As doulas we beat the drum for caregivers and systems to
adhere to good evidence. We help our
clients locate and use evidence based information to make their decisions and
we benefit from good science that shows why we make a difference.
The Cochrane update by Hodnett et al, 2012 confirms that
continuous labour support has a positive effect for mothers and babies and the best results occurred when mothers had the support of a doula who was not
part of the mothers’ social network or an employee of the hospital. (http://evidencebasedbirth.com/the-evidence-for-doulas/). This is a vital distinction. When the
support person’s allegiance is in question, i.e.: she is employed by or somehow
aligned with the hospital or the caregiver, the effect wasn’t as great.
Let’s imagine that you spend time and money winning over caregivers
in order to secure referrals. The
caregivers, who you bribed with
gifts, meals or more, then assumes you'll influence the mothers’ choices in exchange for those referrals. Who do
you REALLY work for? If you are counting on the referrals from that physician
or that midwife you could be taking a risk by not doing as they ask. If your client has the perception that you are aligned with their caregiver, this can zero
out the “doula effect” and negate the very thing that makes you effective.
Not only is woo-ing caregivers with gifts and goodies
distasteful, it ignores the current evidence. Until we have some good data on
what happens when doulas use these types of marketing practises it’s vital that
we do what we expect of caregivers and follow the current evidence.
Think long and hard before you, as a doula, engage in
bribery of caregivers in any way shape or form. It doesn’t foster the type of collegial respect that
we’re all working so hard for. In the
end, it may cost your clients the support they deserve and you run the risk of
“being for sale”. Earn respect the right
way, with hard work and tenacity and never, ever, be co-opted by back door
deals and un-ethical pay offs.
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