What Doctors Do

You hear it all the time in the local doula groups. Accusations from doulas that what the provider is doing is not evidence based. That clients are receiving unnecessary cesareans. That doulas need to advocate for their clients when they’ve selected a “bad doctor.” And clients have heard about this phenomenon too--to the point that our clients sometimes feel that hiring a doula isn’t right for them if they trust their provider’s recommendations or that clients feel they owe an explanation to the doula for their choices.

Before I found doula work and midwifery as my profession, I was a medical student. I spent four years as an undergraduate juggling being a biology major, a division I student athlete, and working as a nurse assistant at the hospital. Admission to Loyola’s Stritch School of Medicine brought my husband (then boyfriend) and me to Chicago. And there I arrived, 22 years old, star-struck and puzzled at the culture that greeted me.

I was amazed at the sacrifices my classmates made. So amazed, in fact, that I was not quite sure I could justify these sacrifices, as motivated and driven as I had always been. I was forced to give up reading and researching anything that wasn’t classwork--a struggle for me, a perpetual academic and a person of multiple passions. I lost touch with hobbies. There was little time for socialization and when it occurred, it was a given that half of those invited would cancel at the last minute because they needed to get more studying done. I found parts of myself slipping away in exchange for the time and commitment that medical school demanded of me.

When I had a baby a month into my second year, I was in class four days postpartum with my brand new baby. A week after giving birth, I was in the simulation clinic learning how to do a breast exam on a standardized patient--highly ironic, I remember thinking, as my own engorged breasts begged to be with my baby who was downstairs with a friend.

As long as the road to medical school had been, the decision to the leave was quick and easy. Months after taking a leave of absence halfway through my second year, I was accepted to an RN-MSN program for nurse midwifery. That road has admittedly been an easier one though still demanding of significant personal sacrifice.

There is a multitude of studies that examine the health of physicians and find that the grueling work expected of them produces less than ideal health outcomes. For instance, medical residents are statistically more likely to have preterm or growth restricted infants and have a higher risk of pre-eclampsia. Women in medicine struggle to breastfeed when they return to work because breaks for pumping are often hard to come by and not necessarily a welcome part of a greater culture that, although increasingly dominated by women, still employs a great deal of paternalism.

Your doctor that stands before you spent four years in an undergraduate program, four years in medical school, and three to eight years in residency. On top of this, it’s likely they spent time in between any of the above doing research, a post-bachelor’s program, or another career that enabled them to be a more competitive applicant to medical school or residency. By the time they come out of all of this, they’ve spent the entirety of their twenties, and often part of their thirties, putting family, friends, and personal interests on the back burner so that they could take the very best care of you and your baby. The stress doesn’t stop there. Obstetrics is full of liability and insurance policies and provider shortages often mean that your doctor is being over-extended and over-worked.

And still, I am amazed by the compassion and humanity of many of the doctors that care for my clients in the Chicago area. I am not sure that I would have emerged on the “other side” of medical school and residency with such grace, commitment, and attentiveness.

I am a better doula for the time I spent in medical school, but having been there is not a prerequisite for respecting the expertise of medical providers.

The doulas with The Chicago Doulas want clients to have trusting, satisfying relationships with their care providers. We are confident in our clients’ choice of care provider, and we want clients and providers to know that we enhance our clients’ communication with providers and hospital staff, not create conflict or mistrust.

March 30 is National Doctor’s Day--a perfect day to thank the physicians in your life!

Maura Winkler