Did you know that in most hospitals you are allowed two support people? Presumably one will be your partner and the second can be...your friend, a family member, or a hired professional called a doula.  Having an extra set of hands to assist you and your partner can be very beneficial.  In the case of a doula, The assistance comes without judgement and with an expertise in modern birth and a knowledge of the workings of the hospital.

But what if you were told by your doctor that they didn't allow you to have a doula?  Do you think your doctor has the right to dictate who your support people are? One such incident was highlighted to me earlier this week and it got me thinking. 

Consider this, what are the chances your doctor will actually be at your birth? Having a doula offers you continuity of care.  Your own doctor can't offer you that.  The vast majority only work at their hospital once a week or less.  And as most hospital policies do not dictate the precise "who" you can have, where is it coming from that your doctor can say precisely who will be there to support you?

One reason could be that the doctor has had a past bad experience with a doula and has written off the entire profession.  A situation of one bad apple spoiling the bunch.  But like with all things, there is good and bad.  There are good doulas, and bad doulas.  Just like there are good doctors and bad doctors, good nurses and bad nurses.  But you might agree, that one bad experience shouldn't ruin the experience of all mothers and shouldn't take away a woman's choice for her own birth.  If we did that, then most of us wouldn't be seeing doctors at all, or going to hospitals. 

A second reason might be control.  Some doctors, not all, like to micro manage birth.  They like to control the process and don't like to answer questions.  Some feel the questions you ask are actually you questioning them as a doctor and as a professional.  Some think the doula is whispering in your ear and getting you to make decisions that go against medical advice, or that the doula is bad mouthing them behind their back. 

Nothing could be further from the truth.  A doula is there to support your decisions.  To help you in physical comfort and evidenced based information.  To remind you of your birth plan, that you and your doctor agreed to.  To help you cope when things don't go as planned and to be with you even when everyone's shift has ended.  They are not there to make decisions for you, but to help make sure you have all the information to make an informed consent decision.  And informed consent is your right as a patient. 

So what is a parent to do when confronted with having to choose between the birth team she wants and not upsetting their care provider? The easy answer is nothing.  It shouldn't be a choice.  Your birth should be what you want it to be.  With a care provider you like, who is supportive of your choices, in a place where you feel comfortable, either at home or a hospital or a birth center.  With a team of supporter of your choosing who will care for you, listen to you, and be with you every step of the way. 

But how do you do that? Research.  Interview, yes even doctors.  Go on tours of different facilities, ask questions, ask your friends, family, co-workers, prenatal teacher.  Research on-line, read books beyond What to Expect When Your Expecting.  Pregnancy and birth are all about choice.  Don't have that choice taken away from you because of fear and ignorance. 

My Completely Biased Favourite Places to Give Birth in Toronto

I currently teach prenatal classes at York Central Hospital. Because the program is run by an outside organization I often get couples that are having their babies in other hospitals. I realized the other day that I have an obvious bias toward certain hospitals. So as such, I thought I would try to keep my biases out of the classroom and share them here instead.  

Sunnybrook - Having your baby at Sunnybrook is a definite experience. If I were to have another baby and had to have a hospital birth it would be here. The facilities themselves are practically brand new. Private labour rooms double as your postpartum room and are roomy with most medical equipment actually hidden behind cabinets and stored away. The bathroom holds a wonderful deep tub with jets and room for partner should they choose to join mum in the water. And there is optional dim lighting in there too. And the most practical touch of all, a mini fridge to hold your drinks and food to use during labour and postpartum.

But all that is just window dressing. The staff make your birth experience at Sunnybrook truly fabulous. The nurses, who are your main contact at the hospital, are definitely there for you. Whether you are choosing an unmedicated birth or are looking forward to your epidural, the nurses will be there to assist you in executing your birth plan as best they can. I have rarely seen women pressured in to procedures they don't want to the sake of expediency. They are open and friendly and caring. The doctors as well are a rare breed in the world of maternity care. Several I have seen are open to choice, one was even supportive of a clients desire to have her baby in water. Something we only really see with midwives and homebirths. Whether you are hoping for more then 5mins in your appointment or delaying your cord clamping by 2hrs, there is a doctor at Sunnybrook for you.  

