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Favorite Part

An hour or so after one of my clients gave birth, she looked at me and asked, “What is your favorite part about being a doula?”

Before I answer, I will tell you what is not my favorite part.

Some people think I’m a doula because I adore babies and want to squish their widdle cheeks.  And they imagine I get to hold them all the time.  As if I chose my profession to get a newborn fix. 

If you knew me before I was a doula, you would laugh.  I was the person at the office party that stoutly refused to hold the baby du jour.  Even as a high-demand teen babysitter, I took my little sister along to change the diapers.  When I found myself pregnant, I was horrified by how little I knew about babies and how to handle them. 

No, I did not become a doula because of babies. 

Now don’t get me wrong.  I love babies (now).  I can swaddle them like a Moe’s burrito or wrap them to their mama using 15 feet of fabric in 30 seconds flat.  I know the 5 s’s.  I have a three-point lesson on just about any baby subject.  Ask Emily who called today because her 10 month old is biting while nursing.   

But these babies aren’t mine.  You won’t see many pictures of me holding my client’s babies.  I won’t refuse but I will not ask.  I don’t view newborns as individuals yet.  They are a couple–mama and baby.  Attached as firmly as if the umbilical cord was still intact.  If I do find myself holding a baby on the day of his birth, I’m extremely anxious to reunite baby with mama.    

As I looked as this woman with her dreamy post-birth smile, I could answer without hesitation:

My favorite part about being a doula is seeing a woman in her strength and power give birth.  In this single act, she shows courage, joy, sacrifice, faith, resolve, exhilaration, vulnerability, generosity, and above all, love.  It is such an honor to be invited to witness and support women on such a journey.  That, my friends, is a fix.

I had to laugh when I looked at this picture from my last birth.  I was leaving and someone asked to take my picture.  What am I holding?  A baby?  Nope.  

A placenta.

  Yep, I’m much more likely to be holding a placenta than a baby.  Up next, placenta prints!

First Time Mom (Homebirth Story)

New birth story up!

Please do not call yourself a doula if

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You leave a first-time mom when she chooses to get an epidural.

The doctor or midwife spends more time with your client than you do.

You charge extra when a woman labors longer than an allotted time.

You require the client to pay your back-up doula if you have to leave.

You charge extra for “false alarms.”

You are hired by the client but really you are the midwife’s apprentice/assistant disguising yourself as a doula (so that you get paid.). Of course, this is fantastic if you are truly working for the client. But it can be easy to focus too much on pleasing your preceptor and not as much on serving your client.

You tell the client you’re on your way to the hospital and inexplicably fail to show up.

You bring your children to the hospital and ask the client’s family who are in the waiting room to watch them.

You promise to back up a fellow doula but when she calls you have excuses why you cannot. And so does her other back-up. And even her THIRD back-up.

I am sure this offends some of my fellow birth workers and this post won’t win me any popularity contests. We are only human and sometimes there are unusual circumstances beyond our control. But these are real stories I’ve been told in the last few months by women and doctors/nurses who were disappointed by a doula. In my town. A place where the natural birth community is making headway in creating change. Scenes like these send us three steps back.

Birth is sometimes long. It is (usually) inconvenient. Yes, we don’t make as much money when we have to pay a back-up or a birth is long. But at the end of the day, remind youself that you also had some short births (I have many more now that I take Hypnobabies clients!) and scheduled births (thankfully these are rare). These births “subsidize” the long ones. Figure that factor into your fee. Consistently, at the end of each year, when I add up all the hours I spent at births, it averages out to around 12 hours per couple.

Please, dear doulas, stay with your client. Serve her well. We offer continuous care. What kind of message does it send when her doula leaves? Wow, my doula has even given up. Defeat.

We have been honored with an invitation to grace a sacred space. It is a timeless space. We do not punch a timecard. Our shift is not over until our healthy client is nursing her baby postpartum. This might be two hours after the birth or several weeks later. My summer client who birthed prematurely was finally able to nurse her baby after weeks and weeks of coaxing. Only now do I close the file.

