S/O: Will doula experience hurt my application?

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startingover84

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This is a spin-off of another thread that I didn't want to hijack.

Currently, I'm working on my doula certification. I would like to volunteer as a doula, comforting women in labor. I know that doulas are viewed negatively by some in the medical profession, but would it be enough to hurt my application?

I'm doing this, because I truly believe women can benefit from more labor support. Doulas can be expensive, and I would love to provide my services for free.

Thoughts?
 
It may demonstrate some compassion. Do not try to tout it as medical, however, and do not launch into anything that seems to mix personal philosophy and science as your last statement seems to do
 
Thanks for the tip. I'm actually volunteering at a hospital, so that gives me my clinical experience. I found an MD to shadow separately. So this would truly be volunteer only. I don't want to double-dip on the ECs, anyway.

Just curious how I can demonstrate compassion and not say that women could use more support? I mean, can't we all use a little more support in our lives?
 
According to lizzys sig this would be clinical.
 
I know that it's technically clinical, but I don't want to "double-dip" on my ECs. I'm fine with placing it solely under "volunteer" hours.

I'm most concerned with being viewed negatively. Is this a bad thing to do/include on my application? Or, is it positive? Neutral?
 
How can anything where you sincerely care and are helping someone be viewed as negative? Come on.
 
How can anything where you sincerely care and are helping someone be viewed as negative? Come on.
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I give clean needles to heroin addicts because I don't want them to get HIV.
 
pfaction said:
I give clean needles to heroin addicts because I don't want them to get HIV.
Click to expand...

And your point? If you didn't do that, would more people say "ohhh i dont have a clean needle so im not going to share it so i dont risk getting HIV. I will just give up my dangerous habits."

If you were being sarcastic, that's a terrible example. Furthermore, the OP is talking about something where she is helping expecting mothers. It's a no brainer that this isn't "negative" and at worst just would be neutral. It's not something as controversial as passing out needles.
 
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I, too, am confused as to how experience as a doula, particularly when it is volunteer, could be seen as a negative. As a doula, one offers comfort and solace to an expectant mother -- they do not try to provide medical services, nor do they attempt to take charge of a mother's care. They simply offer support; something that I am sure, in the midst of a time [labor] that is known to be quite painful, is much appreciated and comforting to those who receive it. Though I admit to ignorance on the specifics on the relationship between doulas and physicians, I cannot see why it would be hostile.
 
Starlightembers said:
I, too, am confused as to how experience as a doula, particularly when it is volunteer, could be seen as a negative. As a doula, one offers comfort and solace to an expectant mother -- they do not try to provide medical services, nor do they attempt to take charge of a mother's care. They simply offer support; something that I am sure, in the midst of a time [labor] that is known to be quite painful, is much appreciated and comforting to those who receive it. Though I admit to ignorance on the specifics on the relationship between doulas and physicians, I cannot see why it would be hostile.
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A lot of women choose doulas because they want a natural unmedicated birth in a hospital setting. They have the doula there to not only help with the pain of labor but also to remind them of their wishes when confronted with offers of pain medication, episiotomy, etc. Doulas are supposed to remain solely as a support person, but some forget that is their role. So their reputation as a group has suffered.

For example, if the Dr. says to the laboring woman, "OK, I'm just going to make a small cut," the doula would say, "Do you now want to consent to the episiotomy?" I'm sure you can see how doctors might not appreciate a doula in that situation. Obviously, if the situation is an emergency and the baby has to come out NOW, no doula in their right mind would say that. This is more in the case of a doctor who does routine episiotomies and forgot that this specific patient would prefer to not have one.
 
startingover84 said:
A lot of women choose doulas because they want a natural unmedicated birth in a hospital setting. They have the doula there to not only help with the pain of labor but also to remind them of their wishes when confronted with offers of pain medication, episiotomy, etc. Doulas are supposed to remain solely as a support person, but some forget that is their role. So their reputation as a group has suffered.