Toronto East General - Until Sunnybrook came on line, Toronto East was my top pick for hospitals in Toronto. Like Sunnybrook the staff is fabulous. The nurses are kind and caring and the pressure to get an epidural is minimal. The facilities themselves while older are still good, with big rooms and tubs in almost every room.

The doctors are also unique in offering breech vaginal delivery and discussing choices with informed consent as opposed to pressuring patients into what will work best for the doctor and their schedule. Toronto East General is also one of only two hospitals in Ontario that have been awarded an official Baby Friendly Hospital by The World Health Organization and Unicef. Not even Sunnybrook has this. As such they also have an amazing breastfeeding clinic to help you in getting the support you need in that critical time after birth when you and your baby are learning to breastfeed.  

Mount Sinai - While many doulas would not even have Mount Sinai on their list at all, I have had too many good experiences not to have them on my list. Mount Sinai is the only hospital where my clients have not ended up in a cesarean section. Almost 30 percent of my clients have birth there and none have had a surgical birth. That's amazing. While the facilities are old and in the process of being updated, the staff are fairly good with staff who are open to natural birth, even if they don't always understand a woman's desire to go natural. I have seen women pressured to accept interventions simply to speed up the process, but if you enter into your labour with a plan in mind, educated on your options and with good support who will advocate for you then you may not fall prey to unnecessary procedures.  

The Others - The rest that round out the list include North York General, of which I have a certain fondness, having been born there myself. Markham-Stouffville, for its recent achievements in reducing their cesarean section rates. And Scarborough Grace where I had my own children with an amazing OB.

So that is my completely biased list of hospitals in Toronto. If your hospital isn't on this list, odds are it isn't one of my favs. But I'm just one doula. Your birth will be what you want it to be and what you allow it to be. But wherever you are having your baby I always recommend a doula to help you get the birth you want.

Pleasant Hospital Experience

It has been just over a year since SunnyBrook opened their doors to their new Women and Babies unit. I had not had the opportunity to attend a birth there until this past weekend. As it was, it was not my client but I was called in to back up my partner. I was extremely impressed.

The facilities were beautiful. Of course it still had that shinny new feeling to it and the paint was probably still wet but it was nice none-the-less. The room had a fabulous deep tub and the room was large and spacious. And to my delight there was a private mini fridge for mum and partner to bring nutritious snacks and drinks, or a small bottle of champagne. And best of all you don't have to keep food in a communal fridge to be stolen by others.

But beyond the cosmetics and bells and whistles of the hospital, one of the best things about this hospital is the staff. The first nurse I met was Aggie. I had met her when this program was done through Women's College and she is still a fabulous, friendly and caring care provider. Then we met Karoline and she was equally wonderful and caring. The doctor who came on shift while I was there, Dr. Nevo and the resident Stephen (I didn't catch his last name), they were both very patient and spoke calmly and slowly about what their recommendations were and what the procedures would entail. This goes along way to making a potentially stressful situation easier for mum and partner.

Unfortunately for our client the end result was a cesarean section but for the comfort and support of both mum and partner, the doula, me, was allowed to attend the section as well. I was very happy for that, as the situation did require more then one set of hands to keep mum calm and comfortable for the hour it took to complete the procedure.

Overall, the entire experience was more then I could have hoped for, for any couple having a baby. The respect for birth and women and their ability to give birth is a rare gem in our world today. While the bells and whistles are great, women have been giving birth without them since the beginning of time, but what they have always needed to give birth is kindness, caring, support and above all respect. And SunnyBrook Health Sciences Women and Babies Program has that in spades.

Can't wait for my next birth there.