I know it is a tough job. Burnout is high. Please weigh the cost of your commitments and represent your birth community with integrity.

And to the moms looking for a doula: read the contract carefully. The doula should list any extra fees and discuss refunds if she misses your birth. Ask how she handles long births and what her definition of long is. My contract, for example, states that after 24 hours, I might call in a back-up doula so that I can rest and return. I’ve never done this but my contract allows it if I must. Knock on wood.

Good Thing She Wore Her Nike’s (Brady’s Story)

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[shared with permission]

Crain’s Birth Story is one that needs to be shared. I feel that our family and friends need to hear why Crain was born at home and hear how amazing that Saturday Morning was for us. Tyler and I had to make so many decisions with Crain’s birth; decisions that are not accepted by many, but in the end were the right ones for us and Crain.

There are two subjects that I do not share my opinion on with many people and those two subjects are religion and birth. If you are close to me you know how I feel about these two, but even so, I feel that people have the right to worship how they desire and women should be able to birth how they desire (medicated, un medicated, hospital or home).

In this birth story I am going to open up about my views, some will learn from the words that I write and the natural tendency of others will be to pass judgment, but either way you will hear the story of Crain’s birth and hopefully gain an understanding of our beliefs on birth.

Tyler and I enrolled in hypno-birthing classes for Crain’s birth. Julie was once again our guide during this pregnancy, and we learned so much in our classes.  I did my Hypnobabies homework religiously and I feel that Crain’s birth benefited greatly from my hypno studies.  I had been in the care of Dr. Stafford for this pregnancy.  Dr. Stafford delivered Preston and I truly admire Dr. Stafford and I am very grateful to be in the care of such a hands on, awesome physician.  But with all that said, Dr. Stafford cannot control hospital procedures and there was something in me that really did not want to fight to have the birth I wanted.  I knew in the hospital, I would have to battle to have a true hypno birth, and so after going back and forth on the “homebirth idea” We connected with our midwife from the beginning and I felt calm and at peace about the homebirth idea after meeting with her. She was extremely knowledgeable about birth.  So it was decided a Homebirth for Crain!  We were excited and at peace with the idea, however; kept it a secret because I did not want to hear all the negative comments.

So May 7th  (Crain’s guess Date) came and no baby Crain, and boy oh boy how it  made people mad that he was not here.  I was determined to let Crain choose when and how he came into this world.  But it was hard to be out of control and it taught me the first lesson of being a good parent, PATIENCE, and most of all it made me closer to my faith.  I knew God was watching over us and I knew I was doing the right thing.  I read quotes and scriptures every day and had faith I was making the right choice.  Our birth team walked us through this wait and made me feel that it was normal when most everyone around us were asking when we were going to be induced, and when were “they” taking the baby, and don’t forget the people sharing with us why you should not carry your baby past it’s guess date.  It was a long 14 days for many reasons, but looking back I am so proud of us for having faith and waiting on Crain.  If I would have delivered in the hospital, I would have had to been induced and I am so happy I did not do that.  Thank you to Tyler, my Mom, and my sister Laura for really talking me through those 14 days and being so supportive of me.

On Friday, May 20th, I started feeling some Pressure waves, that’s hypno talk for contractions.  I went to acupuncture and had a nice relaxing session.  I texted my birth team and told them that I was having some pressure waves.  In the meantime, my parents came up (I had not told them I was having pressure waves because I did not know if it was truly labor).  That evening, the pressure waves still came and went; I listened to a Hypnobabies script before bed and decided to get some sleep.  At midnight, I got up and walked around, got some water, and tried to go back to bed.  Once again I listened to my easy first stage Hypnobabies script.  At 2:00 am, I got up and was definitely feeling more intense pressure waves.  I woke Tyler up and told him that they were getting a little intense.  I got into the tub as Tyler timed the waves.  Oh yeah, they were close together and getting stronger.  Tyler stood by my side and he does not even have to say anything to me during birth, he looks at me and I regain focus, and I instantly feel calm.  Tyler is my strength when I run out of it in labor.

