Have We Been Conned??? (or, Midwives and Doulas and Prosecuters Oh My! Redux))

So the big TLC event arrived...Anna Duggar gave birth to her first baby, a little girl, at home, and it was filmed by the crew and publicised for all to witness.

Good thing, right? After all, the Duggars have a big following...more ammunition in the "birth is not a medical event, homebirth is safe" arsenal.

Wrong.

When Josh and Anna "decide at the last minute" (I don't believe that for a minute...I suspect that this entire thing was planned) that they want to have their baby at home because their doctor is not in town, they call their Bradley teacher to ask her if she would still be their "doula" for their birth. Of course, she would.

Of course.

Except that the "doula", as it seems to appear on the show, was the only birth professional in the home at the time of birth. Interestingly enough, this "doula", seems to carry an awful lot of equipment that, during my training as a doula by DONA (Doulas of North America), I was specifically taught it was out of my scope of practice to provide to a family.

If indeed what we saw on this program is what actually happened, I think we've been conned by the Duggars, and their "doula".

Don't get me wrong. I think the Duggars are a pretty remarkable family. I don't agree with their "baby a year" lifestyle, but they seem to be self supporting, hard working people who unapologetically live according to their beliefs; but they've had the opportunity, thanks to TLC's penchant for pandering to the public's (and of course I've allowed myself to sink to this level) voyeuristic tendencies, to subtly or not so subtly use their show as a platform for those beliefs.

Now, we're all entitled to our beliefs...after all, it's a free country...but let's at least be honest about them, especially if we have the opportunity to display them in a platform that allows for millions of viewers to be exposed to them. If you believe in a concept, then say so; be willing to stand behind your beliefs...don't just sneak them in under the guise of something else, and, as a result, put that "something else" at risk to serve your own purposes...which is exactly what I think this family did.

The concept of a doula is difficult enough to promote in this culture of medicalised birth. When they appear to be attending home births as the primary birth attendant, a role for which they are specifically, if they are trained properly, taught is not in their scope of practice, their function is further undermined; as such, their role, along with the wonderful, needed, often vital service that they provide to both their clients, and yes, beleaguered nurses who support non-interventive birth practices, is subject to even more misunderstanding. This puts the entire profession (and it is a skilled profession), at risk...as well as the health of the clients they serve. It also puts the profession of midwifery at risk...allowing the public to think that anyone with training as a doula or a childbirth educator can hang out a shingle and call themselves a midwife.

Was it truly a "doula" that served as the attending professional at Josh and Anna's birth? Or was it a midwife flying under the radar, as it seems the one tending to the family in my most recent post was? To her credit, the woman who assisted Anna allowed herself to be filmed, and, if I recall correctly, her full name to be used when her Bradley Childbirth class was filmed; so if she indeed was a midwife posing as a doula, why not just say so? I don't know what the laws are in Arkansas regarding what professionals may serve as the primary attendant at a home birth; but with the recent press regarding homebirth being so negative, and with ACOG using every opportunity to bully the public into avoiding the practice, this episode of the show can only jeopardize the cause of those who are working so hard to establish a woman's right to give birth at home with a properly trained and skilled attendant.

With a properly trained and skilled attendant.

That is the key concept here.

There will always be those who choose to give birth unassisted. I don't agree with them.

Since the dawn of time, women have, by nature, sought out experienced women to assist them during their time of giving birth. Birth, while it is, given the right circumstances, i.e. a healthy mother, carrying a healthy baby, laboring in a clean, comfortable well-equipped environment, is safe, it is still unpredictable. The unexpected can happen, and things can go downhill fast. One of the biggest hindrances to homebirth in the United States (after the ignorance of the public, the sensationalism of the media, and the machinations of ACOG, the AMA, and now the ACNM, that is), is that we don't have the infrastructure that other countries that have such good homebirth statistics (and as a result, good overall birth statistics) have. We don't have a system where a family can prepare, with the full support of the medical community, for a homebirth. We don't have a system where the local emergency management system is made aware that a woman is laboring at home in the community, and resources are made available (i.e., an ambulance) should they be needed; and we're never going to get those things if the public, and the government remains ignorant of the safety of homebirth...with a properly trained and skilled attendant.

Families who chose to birth unassisted have the right, I suppose, to put their laboring mother and unborn children at the risk of the unexpected. If your "rugged individualism" means that you are willing to accept that risk (to say nothing of your unborn child, who doesn't get a say in your "choice"), then so be it; but don't attempt to con the rest of the world into thinking that you are doing it with an skilled birth attendant when you are not. Conversely, if you have a skilled birth attendant, then say so. Either way, be consistent. Don't allow your own selfish need to get what you want to confuse the issue for an already confused public, by default allowing the powers that be to use your "example" as a tool in their arsenal to damage what little progress homebirth and midwifery advocates have made.

There is homebirth, attended by a properly trained, skilled midwife; and then there is unassisted birth. The first is unquestionably safer than the second; and while it may be your right (ethically at least...because legal rights are being continually reinterpreted concerning reproduction), to give birth unassisted, it is not your right to do so at the expense of those who are working within the system, for their own right to give birth at home, with a midwife.

Where was the midwife at the Duggars birth? Who was the midwife? Was there a midwife?

ACOG is gonna love this.

Thanks, Duggars.