My experience of the round pegs and square comes mainly in work as a post
partum doula,Not as esoteric as the situation Nikki describes, nevertheless
I will relate it here.  I often find myself allowing myself to become that
round peg pounded into the square hole.  I know what my role should be, that
of mothering the mother, providing support and information to her so that
she may develop her own mothering style and integrate her baby into her
existing family, or if this baby is her first, help her and her partner
create a new family dynamic.  Despite our discussions before we sign the
contract during the prenatal home visit, and sometimes subsequent phone
calls prior to her birth, despite the packet of suggest reading,
 information and websites I provide,,(and most of them get my name from the
DONA website so they've got an idea of what a postpartum doula ought to be),
when I arrive, I'm pounded firmly  into the square hold of  babysitter.  Mom
wishes only to sleep.  And sometimes just pump and sleep. A baby who won't
be swaddled and sleep in the crib like she did in the hospital is my
problem.  For all intents and purposes it is up to me to be the new mom,
without the obvious down sides. So I feed, care for, change, soothe, and
provide that love and interaction that comes naturally. Fun, but not my
job.  It's increasingly rare and sadly, yet for me, happily, refreshing,
when I actually have a client who wants me to do the job for which I am
paid.  Being a handsomely paid babysitter is not what I signed up for.

So what do I do?  I am failing the mother by allow her to perpetuate the
system that fails the baby by providing what we know is substandard care?
Of course I do my best to encourage her to follow the optimum breastfeeding
practices for success and to avail herself of my professional doula
services.  Rangling from gentle guidance and suggestions to tough love, I
still often come up empty handed, baby-handed I should say. Some give it a
try, others say "it didn't work in the hospital" routine, others use the
pumping excuse, you've heard them all, I'm too tired, my mother will be here
in a week, ....  How hard to push is too hard?  Where does the line of
advocating for the baby?  When you're in the house for 5 or 6 hours a day
for a week, the client/provider is different than it is for a lactation
consult.

The lines of ethical standard of care (as we in our hearts might define it
in our role of baby) advocacy) vs. customer service is a frequent dilemma.
Not so much for the non IBCLC/PPD, it appears in conversations I have had
with pp doulas who are not also IBCLCs. Am I the square peg being bashed
into the round hole of what I have observed of the increasingly normal
expectations of  the mother who wants to sleep, put her baby in the nifty
baby seat that is warm, wiggles, and sings rather than holding her, and has
me feed her expressed breastmilk (because we know breast is best, and we've
got the best $350 pump with which to extract it, and by the way is 3 ounces
at each breast is enough? my friend says she gets 3.5 oz.  should I buy a
different pump? [not should i actually breastfeed my baby] by accommodating
her wishes.
Unfortunately, my answer seems to waiver based on the individual mother, her
husband, family support and my energy level of the day.  Not good, huh?
Help!

Barbara Ash, MA, IBCLC, PCD (DONA)

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