We called Julie, but told her that she did not need to come yet and that we would call her back in an hour.  Tyler woke my parents and they took Preston to Tyler’s parent’s house.  My Mom knew of the homebirth, but I had just informed my Dad that evening when I thought I was in labor.  I knew he would worry, but once again my Dad surprised me and handled it beautifully.  I guess he trusts his “little Miss Magic”.  At 3:00 am Tyler called Julie back and told Julie to call the midwife.  Julie had already gotten her gear together and was on her way.  My Pressure waves were strong and very close.  I hummed during waves, yes I sounded like a dwarf from Snow White [note from Julie:  the “hi-ho, hi-ho, its off to work we go” song], but you know that is what I love about a natural birth, if you let yourself go and let your body lead you, it does things to get you through birth.  And my body apparently wanted me to hum, and so hum I did.  I told Tyler to get my “Birthing Outfit”.  Yes I like to look cute when I deliver!  My birthing attire was a knit skirt and tank and most important my Nike’s.

[note:  notice the wall behind her is covered with birthing affirmations]

Julie came in a little after 4:00 am. She just saw I had my Nike’s on and I remember she said “Oh you are ready!”  I wore my Nike’s during my labor with Preston and would have delivered in them if the hospital would have let me!  So with my outfit on and Nike’s laced, I was ready to go.  [note from Julie:  When things got intense with Preston’s birth, Brady ritualistically put on her Nike’s.  I knew when I saw them on her feet, we would meet a baby soon.  I got on the phone with the midwife and told her to hurry!]

I had had the urge to push a little right before Julie arrived.  Now the urge was uncontrollable.  Crain’s birth took over my body and of course my body knew just what to do.  I remember feeling like I was just watching myself birth.  You go to this whole entire different realm, or at least I did.  It one of those experiences in life where you are not the driver, but the passenger and you let your body drive and have faith that it knows what to do.

I think my water broke at 4:45am or so and I remember saying “that felt great.”  Crain’s birth was moving really fast and the midwife was not there, but I was not scared, I actually felt very calm.  I had Tyler and Julie there, and it was really calm and peaceful.  My pressure during pushes became really intense, so intense, and so difficult.  The only position I was comfortable in was standing up.  When I pushed it took over me and literally lifted me onto my tip toes (good thing I had that extra support from my Nike’s).  I felt burning, and knew that Crain was coming, but it was happening so fast.  I remember telling Tyler and Julie that I felt burning.  I reached down and felt Crain’s head, and saw Tyler place his hands below.  I pushed again, and my beautiful Crain was caught by his father’s hands, and my world stopped.

Crain laid in my arms and talked, instead of crying he talked and talked (you know baby cooing).  He apparently had a story to tell me about where he had been for the past 40 weeks and 14 days.  The midwife arrived within seconds.  Our birth team took great care of me and Crain in the hours to come.

So why did we have a home birth?  On May 21st, 2011 at 4:53 am, Tyler caught our 9lb 6oz son with his strong hands in the comfort of our home.  I had no nurse chasing me around trying to check me.  I was free of wires and IV’s.  I was able to have a true, calm Hypnobabies birth.  I was not met with paperwork to fill out nor did I have a nurse counting for me while I pushed.  I was able to place Crain directly on me after birth.  Tyler and I did not have to fight for anything we desired for Crain’s birth.  It was a calm, beautiful, safe birth. We have been asked if we worried or why we would take a “risk” of having Crain at home. To answer those questions yes, of course I worry.  I worry about both my children, constantly.  Did I worry about birthing him at home?  No!  I was in safe hands and I knew our birth team would never put me or Crain in an “unsafe” situation.  As far as risk, you take a risk whether you are at a hospital or at home.  Ironically, if you do some research and listen to other birth stories, sometimes hospitals and their many interventions put you and your baby at more risks.  Tyler and I weighed the benefits and risks and in this situation; and the benefits outweighed the risks.  Tyler and I educated ourselves and surrounded ourselves with birthing professionals.  It saddens me that instead of excitement after Crain’s birth, most everyone’s first reaction was that of worry and judgment.  I understand that this is not the “norm”, but to those I say open your minds to a new yet old way of birth, do some research on natural hospital births in the US, and have faith that people make decisions for all the right reasons, and be okay with women who choose to not be the “norm” when they birth their children.  I certainly do not judge other woman on how they choose to have their child.

