I was looking for recommendations for infant sleep yesterday, when I wandered onto the Society of Obstetricians and Gynecologists of Canada (SOGC) website. On the page titled Women’s Health: Pregnancy: Birth Plan, I discovered a small piece of text that I found troubling in terms of how it might mislead pregnant women and their partners reading the site. This is the paragraph, verbatim:

The labour coach
Studies show that when a woman in labour has the continuous (italics mine) support of someone who cares for her (a labour coach), she will have a more positive experience. The hospital will provide you with a professional labour coach (an obstetrical nurse) who will help you during labour and delivery, and after the baby is born. (http://www.sogc.org/health/pregnancy-birth-plan_e.asp)

While I have no issue whatsoever with the first statement, in fact I heartily agree with it, my concern is with the second sentence in the paragraph. An obstetrical nurse is not a labour coach or labour support person. They may provide some comfort or support to a labouring woman, but they also have many other duties, as well as other patients to attend to. The benefits of a doula, or labour support person, labour coach, etc. are experienced when support is continuous and one-on-one. The first sentence even indicates that the support ought to be continuous.

My comments here are not meant to disparage obstetrical nurses in any way. They work hard and have very challenging jobs and many do feel inclined to offer comfort to women in labour, but I fail to see how they could possibly provide continuous support when they cannot possibly be in the room the whole time. Every time the labouring woman and her partner are left alone that support is discontinued. Even while in the room, the nurse has other tasks of a clinical nature that she must attend to. This means that while she is attending to these other duties, she is not focused on providing support to the labouring woman. In addition to this, obstetrical nurses work in shifts, meaning that depending on when a woman in labour arrives at the hospital and how long her labour lasts, she may not be cared for by the same obstetrical nurse from the time she arrives until after her baby is born. That means that she may encounter different nurses, with different birth philosophies, perspectives and different styles of providing comfort (or in some cases, no tendency to provide comfort at all).

Reading this paragraph, one might easily be led to assume that a labouring woman would be assigned a single obstetrical nurse whose primary role is to provide support and that that nurse would stay by her side until after her baby is born. It would be quite a shock indeed to discover while in labour that that is not the case at all.

Again, this is not to diminish the role of the obstetrical nurse. When a client chooses to have a birth with an OB, obstetrical nurses are vital components of the overall health-care team. I would argue though, that doulas are too. This statement not only misinforms labouring women and their partners, it also diminishes the work that doulas like myself do. This benefits no one.

I have already emailed the SOGC – if you too feel that this statement is misleading and unfair, I urge you to do the same. Doulas are assets to the doctors, nurses and midwives that we work alongside, as well as essential to our clients, our value should not be overlooked.

What do you think?