No Bradlies, doulas or contracts allowed.

At least, not according to the OB-GYNs at Aspen Women’s Center at Provo, Utah:

This picture seems to be making the rounds of the crunchyboardz, with lots of tut-tutting about the snotty, woman-intimidating OB-GYNs with God complexes.

I have nothing against doulas in general (though I saw no reason to use one myself. I find certain specific doulas insufferable, however). I also studied the Bradley method in preparation for my first birth (somehow missing the woo-ier aspects of Bradley philosophy like endorsing the Brewer diet for preeclampsia). And I’m not entirely sure what a “birth contract” means- an overly rigid birth plan with the implicit threat of legal repercussions if the OB swerves from the script, perhaps?

But when I first saw the picture, I suspected the doctors put up the sign as a result of bad experiences with former clients who’d been brainwashed by local doulas and Bradley instructors into believing that OBs are the one obstacle between a woman and her ‘perfect birth experience’.Hence OBs need to be shackled by contracts, and the information they provide should be suspect until corroborated by more ‘natural’ sources. Did one or more of those external ‘advisors’ perhaps endanger a client by giving bad advice? If I were in a private OB practice and had the opportunity to pre-select my patients, I’d also state my preference for those patients who were willing to trust that I wasn’t out to hurt or undermine them.

Another point I’ve seen in the mommyboard hysteria about this sign is that this must mean that ‘natural’ birth is nigh impossible at this practice. Because, yanno, it’s quite impossible to have an unmedicated, low-intervention birth without doulas, Bradley claptrap and ‘birth contracts’….pffft!

Ironically, the director of the Aspen Women’s Center, Dr. Thomas Judd, seems (at least from the little I can glean about him on the Internets) to be an old-school doctor who knows his way around forceps and vaginal breech births, though he’ll not hesitate to recommend a C-section when he feels it’s necessary. The sheeple…oops, excuse me, women who go to him seem, for the most part, very pleased with his manner and professional demeanor. In fact, here’s a comment from a local CNM who claims to know and admire Dr. Judd:

I am a CNM in the area, and I can tell you that He is the only MD who is willing to back us up so we can be midwives. So patients who want birth plans, doulas and bradley…he kindly refers to our Clinic. Dr. Judd has saved a few of my patients from C-sections with his brilliance in forceps, I normally wouldn’t advocate forceps but he is overly safe with them and knows when to use them and when not to.

When all’s said and done, I wish all OBs were as upfront about their preferences (and previous bad experiences with certain types!)…

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29 Responses

  1. That is interesting. The OB group I’ve used for my two kids has stated up front in their welcome packet that if a pregnant woman wishes to use the Bradley method they aren’t the group for her and encourage her to find another one! They specifically say they find the Bradley method to be too confrontational between the mom and OB. That being said, I had a doula and natural deliveries for both my babies and the OBs were very supportive of it.

  2. I wish he’d had someone proofread his sign.

  3. @Emma–maybe he just has a VERY small practice. 😉

    It’s just as well he states his policy up front. I’ve heard plenty of complaints from women who say their OBs or midwives claimed to be supportive of their preferences, but feel they were misled.

  4. You know, I don’t like Bradley (I think that, particularly in the hands of some instructors, it promotes distrust between practitioner and patient and sets up a very combative environment, and I’ve heard stories to that effect from L&D nurses). But, doula banning, I can’t get behind. The OB shows up to catch. Can you guarantee that I’m going to have 1:1 support from the nurse? No, you can’t and any OB who said that would be a liar. And since that’s the case, I do not blame any woman who hires a doula.

    You want to tell the patient that a doula is only for support and you want to set limits on how you’ll work with them, that’s one thing. But to ban them? That is control, and it takes away the one support method many women have. (Husbands are not great support for many women, which is one of the other issues I have with Bradley.)

  5. I wonder if there are very few doulas operating in Provo. It might explain why he’s completely banned them–if there are four operating in the whole city and they suck, it makes sense.

  6. RE: Bradley – I’ve had five natural births, four using the Bradley Method, and I’ve never heard a distrust for doctors.

    Choose a natural-birth supportive OB / birth place? Yes.
    Make informed decisions for your baby’s care by asking questions? Yes.

    But, never in any of the Bradley curriculum nor from my instructor, have I ever seen or heard students told to distrust their doctors. Instead, Bradley’s book tells women to GO to the hospital. Bradley teachers are trained to _defer_ to the physician.

