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A doula’s challenge

Each week, I send an email to my pregnant clients.  These emails are usually for their eyes only but I thought I would share a recent one.  Note:  most of my clients (lately) are hospital births so we typically spend much of the labor in their homes.   

Restraint.  When folks ask me what is the hardest part of being a doula, I answer “restraint.”  We doulas get riled up about doctors and midwives who use unnecessary interventions.  “Humph,” we complain.  Why can’t they simply trust birth? 
But we are often guilty of the same thing.  When I first began as a doula, I thought I was supposed to whip out all my tricks and tools.  I figured these families were paying me to do something.  My thoughts went something like this:  “Ok, I need to do x to keep her labor from stalling.  I should do y to make sure the baby descends.  I must do z to encourage her to release more oxytocin.”  You realize what I was doing?  Using unnecessary interventions.  Maybe they were harmless and maybe they even helped but they may not have been necessary.  And sometimes, they took away power from the birthing woman. 
Why couldn’t I simply trust birth? 
Do you remember those early studies on doulas–you know, the ones that showed incredible reductions in c-sections and other interventions and incredible increases in mother satisfaction?  Most often, the mom didn’t even know she had a doula.  The doula was simply present as part of the medical team–it was a blind study.  Her mere continued presence resulted in positive outcomes.  How could that be? 
It is a tricky profession.  In the aftermath of a normal birth, it should feel like the doula or the midwife/doctor didn’t do anything.  Our goal should be to fade into the background of the story.   
Now don’t worry–this rambling doesn’t mean that I’m not going to give you nice foot massages or help you relax during your labor.  It does not mean that if I suspect any roadblocks (positioning, difficulty focusing, etc), I won’t pull out a trick or two.  But if your labor is progressing normally, sometimes the best tool I have is simply to be there.  To be a gatekeeper or lifeguard; not a director.  And yes, I struggle with this.  I want to jump in and save the day. 
Ah, but you don’t need to be saved.  This journey is yours and you are the hero in this adventure. 
Homework:  Trust is an essential element in normal birth.  Do you trust your body?  For some women, pregnancy may offer the first challenge of this sort; the first opportunity you’ve had to be awe-struck by your amazing body at work.  Practice trust and intuition by asking and listening during pregnancy.  For example, thoughtfully ask yourself questions like “how does my body want to stretch?” “should I rest now?” “what would nourish me today?”  
This quote was written to midwives but I think it applies to all those who are invited into the presence of birth: 
Do good without show or fuss. 
Facilitate what is happening rather than what you think ought to be happening. 
If you must lead, lead so the woman is helped yet still free and in charge.  
When the baby is born, the woman will rightly say, “We did it ourselves.” 
–from the Tao Te Ching

4 responses »

  1. I have the greatest doula ever!

  2. i think you have a lovely attitude. :^)

    your post reminds me of an unfortunate incident with my midwife during my second son’s birth. she offered to break my water .. i was, to say the least, extremely surprised. and displeased. i didn’t think i should be better informed than my midwife. (it was, unfortunately, the only midwife in my midwife rotation that i *didn’t* like, and murphy’s law determined she would, indeed, be my midwife during the birth.) anyway, when i said, why oh WHY would i want you to do that?! she replied, “some people just want a change.”


  3. this is a great post. something i find myself still struggling w/. at one of my births this past year everything was progressing nicely, not too slow, the mother was very in tune w/ herself, very in the zone, it was very quiet, peaceful. i was following the attitude of the room. the midwife, a very well respected, long time midwife in our area, comes into the room and tells the mother that she is doing fine, and she can keep doing what she is doing, but if we want to move things along she needs to get o/o bed. she had been sitting “indian style” for a little while. mw then asks hubby what he thought, should she keep doing what she was doing or get o/o bed. i said, i had asked mom if she wanted to try a different position, mw says, “oh honey, at this point we don’t ask anymore.” takes her leg and proceeds to “help” her o/o bed. at 1st i thought it was kind of cool b/c it was a little humorous and baby was born 15 minutes latter.

    a few months latter, same hospital, same midwife. client has had a long, hard labor, is lying in bed, very much relaxing thru contractions. it has been awhile since mw has been around, i start feeling like maybe we should get her up, try something new. but i really think i only felt that b/c i was worried about what this mw would think, and knew she would be coming back in a few minutes. i mention changing positions to midwife as she enters, she says, “oh, no hurry, she’s doing fine.”

    i don’t know. i kind of think that i was right in following my instincts in letting the women be. i think i was starting to worry about what the midwife thought about how good of a job i was doing, instead of following my gut, and listening to the clues that the mothers were giving off as they labored.

    and i still ? the mw’s mixed signals.
    thank you for this post, as a new doula, i appreciate being reminded of where my place is, even tho i still feel like i’m trying to find it(!)

    sorry i wrote a book here!!

  4. I have “midwife awe” and often feel performance anxiety around midwives. There have also been a few hospital moments involving nurses that felt like a momentary turf war. Both the nurse and I competing to “help” the mother. And, of course, neither of us actually helping at all.

    It is something I constantly remind myself. It doesn’t matter if no one sees what I’m doing by appearing to do nothing.


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