For example, if the Dr. says to the laboring woman, "OK, I'm just going to make a small cut," the doula would say, "Do you now want to consent to the episiotomy?" I'm sure you can see how doctors might not appreciate a doula in that situation. Obviously, if the situation is an emergency and the baby has to come out NOW, no doula in their right mind would say that. This is more in the case of a doctor who does routine episiotomies and forgot that this specific patient would prefer to not have one.
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Are you kidding me? Sound like they are just in the way then.
 
Holy FranZ said:
Are you kidding me? Sound like they are just in the way then.
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Not at all. I mean, that's certainly what some people in the medical profession think (hence my post). However, my role is simply to support the mother. If she then says, "Yes, I consent," then I drop the subject and move on to whatever else she needs. It's no different than having an informed family member present for any medical procedure.
 
startingover84 said:
A lot of women choose doulas because they want a natural unmedicated birth in a hospital setting. They have the doula there to not only help with the pain of labor but also to remind them of their wishes when confronted with offers of pain medication, episiotomy, etc. Doulas are supposed to remain solely as a support person, but some forget that is their role. So their reputation as a group has suffered.
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Understood. I was thinking that, if there was hostility, it was not because of the technical role itself; but due to those who step outside that role and/or the general philosophy of doula groups. I can see how this would make sense. Knowing that this stigma exists, then, when writing about your experiences, I would ensure that you emphasize your role being one of a supporter and advocate, not one who attempts to assist in medical procedure or decision making.

For example, if the Dr. says to the laboring woman, "OK, I'm just going to make a small cut," the doula would say, "Do you now want to consent to the episiotomy?" I'm sure you can see how doctors might not appreciate a doula in that situation. Obviously, if the situation is an emergency and the baby has to come out NOW, no doula in their right mind would say that. This is more in the case of a doctor who does routine episiotomies and forgot that this specific patient would prefer to not have one.
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I can see how a physician might find that to be an annoyance; however, as long as the doula stays within the situation you describe (ie, not attempting to interfere during an emergency or moment of medical necessity; only serving as an advocate for a woman's wants and needs, not attempting to push one particular philosophy not based upon evidence; and so forth), I am in support of someone filling that role, particularly for low-income mothers who do not have that informed family member. From what you are saying, it seems, more than anything, that doulas serve as advocates and educators for pregnant persons. I do not see that as, at its core, a bad thing.

On a side note, in reading up about all of this, I discovered abortion doulas. In a situation often filled with much pain, fear and stigma, I can see how they have a place there, particularly for pregnant teens seeking abortion.
 
I can't see how that would be anything but positive (unless you are interviewed by a grumpy OB who's butted heads with doulas before). And working/volunteering as a birth doula is absolutely clinical experience. CougarMD was a doula before starting med school. I'm sure you could PM her for advice.
 
startingover84 said:
This is a spin-off of another thread that I didn't want to hijack.

Currently, I'm working on my doula certification. I would like to volunteer as a doula, comforting women in labor. I know that doulas are viewed negatively by some in the medical profession, but would it be enough to hurt my application?

I'm doing this, because I truly believe women can benefit from more labor support. Doulas can be expensive, and I would love to provide my services for free.

Thoughts?
Click to expand...

What a gem you are.

I had a doula for my most recent birth, and she truly made it an amazing experience for both my husband and me. The science behind doulas is sound, and doctors who keep up with research have a good grasp on this. I was a high-risk pregnancy, and was cared for at the Duke perinatal clinic throughout my pregnancy. I ran the "doula thing" by them, as I was similarly concerned about whether they would be supportive. To my surprise and delight, they were absolutely thrilled.

I'm definitely not an expert on applications. But you might consider talking about your experience as a means of humanizing patients, or perhaps how it has expanded your perspective of how different members of the healthcare team work together. In all fairness to physicians, laboring/birthing mamas need a TON of *professional* care and support. There's no way doctors and nurses can reasonably be expected to do that. Doulas are a great example of how laypersons can come in and assist with the nurturing women need while taking pressure off of doctors and nurses, and freeing them to assist other patients.
 