The coolest part of Crain’s birth is that I felt so connected to my faith.  They say that God is present with every birth and by having Crain at home, and being surrounded by calm, supportive people, I felt the presence of God.  It was truly the most incredible experience. I am so happy that I trusted my gut and stayed true to who I am, and had Crain the way Tyler and I wanted to.  I look at Tyler and feel closer to him than I ever have; he truly is a great birth partner, and even a better husband and father.  I know that I am a stronger wife and mother.  I am proud of Crain’s birth, and do not look at his birth in any negative light.  I look at his birth as a gift.  Both of my boys gave me the gift of birth and I discovered if you open your body and mind to birth it is truly life changing.  On May 21st, 2011 at 4:53 am as Crain entered this world something in me changed, just as it did when Preston was born.  I cannot describe the change; it is just the most amazing feeling, and I know it was because of how we brought both Preston and Crain into this world.  I will never forget either one of their births, but especially Crain’s birth.  I grew that day, and I am so glad that I experienced the gift of birth.  Thank you to our birth team for supporting us, and helping us through this pregnancy.  Without you guys I would not have had the experience I had, and for that I am forever grateful to all of you.

Crain still “talking” to his mama an hour after his birth:

 [Note:  Brady and Tyler made the challenging choice to change care providers and birth location at around 36 weeks.  If your intuition is telling you to explore other options, it is never too late.]

What a Doula does #5

You thought I’d forgotten this series, didn’t you?

So what does a doula do for an unassisted birth, an accidental birth, or a birth with an unlicensed care provider?

The SAME THING SHE DOES FOR ANY OTHER BIRTH.

Catch that?

Mid-wifenoun.  a person qualified to deliver babies and to care for women before, during, and after childbirth

Ob-ste-tri-ciannoun.  a physician who specializes in obstetrics.

Dou-la:  noun.  a woman experienced in childbirth who provides advice, information, emotional support, and physical comfort to a mother before, during, and just after childbirth

Information, emotional support, and physical comfort.

I do not deliver/catch babies.  I do not carry a doppler.  I do not carry a blood pressure cuff.  I do not carry medicine.

I do believe that women deserve to be supported by another woman no matter their birth choices. 

I love midwives.

I am not one.  I do not desire to be one.  At a birth, I am not the substitute midwife until the real midwife arrives.  I am not the midwife’s assistant though I am glad to lend a hand if needed.  My job is first and foremost the emotional and physical support of the birthing woman.  My second job is to serve her birth partner and other family.  If I’ve done my job during prenatal meetings, everyone is clear about my focus and role.

Unassisted Childbirth (UC):  If a woman chooses to birth without a medical caregiver, I will have a mutual interview with her like any other potential client.  I will be very clear about my role.  It is carefully written in my contract.  Should we agree to a contract, I will behave the same way at her birth as any other.  She has deliberately and mindfully made this choice.  More than anyone, she doesn’t want me to play the part of a midwife or doctor since she has purposefully chosen to birth without them.  I’m the brow-wiper, smoothie-maker, cleaner-upper, emotion soother, foot-massager.  I’m not the babycatcher.

Accidental Birth:  For the record, I’ve not experienced an accidental birth (i.e. mom gives birth on the side of the road or before we leave for the hospital).  I would call 911 and support the birth partner in the steps of emergency childbirth.  If the birth partner was unable, I would assist the mom in birth as needed.  As any friend or bystander would.  And I’m certain I would throw up afterwards from the adrenaline of such an experience.

