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Row over private birth assistant curb
[Posted: Fri 09/03/2007 - www.irishhealth.com]
By Niall Hunter-Editor
A group which provides an independent birth partner service has expressed disappointment with a decision of the Rotunda Hospital in Dublin to restrict their availability to mothers delivering at the hospital.
The Rotunda, in a statement, said the birth assistants concerned, called Doulas, will no longer be facilitated in any other role other than that of the patient's nominated birth partner at the hospital.
The Rotunda says 'in the interest of equity and fairness to women' it is allowing only one nominated birth partner per patient, thereby ending the option of having interchanging birth partners, eg, between the mother's life partner and the Doula service, which is provided on a fee-paying basis to assist the mother.
Doula Ireland provides the birth assistant service, it says, primarily to preserve the birth memory of the mother by providing support to make the birth experience as satisfying as possible.
Tracy Donegan of Doula Ireland said they were disappointed with the Rotunda's decision and were seeking a meeting with it and the two other Dublin maternity hospitals, which were also imposing restrictions on Doulas, in order to reach some accommodation that will meet everyone’s interests.
She said she believed the restrictions imposed at the Rotunda followed an incident whereby a person falsely represented themself as a Doula, thereby sparking security concerns at the hospital.
"We are very disappointed with the decision, however, as we feel it restricts a mother’s choice during birth."
Formerly, she said, a mother could have her normal partner and the Doula both attending at a birth on a rota basis; now however the mother can only choose one partner.
She argued that this could also affect mothers who do not hire Doulas to assist them, as, for example a mother who would formerly have her partner and her mother at a birth cannot replace one with the other when one has to be absent at certain periods during the labour.
Ms Donegan said one solution could be for a Doula to be formally registered with a hospital for security purposes, and this would be preferable to what was essentially a blanket ban.
The Rotunda said that while it has facilitated approximately 10 women with Doulas in the past year or so as birth partners, and allowed a policy of partner interchange during labour, it is now restricting this to only one partner and interchanging will not be permitted.
The hospital said Doulas are relatively new in the Irish context but it believes they should not replace the role of the registered professional in giving advice and support.
It said its revised policy on access to the delivery suite stemmed from health and safety, security and infection control concerns.
"All staff employed in the Rotunda Hospital have rigorous health screening and those involved in direct contact with patients are vetted by the National Garda Vetting Unit. The hospital cannot guarantee these standards for independent providers of services."
Ms Donegan said Doulas were now effectively banned in most cases from the three Dublin maternity hospitals. However, other hospitals, such as Our Lady of Lourdes Hospital in Drogheda, had a more liberal policy on Doulas.
She said this was an issue of choice for mothers and it was an issue that should be driven by consumers of maternity services.
For more information on Doulas see…
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Jene(HEJ59578) Posted:
09/03/2007 08:41 |
| The recent statement and policies regarding the ban on doulas and additional birthing partners within the Rotunda is very unsettling and goes agaisnt evidence based research. The official statment itself is inconcise and does not address the issue at hand. I particularly like that the hospital has throw this new policy back at women. "The Rotunda says 'in the interest of equity and fairness to women' it is allowing only one nominated birth partner per patient, thereby ending the option of having interchanging birth partners, eg, between the mother's life partner and the Doula service, which is provided on a fee-paying basis to assist the mother." The Use of additonal birthing partners is a UN recognized 'right' for birthing women in other countries. It is yet another way that the Irish Maternity System is taking away Irish women's choices in birth. |
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Koogs Posted:
09/03/2007 08:50 |
| Limiting birth partners is convenient for hospitals, but completely ignores the wishes of laboring mothers who want constant support from people (partner, family, doula) who care about them. Not that hospital staff do not care, per se, but to them the woman is just one of many patients to treat/monitor. The solution to the infection-control and security concerns for doulas are simple: start with a dialogue between the hospital and the--what? two or three doulas who are attending births there?--to establish a relationship, screenings, registration with the hospital etc. Banning this support for the mother might be more convenient for the hospital with fewer people in the room, etc. but where does that leave the mother in terms of support? The "support" provided by hospital staff (complete STRANGERS to the laboring woman) is regulated by work schedules and policies--sure a woman will get support from her midwife at intervals for the duration of her shift, but once the shift changes, the laboring woman is transferred over to new staff. The constant presence of a birth partner/doula gives women seamless support from those who know them and can help keep them calm in an otherwise frantic situation where people/staff might not care--you are just a number; a body in a bed taking up space until the next patient arrives. The decision to ban Doulas from hospital outright is basically avoidance of coming together with this increasingly popular group of pracitioners who are proven to help women AVOID medical intervention and longer hospital stays. Let's not confuse the role of the midwife/nurse (follow hospital protocol) with the role of a doula or birth partner (support and encouragement). Who can argue that giving birth is one of the most (if not THE most) important moments of a woman's life? Shouldn't she have some say as to who is there and who helps her throughout the process? |