    There are obnoxious people from all birthing schools of thought, which is why this sign is particularly sad. It would seem that they had a bad experience and then made a decision for ALL women based on that experience. Perhaps the bad experiences all came were with students from the same teacher in that area? (I wonder if the hospital consider calling that teacher or the AAHCC, which certifies Bradley teachers?)

    No Doulas? Does that mean my mom can’t be in the delivery room to encourage me? What about the baby’s father? Or, is “DoulaH” only a paid position.
    No contracts? Does this mean birth plan? As in “I want my husband to cut the cord” and “I would like the baby to room with me and not put into the nursery without cause”?

    I think this policy is a step backwards for women to have choices taken away from them, especially during birth when they need the most comfort and loving care.

    • I suspect Bradley’s disciples and the purveyors of his method have added on a lot of generic ‘natural’ birth baggage in the manner of Lamaze, so going by Bradley’s book (which I read about 12 years ago, and don’t remember anything particularly inflammatory about it) is probably not an indication of how some of Bradley’s followers act today.

      And it seems to me that the sign talks about doulas in their professional capacity only, as prenatal instructors and as labor support. I doubt that if you were to hire a doula and pass her off as your dear SIL who will accompany you to the birth, the practice could actually do anything.

  7. Banning doulas may have more to do with small delivery rooms and doulas who won’t step aside in an emergency like family will. Since I’m sure they allow family and friends, they’re probably only banning professional doulas, and if their experience has been that professional doulas believe they are qualified to catch babies, I can see wanting to ban them.

    I look at it like this. The average clinic with strict rules about things like birth plans, doulas, and methods won’t tell you up front. Or they’ll claim they have different rules then do an about-face during the delivery. This clinic is informing women right away so they don’t waste their time and energy with a doctor who is not comfortable with their chosen methods of giving birth, and who might be overly anxious and cautious during the time. Instead, they can be referred to one of the many midwives he backs up, midwives who are trained in the methods the women want to use and are comfortable with them, and who can operate in facilities designed to accommodate them.

    This guy is actually encouraging women to make informed choices. He gives them accurate and fair information about his practices, then, if they want an alternative, makes sure to find them another practitioner who will meet their needs. He then makes sure he is available as backup if there is an emergency that the other practitioner can’t handle, so they don’t have to choose between no doctor or no birth plan.

  8. I also initially wondered if this is a small-town issue, where there’s only one Bradley instructor and she’s a real martinet.

    In this specific case, though, I think there’s something else at work. Provo, UT isn’t exactly a small town — it’s the second-largest metro area in Utah, and is home to Brigham Young University. I would assume that the clinic’s population reflects the heavily Mormon population of the city, and that the women have a vested interest in going as natural as possible, just as Orthodox Jews and devout Catholics do. If you plan to have six kids, you’re a lot more concerned about avoiding a CS than a woman who only wants two. I’m not 100% sure about this, but I think there may also be a religious aspect at work here — you run into the “Christian midwifery” folks here and there, and I have the outsider’s impression that LDS attitudes intersect well with that . I’d actually be interested to hear what Rixa Freeze has to say about this, since she’s LDS herself (and I think she’s a BYU graduate).

    • I’m not following you…is the religious aspect on the part of the women or the practice? I don’t think many ultra-Orthodox religious women use doulas here (it seems to be more the province of the more modern Anglo women and the Tel Aviv sophisticates).

      • I read it situations in which women want to have more than one or two children – more like 6 or more. In that situation it would be better not to have multiple C-sections. In my husband’s deeply Catholic family his own family with 5 children was seen as small. And I met an Irish lady in a laundrette in East London who’d had 21!

        • BTW I think I have to stop looking at this late at night so that I can stop saying exactly what you’ve just said in a slightly altered from.

      • Sorry, late-night posting, and I forget that there’s some weird US religious stuff you probably aren’t familiar with.

        There’s a certain subset of Christian women who buy into ultra-natural childbirth specifically because they think that it’s Godly — labor pain is the fruit of sin, or the curse of Eve, and Jesus was born via UC in a stable. There are a couple religious sects like Jehovah’s Witnesses who also refuse certain types of medical care such as blood transfusions, and some very small groups explicitly believe in homebirth/UC, and in the power of prayer to cure any and all complications. The LDS Church as a whole isn’t necessarily that out-there, but there is definitely a fringe element that is very… independent, shall we say, like the FLDS breakaway sect whose Texas compound was raided last spring.

