In a now-viral story, the International Cesarean Awareness Network (ICAN) of Huntsville, AL and Exposing the Silence shared that an OB/GYN in Huntsville, AL will no longer allow women to have doulas with them during their birth.
People are outraged, and rightfully so.
Doulas are trained professionals who are hired to provide support to women and families during pregnancy, birth and the postpartum period.
According to this photo, the new policy of Dr. Edith Aguayo of All Women's' Obstetrics and Gynecology states,
"Please let us know if you hire a doula during your pregnancy as Dr. Aguayo has decided not to collaborate with doulas or other lay support. We hope this strengthens the relationship between your physician, hospital care team, and yourself. Please feel free to discuss any questions or concerns at your appointment."
Motherly contacted the office but they declined to comment for this piece.
But the issue goes far beyond this particular office. For starters, this policy disregards evidence-based research which overwhelmingly demonstrates how impactful doulas are. Women with doulas have shorter labors, with fewer interventions (including fewer Cesarean sections), and report more satisfaction with their birth experience overall.
Doulas may also be key in improving the disproportionate rates of maternal morbidity and mortality for black women in the United States.
The American College of Obstetricians and Gynecologists (ACOG) supports the use of doulas, writing in a 2018 position statement that, "Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor."
And, this new policy does not seem to reflect that of Crestwood Medical Center, the hospital where Dr. Aguayo attends births. According to their website, doulas are welcome. "Share your birth plan with us. If you have specific requests or opinions about your care, we'll be happy to do all that we can to help facilitate your labor plans. Crestwood Medical Center's Maternity Center also welcomes birth coaches and doulas."
All of these factors make it hard to understand the reasoning behind Dr. Aguayo's decision.
But it is actually not my intention to admonish this obstetrician or her office for this decision. Negative reviews are pouring in. They are aware that people are angered, and I am sure Crestwood Medical Center is too. Women for whom this policy does not work will transfer their care if they are able, and the doctor and hospital can make a business decision about whether this policy is worth it.
My concern is with the culture that got us here.
The birth culture in this country continually sends women the message that they are not in charge of their births, that birth is somehow owned by care providers or hospitals and not women.
That we need permission to have our desired support team present.
That we have to tolerate mistreatment in labor.
That our self-knowing and intuition are not to be trusted, because obviously, someone else knows what's best for our bodies.
It is evident in the way little policies like this creep up, and glaringly obvious in the way huge disparities in maternal outcomes exist.
So while I am not interested in addressing this particular practice, I am very interested in addressing the people giving birth. If that is you, here is what I want you to know:
Attending your birth is a privilege and an honor. There is this moment just before a baby is born (however a baby is born), that everything goes still with the hushed anticipation of a world about to change. It is a moment so powerful it cannot be described, only felt—and mama, you are at the core of its power. To be in your presence at this moment is a gift, and I am sorry if you have ever been made to feel otherwise.
Please know that this is your body, your baby and your birth. No one can ever take that away from you. Listen to your health care team, because it is their job to keep you safe. But listen to yourself, too. Your intuition is so wise. If it's telling you that you need a doula, find a provider who welcomes them. If it's telling you that something isn't right, keep pressing the call bell until somebody pays attention.
You own your birth. Please don't less the world tell you otherwise.