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Anonymous
Posted:
09/03/2007 08:51 |
| This seems not only excessively restrictive and very unfair on mothers at the most vulnerable time in their live but a rather pointless policy. |
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anne(XXS59583) Posted:
09/03/2007 10:08 |
| I work in the field of pre and perinatal psychology and am shocked at this decision made by the Rotunda to limit choice for the birthing mother. |
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L(JUQ59596) Posted:
09/03/2007 15:35 |
| 'in the interest of equity and fairness to women' it (The Rotunda) is allowing only one nominated birth partner per patient' How is that fair to women? My husbands father died the day before I gave birth, so he couldn't be with me at all times. I NEEDED the family members that came to visit me and help me. I also had a C-Section and so wasn't able to fully take care of my baby on my own in a busy, understaffed hospital. What would I have done without having help with lifting him in and out of his cot, changing his nappy, feeding him etc? Are the Rotunda saying that if this same situation arose in their hospital today, some poor unfortunate mother would be left alone, emotionally vulnerable to care for a baby on her own with only an hour or 2 support from family / friends? Thank God I do not attend the Rotunda! Are other maternity hospitals adopting the same rediculous policies? It sounds like pathetic excuses to me. Surely Doula's could put themselves through the same security checks as the medical staff? Surely they could be registered with the hospitals and have a working realationship with them. Surely the hospitals should be grateful that their midwives do not need to be the sole emotional and physical support for a labourng woman / new mother? Midwives do a fantastic job but they cannot possibly have the same role as a doula or a husband or a mother. If The Rotunda really are interested in 'fairness to women' they need to take women's choices and needs into consideration. Surely there can be a happy medium here? |
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Elaine(elainebyrnes) Posted:
09/03/2007 16:26 |
| Yet more evidence that the needs of a labouring mother and baby are the least of the concerns of maternity hospitals in Ireland. At a very vulnerable time for a woman (and indeed her partner/husband/boyfriend/mother/friend) to be denied the support of a doula who has been a constant source of reassurance throughout her pregnancy is appaling. Shouldn't hospitals be facilitating anything and everything that not only helps a positive experience for all involved but also is proven in reducing the necessity for intervention? Shouldn't this be encouraged? Yet another example of bullying bureaucracy. |
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Chris Posted:
09/03/2007 17:39 |
| What if the mother's partner THINKS he can handle being present at the birth, but then changes his mind? It seems like a huge pressure on him that he might have to commit to being there all the way, with no "relief person" waiting to assist his partner should he feel unable/unwilling to stay present. |
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Calmbirth Posted:
10/03/2007 07:21 |
| Posting on behalf of Marie Mongan. I am both disappointed and saddened for birthing women in Ireland to hear that a maternity hospital, supposedly dedicated to the improvement of maternal services, would stray so far from evidence-based obstetrics in their recent decision to ban labor support, chosen by birthing mothers. Studies definitely point to better outcomes in birthings when women are accompanied by support persons of their choice. Women who are emotionally supported in childbirth by the presence of people they have chosen to accompany them on this most important life experience require fewer interventions, have shorter labors, require less medication, have fewer complications, and birth babies that are better natured--to say nothing of the resulting reduction in cost to the health system. It would appear that by ignoring the wants and wishes of birthing mothers, the Rotunda Hospital is revealing motives are not entirely altruistic, though they claim that the policy of denying support persons is to effect fairness and equity--for whom? That rationale is totally nebulous. It seems that in an absence of knowledge about the role of doulas or other labor companions, hospital administration and medical personnel who attend birthing mothers are overlooking a basic tenet--birthing is not about them. It\'s about the family they serve. They also seem to dismiss the huge contribution that a birthing facility can make to the overall well-being of that family from the very beginning. It is a natural tendency for someone to want the security of being surrounded by family and friends whom they love during any of the life passage events, weddings, baptisms, engagements, anniversaries. This being the case, why would the Rotunda Hospital choose to isolate a woman from her chosen companions at the most monumental experience of her life--birthing. Marie Mongan, Childbirth Educator |
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