[ETA:  I have now.  And I didn’t throw up.  I didn’t experience any adrenaline at all which really surprised me.  It was a super calm birth even with a big potentially scary complication.  I also did not call 911 since the midwife was almost there]

Birth with an unlicensed care provider:  There are all sorts of reasons why a woman might choose an unlicensed care provider.  One of my friend’s mom was a midwife in another state.  Another woman might want a VBAC out-of-hospital.  Someone else might resonate with an unlicensed midwife she met on a forum.  In some states, there is no licensure.  And there was a time when all communities had a woman skilled in birth.  She learned from the woman before her.  That was her license.  Anyway.  As a doula, I go where the birthing mama goes (hospital, home, birth center, RV, waterfall, idyllic glade, whatever).  And I don’t decide who she invites into her glade.  It does not affect me or the role I play.

Other doulas may not feel comfortable in these scenarios (although there isn’t much to be done about #2).  That is ok!  There are certainly plenty of scenarios in which I would not be a good fit.  That is why we do a mutual interview to tease out our personalities and styles.  Frankly, my comfort level is that the birthing woman has carefully considered her choices.  She is informed.  She is making a decision thoughtfully and with understanding of risks/benefits/alternatives.

In the end, I speak no judgement to the woman who chooses an elective cesarean or an unassisted birth.  If she honors me with an invitation to serve her in this powerful and intimate moment, I come.  It isn’t my birth.

I’m not the main character in the story.

What does a doula do? #3 Epidurals

What does a doula do when her client gets an epidural?

a) She picks up her aromatherapy and her rice sock and walks out the door saying, “good luck with that, sister.”

b) She orders a pizza and curls up on the couch with a fashion magazine.

c) She gets down to the business of minimizing the cascade of interventions to follow.

I hope you guessed “c.”

Most of my clients have unmedicated births.  It isn’t a bragging point.  Women who expect a natural birth, make careful decisions about birthplace/care provider, and surround themselves with a good support team easily have such a birth.  Afterall, and you may have heard me say this a time or two, birth is a normal bodily function designed to work. 

Still, epidurals happen.  They happen for various reasons.  Sometimes they accompany the not-so-natural contractions created by pitocin.  Sometimes they offer the mom a last-chance before cesarean in a long labor.  And occasionally, I have a client who plans to get an epidural but wants to wait until later in her labor.  Whatever the reason, epidurals happen.

What do I do when a client gets an epidural?

First, I watch her emotions.  Is she disappointed?  Angry?  Does she need to talk?  Maybe she doesn’t feel like talking but would welcome some pampering.  I might bring her a toothbrush or braid her hair.  Freshen the room.  Whatever the vibe, a doula’s first job is to satisfy the emotional needs of her client.

Then I usually send dad out for a break or a meal. 

And I work out a plan.  In my head; not on a whiteboard or anything!  Mobility is most crucial.  Mom needs to move into different positions regularly.  This movement will help her baby continue his rotations.  Some nurses are uncomfortable with moving mom onto her knees (forward leaning) so I carry a picture to demonstrate.  You can see in the picture here that the mom is able to drape over the bed which is almost in a complete slant.  Dad was supporting by pushing against her lower back.  When mom is in this position, I am even able to sift by standing on the bed.  I remember a nursing student walking in while I was standing on the bed sifting a client with an epidural.  She was shocked.  Curiously so.  And stayed to learn more about sifting.  In addition to moving her onto her knees, I’m also shifting her from side to side every 30 minutes or so.     

I’m also watching for her contractions to space out which sometimes happens with an epidural.  If they do, I hit acupressure points or encourage her to do nipple stimulation to get them going again.  While I’m not usually comfortable with intervening much in labor progress, all bets are off when we move into medical intervention territory.  If the epidural causes labor to stall, then pitocin will surely be introduced.  Pitocin can cause fetal distress which, of course, can lead to a cesarean.  My main goal once a client gets an epidural is cesarean prevention. 

