Sunday, April 7, 2013

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Book Review :: The Doula Guide To Birth: Secrets Every Pregnant Woman Should Know #DoulaProgression

There is a growing trend in women who are electing to have a doula (doo-luh) -- a "woman servant," present at her birth, and many others who believe no woman should be without these assistants, so it is not surprising that more and more written work on the profession and how doulas can be helpful, are appearing in bookstores. This one, The Doula Guide To Birth: Secrets Every Pregnant Woman Should Know, is a text written by Ananda Lowe and Rachel Zimmerman, who both have done extensive work with pregnant and birthing women.

The Doula Guide To Birth places birth companions in the context of pregnancy and shows exactly where we fit. It begins with examining the origins of doulas, and over 12 chapters the pair take turns with discussing the benefits of doulas, whose presence can provide emotional support along with other benefits like pain relief. It also provides information and advice for partners of a pregnant and laboring woman, discusses how difficult yet rewarding labor is, how to find a doula, understanding early labor versus active labor, epidurals, cesareans and more. This easy to understand text is not filled with esoteric ideas and medical terminology that requires a certain level of knowledge about birth practices or medicine. For example, Chapter one, Doulas Are Great Pain Relief, offers an explanation on how pain relief could be curved with the assistance of a doula. Amanda and Rachel tell us that the comfort women receive makes doulas the 'best medicine' in preventing intervention, by being available throughout all stages of early and active labor. In this way, a doula can assist with breathing techniques, suggesting different positions for comfort, offer a massage, and others, all which help to ease or erase a woman's fear. Chapter two discusses Fathers, Partners, and Other Loved Ones, and how we can assist. This chapter discusses the impact doulas have on other members of the family -- fathers, children, grandmothers, for example, and to show how a doula's presence can assist with these other members who choose to be present at the birth.

The remaining chapters on labor, labor techniques, dilation, birth plans, exams and others, are helpful in developing a image of why doula work is a burgeoning field. For those like myself who not as seasoned in the birthing scene, I find The Doula Guide can be used as a tool for practical ways to understand how birth companions can be of assistance to women, who are largely birthing in hospitals. The experiences of women who have used doulas, are a component of this texts, as they share their stories of fears, frustrations and triumph. Though the large part of the conversation focused on romanticized notions, that didn't go as deep as necessary, there was attention given that birthing will not always happen with a mother-father dyad, and that being single or estranged from the baby's father or partner is a possibility.

I became a doula to fortify my breastfeeding work. After doing some researching on the profession, I knew that it would provide me an additional layer of insight, and allow me to go deeper on ways to promote the tradition. I knew that along with numerous other benefits we have positive outcomes with assisting women, and the chances of successful breastfeeding increase tremendously when one is present. Because of this, my initial goal was to practice postpartum. Once I showed up to training, though, and sat through class those few days learning of the countless other reasons why women need these birth companions I knew that my trajectory had changed. This book was initially required reading before attending doula training -- I had no idea it was even on the list until I showed up to class and heard others talking about it. I'm not sure how I missed that important detail.

Authors Ananda and Rachel both have a love of birth and a desire to see women have happy and healthy pregnancies, and for these reasons, it is remarkable that the issues of social inequity that grossly affect the more vulnerable populations are avoided. Since this book talks to expectant mothers as well as doulas, averting discussions on issues of race and racism, class stratification, and others, gives the assumption that everyone experiences pregnancy and birth the same, that everyone can afford a doula, that racism and class issues are not inextricably linked to birth disparities or how someone experiences pregnancy and birth, and assumes everyone has access to a doula. This important discussion remained absent from the text. The usefulness of the large amount of practical information, to me, is overshadowed by the lack of attention to critical areas where birth companions (and everyone) should be concerned. The modern maternal-infant mammification of Black women continues to gain traction, as critical attention to areas of gender, race and class are omitted, and Women of Color's unique circumstances in this society are overlooked.

Although birthworkers ignore these areas, it is no secret to lay and professionals that the scale is unquestionably weighted against certain members in this society. Economically disadvantaged women, for example, have unequal access to resources, creating larger health and equity issues among these groups and the overall society and complications in pregnancy, birth and postpartum increase. It is also no secret that Black women are four times more likely to die in childbirth than white women. FOUR TIMES! And many Women of Color's birthing outcomes are too often fraught with inequality due to racism, immigrant status, sexual identity and many who have issues even getting care. So while I wouldn't disregard The Doula Guide, it is not without the absence of disappointment. I would urge its authors and everyone in this area -- privileged midwives, doulas, birth assistants, Drs, nurses, Lactation Consultants, to stop idealizing birth and pretending that everyone births in an idealistic setting. Stop overlooking that racism, class division and all other socially manufactured circumstances is NON-existent when it comes to carrying a child. Stop ignoring the impact of these on her, her baby's health and safety and breastfeeding success! And more urgently, stop ignoring that Communities of Color are not mostly affected. As birth workers, we bear the responsibility of proactively exploring and examining issues of injustice and inequality, and work at eradicating these for more positive outcomes.

I'm not surprised this text was used in the doula training I was enrolled in -- a training that centered the experiences of Black women. The Doula Guide does offer information that can be useful as a starting point to understand what a doula does, and may possibly be beneficial in allowing women to make more informed decisions. The conversation, however, must move away from the largely idealistic and saccharine ones we too often see in these professions and focus more on birth justice so one day every woman can experience this, because as of now this is not the way it is, and depending on who you are, being pregnant can kill you! 

This text was not provided by the publisher to review on my site. It was purchased with my own funds, as part of Doula Certification, which requires a written review and submission of birth and midwifery texts. This post is here simply to share this report/review with my audience. 

Author: Ananda Lowe, Rachel Zimmerman
Publisher: Bantam
Year: 2009
Paperback: 17.00
Genre: Pregnancy
Pages: 270
ISBN: 9-780553385267

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