Moments in the Life of a Doula

Very Little Known Fact: May is International Doula Month.  2012 marks my third May as a doula, and let's just say the past few years have been nothing short of inspirational. 

I'm on call for my tenth birth.  Number ten!  Two and a half years ago I never thought I'd get here... my dedication to women's health has never been enough, and I fast learned that it's very hard to "get known" as a birth worker, especially when you've never had any babies yourself.  Still, the clients I have worked for have hired me for my presence, my energy.  And as I get more experience, more mamas are realizing that it's energy, not personal experience as a laboring person, that really matters.

Today I'm thinking about all the babies I have had the privilege to watch come into the world: Lundyn, Sara, Quinn, Aaron, Micha, Madison, Gershom, Amelia, and Sullivan.  All born to totally badass mamas with incredibly unique and wonderful birthing experiences. 

Thinking about these nine phenomenal experiences, I ran through my "stats".  Some prospective clients like to know, for example, your clients' epidural rate, though unlike your care provider's cesarean rate, a doula's epidural rate really hinges more on the way the birth progresses itself and not the actual doula.  Or so I tell myself.  But still, I'm proud of my stats.  In my nine births, I have had:

• Three boys, six girls.
• Three mamas who chose to have an epidural.
• Three mamas induced with Pitocin.
• One cesarean birth.
• Two mamas delivered at Forsyth Medical Center, one at Women's Birth and Wellness Center, and six at Women's Hospital.
• The fastest labor was an hour and a half.
• The longest was well over 20 hours.
• My favorite midwife thus far was Kate Layman, CNM at the birth center.  My least favorite was one of the faculty midwives at Women's who, fortunately, was only on for three more hours after my mama was admitted. 
• My favorite obstetrician was Dr. Grewal, my least favorite a tie between Dr. Marshall and whoever the guy was at Forsyth back in September (not worth remembering). 
• I've really loved all the nurses, but my favorite remains the pediatric nurse at Women's Hospital who helped the mama and I convince the father that circumcision has no real medical benefit.

Like any doula, I've experienced the absolute best of human love, compassion, and forgiveness simply by being there in the room.  I've heard mamas and their partners say ridiculously funny shit, sharing a good laugh between tough contractions.  I've also witnessed families make difficult decisions, seen women break down and sob when their birth plans have gone awry.  Fortunately, my birth clients have all gone on to deliver beautiful, healthy babies despite these roadblocks.  I have many favorite moments that straddle these two extremes... to name a few:

• My greatest learning moment came to me in birth number four.  The mama had been having one back-labor contraction on top of the other for a solid 90 minutes.  It had been seven hours since her last vaginal exam, at which time she was 5cm dilated.  When her contractions "stopped," I told her she was probably complete and would be feeling the urge to push soon.  After an hour of continued back pain and no urge to push, the nurse checked her and found that she was 6cm, at most.  As the baby was being born later that day (after an epidural, a nice long nap, and a marathon pushing phase), I saw that he was asyncletic.  Immediately my education flooded the forefront of my mind... it all made sense: the slow progression, the "fake" transition, the lengthy 2nd stage, even the week of prodromal labor. All textbook signs of an asyncletic presentation.  It was in this experience that I re-learned to NEVER estimate the laboring person's progress, that it's not the doula's job no matter how "clear" it seems to be at the time.
• While DONA would surely frown on this, I've been taught a few midwifery skills by midwives who needed an extra hand.  When a birth center midwife was busy stitching up a mama with a 4th degree tear, she asked me to do the fundal massage.  I'd never done it before, but she told me where to place my hand, what to do, and how hard to do it.  While it certainly went against my "doula instincts" to massage so hard, I now feel like I would be able to do hemorrhage control if I'm ever the only person present who knew how to do it.  Another midwife, during a very long 2nd stage at the hospital, gave me a refresher course in how to catch a baby if I ever had a mama deliver on the side of the road.  DONA teaches a little bit about that, but since we're really not "supposed" to do anything medical, they keep it brief.
• There's a popular one-liner amongst birth professionals about the difference between a doula and a midwife: "Midwives catch babies, doulas catch dads."  While I scoff at the obvious couple-centrism, I actually have caught a dad before.  Seeing how he was an ex-Army medic and current paramedic, no one really thought he'd have a problem with witnessing the birth.  However, the sleep deprivation, low blood sugar, and pure adrenalin of "oh my god I'm becoming a father" formed the perfect storm, and while everyone else was watching his baby crown, he was boarding the express train to the floor.  I caught him, this easily 200-pound man, inches above the ground.  Even Dr. Grewal turned from her obstetric duties to congratulate me on my quick reflexes, and hey, it bought the baby's cord some time!
• Speaking of umbilical cords, I once saw a "true knot" in one, which was awesome. The midwife and I shared a moment of "oh wow awesome!" while the new parents were admiring the new baby.  Because we're birth nerds like that.
• Some of my favorite parents have been the ones who "talk back" to care providers that aren't honoring their wishes.  At a rapid (unmedicated) birth last September, the doctor was trying to tell the woman to push when she didn't yet feel the urge.  Any decent research on an unmedicated 2nd stage will tell you this is a waste of energy, but the doctor obviously had a golf game to get to, so he continued to berate her, saying she "wasn't going to have a baby by just laying there and resting."  At this moment, she looked at him and said, "Shut the hell up, I'll push when I damn well feel like it."  Obviously the urge to push came, and within minutes she was holding her baby girl.  My favorite part about that birth was the dad talking shit about the doctor while he was on the other side of the curtain... whoops!

My favorite moments, however, are present at every single birth: the energy you can almost touch, the families being born, the immense joy in the room.  It's really indescribable, and words just cannot do justice to the experience of being present for the birth of a baby.

On another note, I also spent some time this week being the "phone doula" for a woman who was planning an abortion.  I was reminded of how similar the work is even if the outcome is obviously very different (I've discussed this before).  I gave advice, self-care suggestions, and basically was just there to listen and understand.  Without providing too much specific information about her case, I can tell her that her outlook on abortion is far different from mine.  Which is to say, she's never considered herself prochoice or "pro-life."  She was raised what she called "Super Catholic" and honestly thought she would be killing a human being.  But she was having the abortion anyway because it was her only real option.

By the end of our conversations prior to her appointment, she felt good about the choice she was making.  She had more clarity in her values, she was forgiving herself, and couldn't stop thanking me for being there for her without leading, assuming, judging, etc.

Just like at births.

I've been jokingly labeled as a "truly full-spectrum" doula by friends.  Bad Day Doula, Relationship Doula, Sleep Deprivation Doula, Headache Doula... I may end up being my mom's Hip Replacement Doula by the end of the summer.  What it comes down to isn't some certification, or even training... it comes down to who I am as a person, what I am willing to do for people, and the way I treat them.  The training informs the actions we take in response to our instincts, but someone can't simply be trained to be the kind of person a doula is.

Oh hell, I'm rambling.  I'll just let Boromir break it down for you.  Happy International Doula Month, all!!