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Doulas, hospital reach agreement over delivery room presence

So you're having a baby, you want it to be a wonderful experience with the father present and your emotional support – your doula. You hired your doula several weeks before you are due and you've worked closely with her on how you would like the birth process to take place.

But when you go into delivery, hospital staff throw your doula out of the room.

Is it your right to have her there? The issue has been up in the air at King Edward VII Memorial Hospital for almost two months.

Following the release of an article in the July 17th edition of Body & Soul where local doula Sophia Cannonier expressed her personal views on childbirth, some KEMH midwives were upset and refused to allow her to attend births where they were officiating.

Hospital midwife Frances Wedderburn has 34 years experience. In a letter to this reporter she expressed grave concern over Ms Cannonier's pro natural birth views.

She wrote: "People usually take their cars to qalified motor mechanics, a number of people choose private schools for better education and in general in all aspects of life, one prefers to deal with a qualified person!"

But the exclusion from KEMH delivery rooms was not limited to Ms Cannonier.

Doula Lynn Hunt was forced to sit in the hospital waiting room while her client delivered without her.

A situation which greatly upset not only Mrs. Hunt but also the new mother, Amanda Strong.

"The saddest part is we grew close beforehand she was a big part of our lives. I'm sorry she was robbed of that experience (the birth). I lost complete control in the end I could have used her support," said Mrs. Strong.

"I wanted to have that experience with Lynn. I had been preparing with her for weeks. It was all about her being there for me, for the support," she said.

And Mrs. Strong said the disappointment she and her husband Nick felt, soon grew to anger that Mrs. Hunt had been shut out of the birth of their daughter.

"When I had freshened up I was angry especially because the midwives told me that what they saw Lynn do with me is something they could never provide.

"I thought that was crucial. I didn't think they had a right to make her leave," she added.

But local doulas soon learned that because KEMH midwives were so upset with Ms Cannonier, a new policy banning them from the delivery room was implemented.

The problem prompted doulas to meet with KEMH midwives and acting chief of obstetrics Dr. Dale Wilmot. The meeting took place in early August.

It resulted in the hospital laying out a new policy which allowed doulas in the delivery room, but only as a family member. This was tantamount to banning them, as women would have to make a choice between having the father of their child in the room or the doula.

Mrs. Strong said it's too stressful a predicament to subject a woman in labour to.

Expectant parents soon learned of the hospital turnaround and became anxious and even angry. "From our perspective, we see it as the hospital providing a service to us," said expectant mother Rebecca Van Homan. "We have rights as patients. Doulas are common in Europe and England and are there to support father and the mother emotionally.

We are hoping to work with Sophia and Lynn Hunt but if a doula cannot come in the room there is no point in having one.

"That is the person you have seen through your pregnancy, they are the familiar face. It's like having a friendly big sister," she said.

"I think it should come down to what we want," said Mrs. Van Homan's husband Robert Wilkinson.

"I'm just renting a room from you. I don't know why they don't provide that option or let the parents decide.

"We are having the child, we are not children," he added.

Concerned with their fate, doulas tried for weeks to speak with the quality assurance department of the hospital.

They arranged a meeting with the Health Minister Michael Scott and Chief Medical Officer Dr. John Cann who they said promised to look into the matter further.

After an enquiry on the issue from Body & Soul last week, Ms Cannonier said she heard from the quality assurance department of KEMH.

She said she was told the hospital had made a provision that doulas be allowed in the delivery room but that their title would be changed to labour coaches.

In response to the enquiry a KEMH spokesman made no mention of the change in the doula title and clearly said doulas would now be allowed back into delivery rooms if parents wanted them.

"For births that progress naturally, it would be expected the doula can provide full support. However, the hospital's duty is to the safety of the mother and baby in its care.

"Our physicians and midwives, as trained medical professionals, therefore do retain the right to request a doula leave the delivery room if there is an emergency medical need," the spokesman said.

Lynn Hunt welcomed the news but finds it hard to understand why the problem erupted.

"I'm there to help keep an anxious mother calm through the entire delivery – up until the time the baby is born.

"A mother is particularly vulnerable toward the end of labour when she is in pain and tired, this is one of the most important times to be there to help calm her," she said.

Mrs. Hunt also said she would respect the need to leave the room if medical emergency or complications developed where she could not help.

"I am not a medical person, that is not my role," she said.

Asked how she feels about having to assume the title labour coach to work in the hospital, she said: "As long as I know the work I am doing is that of a doula I have no problem with what they want to label it.

"It's the work that is important – working with the mother and medical staff."

Ms Cannonier is wary of what doctors and midwives may deem a medical emergency.

Like Mrs. Hunt she feels strongly that a doula may be of particular benefit for the emotional support she affords at that time.

A strong proponent of patient rights, she said: "The parents have the right to say they want their doula to remain with them the entire time and not to be asked to leave the room at any time.

"The doula does not get in the way. In some hospitals the doula can even go to the operating room with her clients for C-sections."

Is a birthing centre the answer? Unable to comment on the issue, Dr. Wilmot said many of the natural birth methods Ms Cannonier advocates are better suited to a birthing centre.

"The hospital is different from a birthing centre. A birthing centre is built to deliver a woman as naturally as possible, they can be a lot more flexible. The hospital is not equipped to do that," he said.

"We have talked a lot about having a birthing centre in Bermuda. In the future it may be able to be worked into the plans for the new hospital."

Expectant father Robert Wilkinson is sceptical about the idea.

"I think it would be a really good idea but what's going to keep the birthing centre from being maternity ward two? I don't know how it would be approached," he said.

"I guess a private centre would be best. I would like there to be a movement toward being more green," he added.

"There is a row of clinics along Point Finger Road with modern electronic equipment. I want my child to come into the world in the most natural way possible – just with the expectation of being loved."