What's a Good Doula to Do?

Recently, one of my clients went in for a c-section after a trial of labor. The nurses could see how much support I was providing my client, who was definitely more than panicked by labor. I'd say she was bordering on hysteria at times, but with guided visualization and breathing exercises led by me, she would calm down.

When the nurses brought scrubs for the husband to wear into the OR, they gave me a set, too. "She needs you in there," they said.

I went into the bathroom to change, and I could hear the anesthesiologist saying no. Rather than put the scrubs on, I came back out. I asked the nurse "No go?"

The anesthesiologist looked at me directly -- and not unkindly -- said no, I could not go in. She even said she was sorry, then explained to my client "There's just so little space in the OR, and with both your husband there and your doula, it will be too crowded."

I have to admit that I was disappointed, having never been in the OR yet, but I readily accepted her decision. Doulas almost never go into the OR. More importantly, I felt like my client had no expectation for me to be there, and she was fine with it. I told her I'd wait in her room, that I'd be there as soon as they brought her back in, and that I couldn't wait for her to introduce me to her baby.

Soon it was just me in the room, and I was tidying up my client's belongings. Another nurse came in. "Do you still have the scrubs?" she asked. "Put them on, because I think you should go in there."

I told her that the anesthesiologist had already refused me (what I learned in training was that it was the anesthesiologist's call, since doulas and partners would need to share the same space with that doc).

She shook her head. "I'm the OR charge nurse" (or whatever her title was...), "and it's no one's decision but mine, and your patient needs you."

"Is she having another panic attack?" I asked.

"No," said the nurse, "but if she does, you're the one she responds to."

Truly, I felt that my client and her husband were fine, even relieved to choose a c-section (and they did choose it). I said to the nurse, "The anesthesiologist looked right at me and told me no."

"But it's my call," she insisted. "They won't give you a hard time, they'll give me a hard time."

Had my client been unravelling, perhaps I would have reconsidered -- perhaps. But doulas walk such a tough line in the hospital; I'm only as good as the doula the staff has dealt with just prior to me, and whatever I do sets the mood for the doula they encounter after me. And doulas have to work hard to earn the respect of OB's, more often than not. Ultimately, I decided not to go.


What would you have done?


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