If you have been on any of the birth forums in Louisiana lately, you probably have seen this petition. A hospital in Louisiana, Lakeview Regional Medical Center, is requiring that doulas go through a credentialing process to practice in their hospital. Some of the requirements include Proof of Doula certification, Flu shot, background check, drug screen, client confidentiality class, tuberculosis testing, and some other yearly testing. Originally the cost quoted was over $700. Now, with doulas and other entities voicing their concern the cost was reduced to around $100. Even at $100, if this requirement spreads to other hospitals this could become very pricey. Lakeview is a HCA hospital. Louisiana has five other HCA hospitals in the state. Click here for the complete list.
For the Doula – You will likely get business from this hospital. Your name will be given to prospective clients. You will be “approved” by the hospital, so hopefully reluctant staff will embrace your presence.
For the Client – You will be given a list of approved doulas. This will make researching a doula easier for you.
For the Hospital – They can control which doulas work with their clients. They make money from the qualifying fees.
For the Doula – The doula will have more out-of-pocket expenses. The hospital will have more control over them, even though they are not employed by them. The concern with this is that doulas will be working for the hospital (without being paid by them) instead of the client (who’s paying for this service). This article discusses some of the dilemmas labor support may face. I practiced as a nurse for 7 years. There were many times when I felt that my patients did not receive the best care because of hospital rules. There are a lot of politics involved when working for a hospital, and unfortunately sometimes patient care is sacrificed. When deciding to switch from nurse to doula, the idea of simply focusing on my clients needs, instead of the hospital’s needs, was very appealing to me. Will this hospital certification change this? Only time will tell.
For the Client – The client loses autonomy. Women are smart human beings, capable of researching and making their own decisions. What matters is that women feel supported, not if the HOSPITAL thinks the doula is qualified. To read one woman’s thoughts on this topic, read this Improving Birth post. Instead, the hospital will offer a small list of doulas, that may, or may not be, the best fit for that mother. Additionally, prices will go up to pay for extra certifying costs, especially if other hospitals jump on this bandwagon. Many doulas travel at least an hour to a client’s birth place. That will include a lot of hospitals.
For the Hospital – “Boycott” is being whispered throughout the state. They may lose business from clients that do have other hospital options. They will not be the hospital that is known for supporting women’s choices. Women talk, we give advice, and we give a lot of referrals.
SO, WHAT IS A DOULA OR A CLIENT TO DO?
The answer is easy right? –
For the Doula – Sign the petition if you don’t want this to happen. Spread the word. The more people who know about it the better. This is easy with so many social media forums. Don’t get credentialed through this hospital. Don’t take on clients that plan on using this hospital.
For the Client – Sign the petition. Choose a different hospital and doctor. (I only mention doctor because some doctors are only affiliated with one hospital, so it may be an all or nothing deal.) You are the consumer! You or your insurance company is the one paying this bill. Make your thoughts known! Let them know that you are capable of making your own decisions about hospitals, doctors, AND doulas! Birth workers are small in numbers, consumer’s numbers are much larger. The hospital is more likely to listen to you (the paying customer) than a doula. You are more likely to make change happen! Get involved! Louisiana Constituents for Safe Childbirth and Citizen for Better Birth are some groups that are working toward change statewide. If you are in the Northshore area, join Northshore Birth Options.
BUT WHAT IF BOYCOTTING IS NOT AN OPTION?
For some women, switching hospitals and doctors is not an option. It’s easy for women, with birth options, to tell a woman not to go to this hospital, but if their insurance only covers this hospital, that may be THEIR only option. Many people cannot afford to pay out-of-pocket for a hospital birth, or want to. They also may not want to switch doctors. Additionally, they may have limited transportation. Some families do not have cars. I’ve had many co-workers that depended on bikes or public transportation to get around. Or they may not want to labor in a car going to a farther hospital. Whatever the reason, this is THIS consumer’s decision.
What about these women? Doulas chose birth work to support women. If women choose to birth at this hospital, do they not deserve this support? Should all doulas boycott this hospital to take a stand? This is the dilemma that many doulas in the Northshore area are facing. These are tough questions, and I do not know the answer. I do, however, hope that our birth communities stay a safe and supportive place for consumers and doulas alike, as they make these tough decisions.
As we remain respectful to doulas and mothers alike, I hope that more consumers will make some noise. Sign the petition. Contact the hospital. Write letters. Go elsewhere is you can! The petition should actually say Ask Lakeview to Support WOMEN. This is really about women having birth options, not doulas having employment.
I would love to hear from consumers! What do you think about Lakeview’s new policy? What should these doulas do? Take a stand and boycott the hospital? Refuse clients that choose this hospital? Go through the credentialing process, even though they don’t agree with it, so that they can still support women? Or better yet, do you have another suggestion/solution? Comment below!
I am the President of Louisiana Constituents for Safe Childbirth. We are a statewide non-profit with a mission of providing research, education, resources, support of birth options in Louisiana for healthy moms and babies. Check us out: Facebook page, Facebook group, Twitter, Website.