Jessica said:
Be careful! A close friend of mine goes to Ross U (on the island of Dominica) and he had a wild cow chase him home, and he had to live in a shack for a year (the floor was tile sitting on top of dirt) ... there is a bright side to attending Ross though - nothing to do but study! He started in Jan. '01, and he got accepted at age 21/junior in college sans taking the MCAT (from what I understand, you have to take the MCAT now, but it does not matter what you get.) He submitted his app., had an interview almost immediately, and left for school two months later.
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As I am new to this subject, would you mind providing examples of this sound science?
 
ccrone said:
What a gem you are.

I had a doula for my most recent birth, and she truly made it an amazing experience for both my husband and me. The science behind doulas is sound, and doctors who keep up with research have a good grasp on this. I was a high-risk pregnancy, and was cared for at the Duke perinatal clinic throughout my pregnancy. I ran the "doula thing" by them, as I was similarly concerned about whether they would be supportive. To my surprise and delight, they were absolutely thrilled.

I'm definitely not an expert on applications. But you might consider talking about your experience as a means of humanizing patients, or perhaps how it has expanded your perspective of how different members of the healthcare team work together. In all fairness to physicians, laboring/birthing mamas need a TON of *professional* care and support. There's no way doctors and nurses can reasonably be expected to do that. Doulas are a great example of how laypersons can come in and assist with the nurturing women need while taking pressure off of doctors and nurses, and freeing them to assist other patients.
Click to expand...


SpecterGT260 said:
As I am new to this subject, would you mind providing examples of this sound science?
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Indeed.
 
Higher rates of breastfeeding, shorter labors, fewer operative vaginal deliveries and C-sections and less use of epidural anesthesia have all all been associated with doula support. Note - Many of the studies I found looked to be published in nursing or midwifery journals, but they were all found on pubmed. They just seemed more likely to do research on the benefits of doulas. Not all of these are very detailed, but what can you do? I didn't make the site.

http://www.ncbi.nlm.nih.gov/pubmed/19323712
http://www.ncbi.nlm.nih.gov/pubmed/18507579
http://www.ncbi.nlm.nih.gov/pubmed/9800927
http://www.ncbi.nlm.nih.gov/pubmed/2013951
http://www.ncbi.nlm.nih.gov/pubmed/17610053
http://www.ncbi.nlm.nih.gov/pubmed/17273201
http://www.ncbi.nlm.nih.gov/pubmed/10643833

You can look for more if you want. I couldn't find a single article that suggested they were not beneficial.
 
I intend to look through those, but can you think of any reason why higher rates of breast feeding may be coincidental?

It is also vitally important, as a medical student, that you keep your basic sciences in mind..... Shorter labor? Doulas, from what I can gather, are providing only info and a little encouragement. So..... Shorter labor?

The second paper is a great example of coincidental findings.
"the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia."

I can't decide if this paper simply doesn't understand medical procedures or intentionally hides it..... Epidural anesthesia is administered proactively. It is not a need based treatment. The same is typically true of c section. A woman believing in the "beneficial" effects of something like a doula, which is already associated with child birth, are obviously more like to (wait for it) opt for natural child birth..... I.e. vaginal and no pain meds :shrug:
 
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Sure I can. The same women that hire doulas are often determined to have natural childbirth and those same women are usually the ones that really want to breastfeed. That said, feeling better because you've had a shorter labor and uncomplicated vaginal delivery then having the doula stay with you after delivery to help you establish breastfeeding like ensuring you have a good hold and the baby has a good latch (BTW, this is a standard component of a birth doula services) go a LONG way. Many women quit breastfeeding fairly quickly because it's painful (and it is, especially at first) and very often, its for something like a poor latch.
 
Geekchick921 said:
Sure I can. The same women that hire doulas are often determined to have natural childbirth and those same women are usually the ones that really want to breastfeed. That said, feeling better because you've had a shorter labor and uncomplicated vaginal delivery then having the doula stay with you after delivery to help you establish breastfeeding like ensuring you have a good hold and the baby has a good latch (BTW, this is a standard component of a birth doula services) go a LONG way. Many women quit breastfeeding fairly quickly because it's painful (and it is, especially at first) and very often, its for something like a poor latch.
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I guess what I am getting at is that such coincidental findings do not constitute showing a benefit. At best they constitute not doing harm or neutrality. Waaaayyyyyyy too often I see papers in such journals that show "no increase in problems" and try to spin it as "beneficial" or "as good as standard treatment" when these are just not appropriate conclusions
 
SpecterGT260 said:
I intend to look through those, but can you think of any reason why higher rates of breast feeding may be coincidental?

