Who is the Most Important Person in the Room?

Not too long ago, we had a very interesting birth.  Actually, all of the births are interesting and you never know what new protocol has been instituted at the hospital regarding inmates.

Many times, the inmate is not taken to the hospital where we usually go for their births.  An ambulance is only called for them if the Nurse in the Medical Department of the jail is concerned about getting her to the hospital in time.  Normally, they go in a squad car with the Deputy.  Understandably, taking an inmate out of the jail and into an unsecured environment is a safety risk for everyone involved.

If the inmate goes by ambulance, the EMT’s can make a decision to go to a closer hospital.  This can become interesting if we, the doulas, have not been told of a hospital change.  In this case we do a lot more driving trying to find our mom!

Recently, one of our doulas did the “find the right hospital” in the early morning light.  After she got there, the inmate was so relieved to see her.  She was afraid that the doula would not know which hospital to go to.  Thankfully, she was there and was able to support her.  The inmate was precious in her very fast birth.  Heather, the doula, was stroking the inmate’s shoulder.  The inmate put her hand up as if to say stop touching me.  Heather apologized and the inmate said, “No!  I want you to keep doing that.”  Heather put her hand back on her shoulder.  The inmate reached up with her hand and then tilted her head as if she was trying to get even closer to Heather’s hand.

For many inmates the comforting touch of a doula is the only nonviolent contact they have experienced in months.  Many are coming from less than steady relationships on the outside.

After the birth, if the mom is addicted to drugs, then time is spent waiting to see how the baby reacts to being out of the womb and not having drugs going into their system.  There is a procedure the nurses do each hour to test how baby is doing.  At a certain point, in all cases of addicted babies, they are taken to NICU so they can be monitored more closely. 

This mom was addicted to drugs. She cried and held her baby tight. She kept apologizing to the baby for taking the drugs and making him sick.  It is not as if they found out they were pregnant and then started taking drugs.  They were addicted long before they were pregnant.  Just as any disease, addiction is very hard on the body, the baby, and extremely hard to stay clean.  This is not an excuse; it is the facts of this terrible disease.

The baby did end up having to go to NICU.  Before Heather left, she could see the signs in the baby that he was now feeling the affects of not having the drugs in his system.  This is a radical departure from what the baby had been experiencing in the mothers womb.

So, why my question, WHO IS THE MOST IMPORTANT PERSON IN THE ROOM?  In this case, because of some confusion, the hospital staff was not sure about when to take the mom to NICU to see her baby and how many times they could.  By this time there was a new doula that was now working with the inmate postpartum, everything is different from the protocol we are accustomed to.  And we are in a hospital that we rarely go to. 

The doula, Cheryl, was texting me asking questions on certain policies and what the procedure would be.  It was at this time I learned a very valuable lesson.  Everyone wants the best for the mom who is an inmate.  You, as the doula want the best, and also the hospital wants the best for their patient (the inmate) and now their new patient, the baby.  But many times things do not turn out the way you as the doula want them.

Being a doula, and “standing your ground” and saying I will not be moved and I want Plan A to be done NOW does not help the inmate who is the mother. The most important person you are working with in the room is the nurse.  She is doing her job. She is the medical professional on scene.  There may not be a written policy for inmates.  The nurses can also be questioning what to do too.

In situations like this, instead of “standing your ground” and saying it WILL be Plan A, work WITH the nurse and the staff, not against them.  You want to let them know that you recognize they want what is best in this situation and you want to help them and the new mother with this plan.

It is at this point, if you fight to get your way with the hospital you may loose your right to be a doula and to help her.  Remember why are you there.  It’s to help the mother, the inmate.  To help her bond with her new baby.  To help this baby get the best start in life.

If you spend this time fighting, and loose the privilege of being with the inmate, who will be there for the next inmate that is giving birth?  That is the question you need to ask yourself.

 We have found that many times, that if we don’t try to change the policy of the jail or the hospital, just our presence alone has changed many different situations and policies.  I believe this is the reason why the jail we work with and the hospital and caregivers, have been more on the cutting edge of incarceration reform than many other institutions in the county.

Care for the mother first.  You will be surprised how much you can influence the circumstances around you.

****Disclaimer: This blog is from the perspective of a jail, not a Sate or Federal prison.  Protocol will vary from initiation to institution.