Finally, while her birth plan may have hit a bump, I work to keep the environment woman-focused.  In my experience, it seems that the medical team acts differently with a medicated patient.  There is more chit-chat, the lights come on, the traffic increases, the door gets left open.  Nurses and doctors think they can do vaginal exams anytime they please.  She is now continuously monitored by a machine.  She has a bladder catheter, IV, and blood pressure cuff.  Even the dad can get caught up in watching the contractions on the monitor and reporting them like a sportscaster.  “Wow, did you see that one?  It was a whopper!”  I might hit the silence button on the monitor or cover it with a towel.  I’ll encourage my family to stay focused on their baby instead of turning on the TV.  Maybe I’ll do guided imagery or suggest dad could read a story out loud to his baby.  

So while it might seem my job would be easier when the epidural enters the scene, it isn’t.  Nope. 

Meanwhile, I am happy to report that none of my clients this year have had an epidural.  Call me a lazy doula but I like it that way!

My sister’s doula

My family is tight.  I have one sibling.  My parents still love each other.  We have weekly Sunday dinner during which we sit at the table talking long after the coffee has cooled.  And for this rare moment, we all live in geographic proximity.   

When my sister became pregnant, I coached myself on:

  • respecting her privacy
  • not using scare tactics
  • not saying too much
  • not saying too little
  • keeping horror stories to myself
  • keeping homebirth talk to a minimum
  • stepping back and allowing them to make informed decisions

All the while, I wondered how I could possibly be her doula in the hospital setting.  I imagined scenes of security guards forcibly removing me from the hospital.  But they chose a homebirth and I breathed a sigh of relief.  I wouldn’t need to guard her or time her arrival at the hospital just right.  I could relax into supporting.

Ha.

As her time approached, I had so much anxiety.  If she had to transport, I would blame myself.  I knew this.  Deeply knew this.  A big sister thing, you know?  I did a Hypnobabies “fear clearing” before her birth. 

Then her birthing time began.  And it felt so normal.  The anxiety melted away as I moved into the familiar and comfortable space of birth.  I hunkered down to support her in the work of bringing a baby. 

What I was not prepared for was the emotion.  The powerful emotion that hit me full force out of nowhere as she was close to birthing.  At this moment:

Yes, this moment.  Do you know what I was thinking?  I was remembering the time I left her in my uncle’s hayloft.  She was little and refused to come down the ladder.  So my cousins and I left her crying.  My horrible brain fired off many of those memories in rapid succession leaving me a pile of mush.  I wept in her shoulder so she wouldn’t see.  I was entirely unprepared for the onslaught memories.  I never cried at my own births. 

She was a warrior, as I knew she would be.  And Zach was a strong birth partner whispering prayers and endearments throughout. 

Her sweet babe weighing in at 8lbs 4oz was a precious dumpling.

And her doula was busy remembering every mean thing she ever did to her. 

What does a doula do? #2

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Continuing my new series

What does a doula do?

A doula makes the dad look good. 

Here is the truth:  Birth makes most dads a tad nervous.  He wants to support her wishes, keep her safe, keep baby safe, not pass out, not have a baby in the car, say the right things, not get yelled at, have fresh breath at all times, look confident, and not melt into a pile of mush. 

Dads really shouldn’t have to learn everything there is to know about birth in order to be Mr. Super Birth Partner.  He already has all the tools to be this superhero.  A doula can take the load off and let him do what he does best.

And what is that? 

Love on the mama. 

Inviting a doula into your birth scene frees up the dad to love on the mama.  See, birth needs this one special hormone to get it going and keep it going.  The Love Hormone, Oxytocin.  Why yes, it does deserve to be in all-caps.  An important hormone, this.