It is also vitally important, as a medical student, that you keep your basic sciences in mind..... Shorter labor? Doulas, from what I can gather, are providing only info and a little encouragement. So..... Shorter labor?

The second paper is a great example of coincidental findings.
"the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia."

I can't decide if this paper simply doesn't understand medical procedures or intentionally hides it..... Epidural anesthesia is administered proactively. It is not a need based treatment. The same is typically true of c section. A woman believing in the "beneficial" effects of something like a doula, which is already associated with child birth, are obviously more like to (wait for it) opt for natural child birth..... I.e. vaginal and no pain meds :shrug:
Click to expand...
Regarding the second study, I believe those women were assigned doulas randomly. These were not women who sought out and hired a doula themselves, but if that were the case then yes, I would agree with you.

You are admittedly unfamiliar with the concept of doulas, and I assume you have not given birth or been present at a birth before (please correct me if I'm mistaken). Doulas suggest positions and movements to help the mother relax, cope with the pain and (supposedly) progress. If these are effective, then yes, shorter labors and less use of epidural anesthesia are understandable. You are also underestimating the effect that encouragement and emotional support can have on a woman in labor. Fathers/partners try to be supportive, yes, but they also tend to freak out or agree to whatever comes out of the mother's mouth in the throes of labor (even if it flies in the face of her stated preferences) because they don't want to see her uncomfortable. I know it sounds wishy washy, but having someone there whose job it is to remind the mother of her preferences and her ability to manage the pain is more helpful than you might think.

In the interest of full disclosure, I have never hired a doula. I wish I had with my daughter, but I didn't need one for my son because my nurse-midwife was in my room for pretty much my entire labor, coaching me and my husband very effectively. A doula would have been superfluous with her there. To be perfectly honest, I would consider them beneficial even if the only finding they had any influence on was that more mothers rated their birth experience as positive if they had doula support.

Also, can you please clarify what you mean by the bolded statements?
 
Geekchick921 said:
Regarding the second study, I believe those women were assigned doulas randomly. These were not women who sought out and hired a doula themselves, but if that were the case then yes, I would agree with you.

You are admittedly unfamiliar with the concept of doulas, and I assume you have not given birth or been present at a birth before (please correct me if I'm mistaken). Doulas suggest positions and movements to help the mother relax, cope with the pain and (supposedly) progress. If these are effective, then yes, shorter labors and less use of epidural anesthesia are understandable. You are also underestimating the effect that encouragement and emotional support can have on a woman in labor. Fathers/partners try to be supportive, yes, but they also tend to freak out or agree to whatever comes out of the mother's mouth in the throes of labor (even if it flies in the face of her stated preferences) because they don't want to see her uncomfortable. I know it sounds wishy washy, but having someone there whose job it is to remind the mother of her preferences and her ability to manage the pain is more helpful than you might think.

In the interest of full disclosure, I have never hired a doula. I wish I had with my daughter, but I didn't need one for my son because my nurse-midwife was in my room for pretty much my entire labor, coaching me and my husband very effectively. A doula would have been superfluous with her there. To be perfectly honest, I would consider them beneficial even if the only finding they had any influence on was that more mothers rated their birth experience as positive if they had doula support.

Also, can you please clarify what you mean by the bolded statements?
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I haven't done OB yet. So it's largely anecdotal. Just stories I've heard of women wanting epidurals before it is indicated and then being told it's too late for the drug by the time they are in active labor. I get the impression administration of the drug midway through birth is mostly useless. I also dont think c sections are commonly opted into mid way through labor unless there is some complication so inclusion of that data seems odd.

After thinking about it the epidural comment was only relevant to fast births.... I still don't see it as an appropriate end point but its not really a strong argument either way. "Women less likely to use anesthesia when partnered with another woman who tells her not to" doesn't strike me as ground breaking
 
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