Doulas as Bridges

Recently Monica Lundry ( an RN and friend) and I hosted an event for the book launch of Dr. Mark Zakowski called “C-Section: How to Avoid, Prepare for and Recover From Your Cesarean“. Dr. Zakowsi is chief of Obstetric anesthesiology at LA’s Cedars-Sinai, my favorite hospital to work at as a doula as of late. “Dr. Z”, as many of the nurses call him, is a kind man who not only shows incredible skills as an artist anesthesiologist, but also calms laboring mothers with his gentle bedside manner that puts everyone else at ease, including the fathers. In listening to him describe his role in the O.R., it told him that he’s an “O.R doula.”

Dr. Zakowski’s book event was held at BINI Birth and many doulas, childbirth educators, physicians and nurses came together to celebrate. The atmosphere was festive and we relished in the opportunity to socialize and celebrate Dr. Zakowski. Many thanks to the cord banking company, StemCyte, for providing a wonderful assortment of food and drinks!

There was one moment in particular when I stepped back and looked around at all the wonderful, talented and compassionate birth professionals at BINI. All together, all sipping champagne, eating and talking.

12 years ago when I began practicing as a doula, such an event would sound like a Utopia, but today, in our community, it is possible, thanks to open minded, well-informed professionals and an empowered community of mothers who are not afraid to ask for what they want.

During the event, Dr. Zakowski shared the intentions of his book: to offer pregnant women information. He stressed many times the importance of childbirth education and the value of labor support. It was a delight to hear. We had a fantastic panel with nurse and new mother Amy Morisson, Dr. Suzanne Gilberg-Lenz, Julie Freitas and Dr. Z.

The audience had many questions about myths of anesthesia, and cesareans.

There was a conversation about compassionate care, informed consent and the enormous importance to pick your care provider wisely.

There was also a discussion about doulas in the O.R. and it was voiced that many professionals feel concerned with their presence during surgery for space and safety reasons. I am still processing this one and may write more about it later (stay tuned).

In the end, the feeling was of understanding and mutual respect and admiration. A success.

Now, not everyone has it so easy. Hospital Santa Joana, in the city of Sao Paulo, Brazil banned doulas from coming to their institution a few weeks back. Doulas and mothers from around the world (myself included) got busy on their Facebook page. The hospital then came out with a statement saying they would allow only doulas that were registered with the hospital. The problem is, only psychologist and physical therapists qualify for this registry. In essence, they found a cute, discreet way to continue to ban doulas.

The incredible news is that Brazilian women are tired of it and so are the doulas and activists. On Feb 3, Ana Cristina Duarte ( a doula trainer and midwife) organized a protest wherein thousands of people were mobilized themselves in front of the hospital and around one of the main avenues in a central area of the city.

Ana Cristina, has been trying for many years to bridge evidence based medicine in hospitals. It is amazing to me that even a study with 13,000 women by one of the most respect medical journals in the world (Cochrane Review) cannot convince these hospitals of the benefits of the doulas, or maybe they just don’t want them there as their cesarean rate is in the high 80%…

Looking at Brazilian doulas and mothers, and their struggle to achieve a humane, kind and gentle hospital birth, fuels my heart to work harder. My hope is that one day, in every country, many more physicians, nurses and doulas can drink champagne together because ultimately the main beneficiary from the result of this bridge are the mothers, mothers who deserve compassionate, honest and safe care.

Ana P. Markel, ICCE, CD(DONA)

Founder of BINI Birth, birth doula, doula educator, PAM Advisor, and mother.

**the experiences above are Ana’s personal ones during her recent trips to Brazil, educating doulas and the communities she visits and the variety of clientele and speakers she hosts at her center: BINI Birth in Sherman Oaks, CA.

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