired to Help in Childbirth, They Sometimes Clash With Doctors and Nurses," can be found online at http://online.wsj.com/article/SB107446888698004731.html?mod=home_page_one_us and is a must read.
Doula antics, such as telling clients that an emergency cesarean really isn't necessary, that interventions such as a simple IV drip, a dose of Nubain, or even an epidural are harmful to the baby, and even messing with pitocin drips have rightfully earned them the name "nature nazis," which is used commonly in many circles to refer to these women who practice with an anti-medicine agenda. This agenda is a lot of things, but compassionate is not one of them.
When I was pregnant with my daughter in 2003, I looked into obtaining a doula after reading the hype in many of the parenting magazines. However, after talking to friends who were nurses and to my obstetrician, I changed my mind. When I "met" a couple of doulas on an online mother's board a year or so later, I was confident that I made the right choice in not allowing a doula in my delivery room. One will not be welcome when I deliver this summer, either. I prefer to put my life and that of my child into the hands of trained PROFESSIONALS, not some yokel who might or might not have even a high school diploma.
I implore you to remember this information when putting your next edition of "Smart Family" together.
In ending, an anonymous quote found online at http://doulicia.blogspot.com/2005/09/guests-at-birth-part-i.html says it best: "The person who cuts your hair has to have a license…why not someone helping in the birth of your child?"
Sincerely,
Pamela
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