After spending time in Romania I am full of thoughts, mostly questions: where do we go from here?
I went to Romania on July 4th for the book launch of the Romanian translation of my book, Ma Doula: A Story Tour of Birth. Many of the mothers I met were hoping I could help them have more of a say or just work toward having choices for their births. Having a doula as an advocate seemed to them a possible solution.
It didn't turn out to be that easy. Actually, there are multiple factors affecting women's choices in Eastern European countries. For one, the overthrow of the Socialist Republic of Romania only happened as recently as December, 1989. The recession in 2008 squashed any progress that had begun. A Communist government continued to hold court as they always had: controlling the people and the country. Not a whole lot has changed.
I am not sure why, but the hospitals continue to be run much as they had been in the 1960s and '70s in the US. Routine procedures such as automatic episiotomys, birth in stirrups flat on your back, C-sections for any abnormality such as breech, cord around baby's neck, etc. But while all this is going on, women in Eastern Europe are educating themselves. They now have computers, Facebook, and YouTube. They are hearing about home birth and water births. They want to be a part of their births, not laughed at when they show up at a hospital in labor and mention that they would like to try a natural birth.
So I wonder. I don't think doulas are the immediate answer here. Then we have another problem compounding the situation. There are doulas in Romania, Hungary, and neighboring countries who are not only teaching other women to be doulas, though they don't have certification to do so, are passing themselves off medically trained midwives, offering to do home births (for a price) and thus making a very bad name for all doulas everywhere, including the hospitals and entire medical community that we are hoping to work with to obtain those choices.
Some facts:
1. I do not advocate home birth at any cost. As a licensed midwife, I would not attend a home birth without hospital backup. I would not attend a home birth if the mom had any exhibiting risk factors as listed in my protocols.
2. As a certified birth doula, I would never offer to be the sole provider at a home birth. I would also not attend a home birth if the midwife was not licensed with an accredited agency.
3. I would never undermine a woman's relationship with the provider she has chosen and encourage her to contradict any of his/her advise. As a doula that would definitely be outside my scope of practice.
4. Doulas are trained ONLY in emotional and physical support during labor and birth. They do not have medical training, expertise, nor experience. They are not prepared to represent that they possess any of the latter. They are actually at grave risk of endangering life, both the mother's and the baby's.
Some of the ideas we came up with at the end of my time in Romania was that the pro-life organizers that invited me would try to connect with friendly doctors that we could present our concerns to in the near future. Hopefully they can spread the important issues at stake here.
My job will be to educate moms (via my blog and website*) and work toward making their needs heard.
It is not my intention to start a raving feminist movement in Romania; rather I believe women should have a say and be an active participant in their births. Statistics prove that when women are allowed to make choices, labor times are shorter and interventions are often avoided. Patient satisfaction soars--are you listening physicians?--and birth is returned to the family where it belongs.
* coming soon.
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