Oxytocin releases when you feel good.  When you feel safe, warm, nourished, juicy.  The saying goes “What got the baby in gets the baby out.”  Go ahead ask.  I know you want to.  How many of my couples make out in labor?  This doula’s lips are sealed.  But it does work beautifully!

Dads do this best.  I’m not going to smooch on my clients.  And while I can hug and rub and spoon with them…I’d much prefer to guard their privacy and let the dad take this role.  She probably would too!

My job is to quietly give them safe space to get cozy.  Some clients want me to stay physically present and others want me to hang out downstairs or go for a walk.  Some just want me available by phone until things really pick up.  Often, for dads, the fact that I’m relaxed and in no hurry to call the midwife or go to the hospital frees them to relax. 

During active labor, I might show the dad some ways to lay hands on the mama or hand him a warm rice sock for her back.  Though I want to rush in and do it myself, it is best if I can stand back and let the couple do the work of birth. 

If interventions of the doula sort are called for, then I step in.  A dad shouldn’t have to worry about what to do with a cervical lip or a posterior presentation.

I’ve interviewed couples with concerns that the doula would “take the place of the dad.”  Far from it.  I give the dad peace of mind.  I give him ideas or, better yet, make them look like his ideas.  I give him bathroom and sleep breaks.  I bring him dinner.  I offer him gum.  And I make him look like a rockstar. 

I’ve never met a dad who said, “I really wish we wouldn’t have hired a doula.”  Most become doula evangelists.

What does a doula do?

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The most common question I get:  What exactly does a doula do?

I can’t speak for all doulas but I don’t have a “scope of practice.”  I do whatever my families need me to do.  There is no “exactly.”  I’m going to do a series, then, on what we do–in general.  I’ll carry it on until 1)  I get tired of it.  2)  I forget about it.  or 3) I reach the end of all that doulas do (which means I’ll post about it forever).

Today I’m going to look at one thing I do.

I ask questions. 

I didn’t go to medical school.  I’m not a midwife.  I don’t read obstetric textbooks in my spare time (anymore).  I don’t know all the answers.  Sure I keep up with some research.  I peruse the Cochrane database and read blogs like this and this.  I have a doctor and a midwife on speed dial when I have burning questions.  But I don’t kid myself into thinking that I have some special knowledge.  I probably know enough to be dangerous.  Which is why… 

I ask questions. 

To the family, questions like “Have you considered?”  “What is most important to you?”  “What would that look like to you?”  I carve out the space for families to ask their questions, express their concerns, tease out informed consent.   

To the caregiver, “Can we wait?”  “Could they go home?”  “Could we try?”  “What are the benefits? risks? alternatives?”  “Can we wait?”  “Can we wait?”  “Can we wait?”

I ask questions.

I do not make decisions for families.  That is the glorious privilege of the new parents.  My job is to support them in whatever decision they make.

Brow-wiper

It is a hard thing for a doula to admit:

The best births are the ones at which I’m not needed.  Superfluous.  Merely a concierge service.  Standing around twiddling my thumbs or sitting in the corner knitting. 

Because at those births, the birthing couple can say entirely, “We did it all ourselves.” 

I was on my way to a birth recently when the dad called and said they had decided to go on to the hospital.  I arrived at the hospital just before they did.  Maybe 7 contractions from the elevator to the bed, the baby was born.  The doctor barely got a glove on. 

What did I do at this birth?  Hmmmm.  I wiped a brow.  Spoke some words.  Took a couple of pictures.  Made some red raspberry leaf tea for afterbirth pains.  The mom and dad were the only heroes in this birth story–as they should be! 

In this instance, I was just an expensive brow-wiper. 

The trouble with birth is that you can’t predict the path it will take.  And you often can’t predict the caregivers who will attend you.  Will they have patience?  Will they know labor tricks to resolve a complication without resorting to abdominal surgery.  Because I attend births both in-hospital and out-of-hospital, I’ve seen c-sections for things that were resolved with time and technique in other settings.

A doula is an insurance plan.  You hope you won’t need her but you’re glad she’s there!