        What I’m speculating (emphasis on speculating) is that perhaps this childbirth-as-religious-devotion attitude is suddenly becoming more common among younger LDS women in the area. They already want to have lots of kids anyway, so they’re motivated to avoid CS. They’re subject to competitive motherhood pressures just like non-Mormon women, especially given that it’s a university town full of well-educated women. What if there’s been some kind of change — perhaps a visiting speaker, or maybe the local women’s auxiliaries have been talking about it lately — that’s selling Bradley as not just the best way to birth, but also the holiest?

        If you believe that God wants you to have a natural birth, and that Bradley is the best way to go about achieving it, you’re going to be that much less inclined to listen to anything your doctor says which contradicts Bradley doctrine. If the mothers of the community are getting the religious message, perhaps the practice has lately been dealing with an influx of hardcore Bradleyites, and have had some bad situations arise from it.

        (To be clear, I’m not blaming LDS specifically. I could see the same thing happening among the Southern Baptist community in my city, and I have the impression that the local Pentecostals/Apostolics already ascribe some religious significance to childbirth practices. It’s just the dominant religious group of the area in question, which is significantly more devout than the country as a whole.)

        • Hmmm…very interesting! Antigonos should probably be the one to comment, but while VBACs are less of a deal and there are certainly plenty of women who have close to Duggar-sized families here, there doesn’t seem to be the same reluctance in that particular set (for the most part) to use pain relief nor avoid CS’s at all cost…though an ultra-Orthodox relative of mine had a CS for baby #6, was told not to get pregnant again and blithely ignored that advice 3 times over.

      • If you read the forums on imamother.com, you will discover that a lot of American Orthodox women, including some from American Chareidi streams, are very into AP practices. Homebirth, less so, because of the tznius issues, but some women do it.

  9. I think it is good that they are up front about what they are about. You cannot be all things to all people. I wish more Docs would be able to say, “hey this is what we are about.”

  10. On the other end of the spectrum: I wish hospitals with crappy anesthesia would put up a sign saying, :”we think most women should try to go as natural as possible. Anesthesia is provided for only a few women and it will not be a heavy epidural.” This way if you want a really really good epidural, you will go somewhere else. But if you want a natural delivery, you would go there.

    • LOL.. Pinky, ours is often the opposite, I wish they’d have a sign saying “Hi, I’m the anesthesia MD and I really want to do this epidural and then go home and go to bed and not have to come back later, so I’m going to give you a ridiculously high dose just to cover myself in case a regular dose doesn’t do it. It doesn’t matter to me that you are 5’1″ and 120 lbs 9months pregnant and sopping wet, or that your bp will likely tank, or that you won’t be able to move your legs….” blah blah blah … need some happy medium here!

  11. I’m LDS, so seeing that this is in Provo made me laugh. 🙂 It’s definitely not a small town! There really isn’t any religious expectation for what kind of birth you will have, although because large families are the norm (while not a requirement at all) there are many women who make the personal choice to avoid Ceseareans.

    You will find groups within the LDS faith who espouse a philosophy of natural birth, or those who are wholeheartedly against it, but there really isn’t anything standard to the faith as a whole. I personally had both of my children with an epidural and I don’t intend to give that up. 😉

  12. Well, actually, I imagine it is hard to have a natural birth without having an informed advocate in today’s hospitals. It’s drug you up and get it out fast or else we’ll cut you open and take it out. That’s how these doctors operate now. Its appalling to me that this hospital would post a sign like this. “No doula” is like saying we only want ignorant people in the room with you, so you have no hope of challenging our authority. “No contract” – well, why can’t they agree to respect the woman’s wishes ahead of time?

  13. How hard is it to get another doctor? Just do that instead of engaging in your slasher fantasies.

  14. I don’t get this youngest generation of women. RUN like hell from any doctor or clinic that dictates how you will give birth. There are directories of midwives and doulas online. Women have been successfully giving birth from their wombs for centuries. For God’s sake, you were given a brain. Use it!

    Natural caregivers; they are out there women! http://birthpartners.com/

    Doula Directory for US:
    http://www.breastfeeding.com/directory/doula_directory.html

  15. Fear.
    Unfortunately, this hospital chooses not to read current evidence-based research that clearly show the benefits to these choices. Which by the way, are their patients, their customer, they way the make money.
    Oh, but by restricting these choices, I bet evidence-based research would show a higher than average profit margin for medical services. It’s big business.
    Smart consumers run, not walk from this one!

