This paper is an examination of the roles, environments, and relationships inside a hospital labor and delivery room. I have volunteered as a doula or childbirth coach since January of 2001. I was drawn to this type of volunteer work by my interest in becoming a midwife. I decided the best way to find out if midwifery was my calling would be to participate in the action. I met my clients when they came to me seeking my services as a massage therapist and then would subsequently invite me to be an attendant at the birth of their child. We would meet several times before labor began for massage treatments as well as meetings with their spouse (all of the women I will be discussing are married) to create a birth plan which reflected the wishes of the expecting parents from the hospital staff.

For the purposes of this paper I intend to synthesize my observations during five different births which occurred on dates ranging from August 1, 2002 until April 13, 2003. Each birth occurred at Santa Barbara Cottage Hospital Labor and Delivery Ward in Santa Barbara, CA. Each birth is unique yet the fundamental happenings are the same. I plan to compare and contr

I tell these particular anecdotes to illustrate the dynamic of roles in these situations. The traditional perception of the hospital is that the doctor is the one calling the shots and the nurse carries out his orders. The laboring woman is expected to comply to whatever the doctor suggests and the husband is only there for moral support. My experiences tell me that if the traditional roles of the hospital room during childbirth ever existed, they have certainly changed. Patients are now seen more as customers than captives. These stories show that even if the doctor is technically the one in charge, the laboring woman is the one who really calls the shots. Her husband will speak on her behalf and act as her protector but few birthing women will wait for the peripheral players to tell her what to do. She does what she has the urge to do whenever the urge strikes her. Doctors sometimes have a reputation of being pompous and demanding believing that they know what’s best because they are the ones with the medical training. That may be true but I think the public’s awareness of what’s happening to their own bodies is improving and a doctor can’t know what a person feels like from the inside. Therefore I see a trend toward hospital birthing centers being more accommodating to the wishes of a laboring woman and the doctors conferring with their patients rather than just telling them what is going to be done to them.

Since I was a beginning doula I tried to pay special attention to everything that happened once we arrived at the hospital. I wasn’t able to do much documentation during the labor aside from jotting down occasional notes so I relied mainly on my memory until after mother and baby were resting in the maternity ward (women are taken to another ward within two hours after the birth of their child)

On another occasion the laboring woman, Sarah, was having her second child. The first baby had come three weeks early and her labor went so quickly she wound up giving birth in the bathroom of a friend’s house. Her biggest concern was getting to the hospital in time to have the second baby in a safe environment. At a weekly doctors appointment a month before the baby’s due date it was determined that she was already dilated to six centimeters and was instructed to go straight to the hospital even though her contractions were very mild. When I met Sarah and her husband, John, at the hospital Sarah’s contractions had stopped but she was unwilling to return home for fear of a repeat of her first delivery. Her husband was supportive of her decision but because of his nerves he spent most of the time pacing the hospital floors and talking on his cell phone. When Doctor Raphael arrived nurse Heidi had told him of her status and he came in for a conference with the expecting parents. Doctor Raphael suggested an intervention which would involve breaking the fluid filled sack the baby was inside of in order to speed up her contractions. Sarah didn’t want any interventions but was afraid Dr. Raphael would send her home if she didn’t comply. Dr. Raphael left the room to give Sarah, John, and I some time to talk. Dr. Raphael proceeded to come back in the room three times to check in each time stating that he didn’t want to be called back to the hospital at three o’clock in the morning (it was approximately three in the afternoon at the time) and he would rather “get this baby out” so he could go home and spend time with his family. After the third time John was furious and told Dr. Raphael that it was his job to be there whenever they needed him and to stop putting pressure on his wife. I pulled John aside and suggested that he compromise with the doctor to give Sarah until eight o’clock that evening and if she hadn’t progressed by then they could consider the interventions. John agreed and I suggested to Sarah that she take a shower because water had played a part in speeding up her last delivery.

Some topics in this essay:
Barbara CA, Dr Raphael, Dr Quigley, Southern India, Mothering Mother, Nurse Nussbaum, Doctor Raphael, laboring woman, dr raphael, woman husband, push baby, due date, heart rate, dr quigley, expecting parents, Sarah John, Santa Barbara, ready push baby, rate monitor, nurse nussbaum, heart rate monitor, fetal heart rate, hospital labor delivery,