Monday, 19 September 2011

Doulas & social media use - what are your rules?

My apologies for the looong blog silence. Note to self: just because you CAN go on a week-long trip and take no time off of work, by working 6 out of 7 nights when you get back...well, that doesn't mean you SHOULD. Especially when those 6 nights are very very busy! But I am (mostly) recovered and ready to get back to writing.

A topic that's been rolling around in my head since my trip was the question of doulas & social media. This has been brought up recently with doulas I know locally to me. I also had a conversation with a doula friend who I visited with while traveling. Apparently it's been a subject of debate/discussion in the doula community in her area as well.

I have always felt very scrupulous about HIPAA and protecting patient privacy. My first experience in clinical care was interning at a reproductive health clinic. We specifically asked clients if we could call them at home; if we could say we were calling from the clinic; and if we could leave them messages; and if we could say the messages were from the clinic. Some of our clients were getting care without the knowledge of their families and/or partners, and preserving their privacy was important to their safety. That experience made me cautious from the beginning about anything that could identify people I worked with in a healthcare capacity. I will only talk about stories of births, or breastfeeding situations, with the details changed, de-identified, without any way for someone to trace the story back to the person.

But our conversation made me think twice about posting even the very general statuses that I have posted about attending births on Facebook (like referencing that I've been busy because I just attended several births, without any specifics about who/where/exactly when). No matter if you live in a very populous area or a big city - communities are still small! I worked with a family recently thinking that we didn't know anyone in common on places like Facebook or blogs. Just before the birth, it turned out that couple were friends with an acquaintance (and social media "friend") of mine. It was a neat connection to discover, but I could have written (although I never did) even general things about them or their birth assuming we had no friends in common, and been very wrong.

My doula friend also pointed out several things I hadn't thought of that could become an issue, including the idea that even when clients are OK with us writing about their births, we have to think about the messages we are sending. She talked about a doula who had worked with a client and posted something lovely and positive on FB like "Beautiful vaginal birth! So honored to be there." This client's friend hired the same doula, and after her (long and difficult) birth she was expecting the doula to post something similarly celebratory about her birth...and the doula never did.

Now we know that the doula may have run straight to another 40-hour labor, or been trying to catch up on the rest of her life, or just not thought to post this time... she probably had no idea this mother was looking for that kind of affirmation (having already seen her friend get it.) But it made the mother wonder whether her friend had a "better" or more "beautiful" (perhaps more "vaginal"?) birth that was deserving of an update.

Another issue is that while one client may have no issues with it, and even be excited to be part of a doula's post, another client may not. Seeing a doula post about attending births and sharing details may turn potential clients off, because they don't want to be part of the news feed.

When this comes up I have heard other doulas defend their use of social media. They feel that their use is appropriate, and/or that they get permission from their clients for all posts, and/or that they work in large enough areas that their social network circles don't overlap. Many doulas use social media as one of their marketing tools. I was actually surprised to hear about the number of doulas who post far more personal detail on Facebook than I would ever dream of doing.

What are your thoughts on this issue? What are your personal rules for social media posts about doula clients?