    Women with a brain, who can read. Patricia Brown

  16. Wow, what a trifecta: I am a Bradley teacher, a doula, and, get this, one of Jehovah’s Witnesses.

    1. The only medical care Jehovah’s Witnesses refuse is blood transfusion, based on a Biblical command. Epidurals are not ‘against our religion,’ nor are elective cesareans, for that matter.

    2. I and the other Bradley instructors I know emphasize, “Find a care provider you trust, then trust your care provider!” There is nothing harmful or to put you at odds with your doctor about understanding the birth process, your rights, and various options. Unless, that is, you have the kind of care provider who doesn’t believe in rights and options for his/her patients. In that case, see the statement at the beginning of this paragraph.

    3. As a doula, I have worked with wonderful, amazing, kind, respectful obstetricians, obstetricians who say, “YOUR BABY COULD DIE IF WE DON’T USE THIS CONTINUOUS FETAL MONITOR,” and everything in between. There are wonderful and not-so-wonderful obstetricians, just as in every other profession in the world. It’s wise to choose carefully.

    4. No doula worth her salt, who is certified with any of the major doula-certifying agencies, believes she is qualified to catch babies (unless of course she is also a midwife, but when working in the capacity of a doula, she would never presume to catch babies). Like I said about obstetricians, there are wonderful and not-so-wonderful doulas. I know a lot of doulas, though, and I can’t imagine any of them contradicting a doctor or trying to catch a baby.

    I’m pretty “hard core” Bradley, as one person above put it, but I promote respect for the medical profession. I love to see a good doctor who respects his/her patients, whatever field of medicine is being practiced, and they ARE out there. Find a care provider you trust, then trust your care provider.

  17. This hospital clearly prefers to perform C-Sections and not waste their staff & dr’s time with something like “natural birth.”

  18. I live in the Provo area and yes Doctor is kind of a small practice most OBs around here are cause people like it that way. I also know that doulas are rare and of like the six in Provo they are finatics. This man will not only due a vaginal breech if you ask he is also only one of two docs at Orem Community that will do a VBAC so he is very supportive he’s just probly had some of the same bad experiences as other doctors in the area with finatics.

  19. Im very offended by such OB’s banning patients who practice and believe in the Bradley method. I studied the Bradley Method with both my pregnancies and I also went to an OB’s office. I did not come across any problems between an OB and Bradley method beliefs. My first deliver was awful and I know had I a doula to oversee my labor my daughter would not have nearly died and been rushe to the NICU. No OB was present to look in on my labor which resulted in severe and life-threatening distress. I begged for a Dr, but the nurses said no one was available. My second pregnancy I found an amazing OB who was better than any mid-wife I could imagine. Point being women who practice the Bradley method are not at all against OB’s. Just against horrible OB’s as all should be. I find not solid or ethical reason to exclude Bradley method patients to one’s practice. I believe that to be a major discrimination, and am highly offended!

  20. I myself am a doula, and I find it really sad that this practice would ban doulas from being with mom! A doulas role is to be mama (and dad’s) advocate and support person, to help mom make informed decisions by having her ask questions. When (for example) a mom is offered pitocin to “speed up labour”, it is our role to ask the mom if she would like more information, or if she can try natural methods, and have HER ask the nurse/doctor. We are NEVER to interfere with the medical side, which includes giving the mom our opinion. There have been far too many times where we have had to bite our tongue over unnecessary interventions because mom agreed to what was offered. If a doula is ever to step in and get in the way of OB/GP/midwife, it should be reported to DONA.
    I feel like this is a one example of why it is so important to hire a doula who is DONA certified/certifying.

  21. I realize this is an old post, but I came across it while looking up Dr. Judd, who delivered my son in 2004. He was wonderful and I was lucky to have him on call. Forceps had to be used last minute, due to baby being face up. He saved me from a C-section (after 12 hours of labor, at that!). Dr. Judd has a very laid back, non-judgmental vibe, – and I respect what he’s saying. There is so much you can’t plan for. Everything could go wrong, even if you’ve done everything during the pregnancy right. I’d never risk delivering somewhere, on purpose, that wasn’t equipped to handle serious complications. It may be an overly neurotic point of view, but I’d say it’s much better to be safe than sorry. And I’m a liberal, nature-loving Bohemian.

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