by MotherWit | Apr 8, 2011 | Uncategorized
I have been noticing in the doula world some stuggles over words. We have so much to do, so many balances to create, so many environments to improve. Some of these struggles are completely spot on and need addressing. Some verge on what seem to be an attempt to be more unique or less mainstream than the average bear. Words most definitely have the power to make us distinct. Language is very important, no doubt. If I’m standing up strongly for myself and creating a stink over injustice, I don’t like to be called a bitch. Calling someone “sweetheart” in a way that’s clearly condescening and sexist, instead of in a loving, nurturing way is awful.
There is tremendous power in words and we do need to be careful. But sometimes quibbles can be much ado about nothing. Yes, apparently I am waxing Shakespearean this evening. I don’t love the quibble over the word “contraction”. Yes, while the endorphin suffused state of birth in no way feels emotionally like a contraction but an expansion of consciousness, in reality the uterus most certainly contracts. Hard. Calling it a wave or an energy rush is not a bad thing, but really, it doesn’t change the fact that a uterine contraction is occuring. Calling it another name might make it seem less “hard” (I consider it to be a word referring more to simple mechanics than to Medicine) and perhaps more spiritual, (and in our culture this desire for a shift of balance in birth perception is certainly helpful for many), but I am perfectly comfortable with “contraction”. The uterine contraction causes a heck of a lot of sensation, and while I understand this phenomenon is perhaps not what some people want to focus on in their birth experience, really, that big sensation which goes hand in hand with the mechanical uterine contractions seems to take center stage in most labours regardless of what we plan or hope for.
I have noticed that many people don’t like to use the “p” word with regards to labour…you know what I’m talking about…..pain. There have been several terms generated to shift perception surrounding the birthing sensations, but in my humble experience both personal and in birth attending, I tend to believe birth hurts, no matter how you try to pretty up the word. But the pain isn’t a bad thing. That strong, strong sensation creates the flow of endorphins, and our experience of it raises oxytocin levels so the next contraction is even STRONGER. We birth hopped up on that beautiful ” ‘ormone of luve”, which is guided and driven by…you guessed it, pain. Whether they plan to or not, the vast majority of women feel some level of pain in labour. Instead of quibbling about the word, perhaps shifting the focus from the pain as being some nasty by-product of the childbearing process that we “shouldn’t” have to suffer through to being a noble, healthy challenge we are absolutely capable of moving through would be more helpful. Call it an interesting sensation, call it a wave, sure…that doesn’t hurt. But the sensation still does. And that’s okay.
I see more and more doulas not seeming to like the word “training” for the process by which doulas learn their skills. The definition of training is: “organized activity aimed at imparting information and/or instructions to improve the recipient’s performance or to help him or her attain a required level of knowledge or skill.” I believe in training. Where I veer from most doula training organizations is that while I believe in good training including apprenticeship with an experienced doula, I don’t care much about certification one way or another. In the doula world that piece of paper, while it is great because it means you did what was asked according to someone’s made up standards, it in NO way means you’re “done” learning. It in no way defines the greatness of a doula. Frankly, it means little to me. I have doulas on my team who are certified and who are not. What attracts me to them is their integrity, reliableness, passion, compassion, and a sense of knowledge I get from them just by speaking to them casually about birth. We develop through constant learning and continuing experience. So while the piece of paper stating “qualifications”is not so important to me, the fact they took the time to invest and immerse themselves into the preparation or “training” of how to be a doula is. There is a basic level of skill being a doula needs. I don’t want to say “required” because that’s too rigid. While the learning is life long, there are basics to know. You might want to know what a cervix is, for example. You need to know how to listen actively. You need to understand the process of labour and how women experience it. You need to know some tools to help. It’s not all hearts and flowers and broadcasting love. So doula courses DO train doulas. Whether we want to claim that word “train”or not as what we do to prepare doulas is up to us, but I am happy with the word. I do not consider it too mainstream. I don’t think it necessarily leads to an assumption of a means to an “end” of learning and major standard of pratice focus over skills. I don’t believe it’s about a check list of qualifications so you can call yourself a doula. It’s about basic skills, information, and personal growth so that all participants can find their unique path and expression of the work. I’m sticking to the term “training” with impunity because I think it’s a good word for the process of learning basic doula skills.
I’m not so down with the term “delivery” for the receiving of babies. What I don’t like about it is that it implies the attendant “delivers” the baby. While they may be actively helping in some cases (whether it’s needed in that situation or not), I’ve always kind of felt that mothers deliver their babies into the world. But I won’t argue with or correct someone who uses this term.
You know what word I really don’t like? “Doula”! It rubs me in all kinds of wrong ways. It comes from the Ancient Greek word “slave”, for crying out loud! And a bonded slave at that. While the ancient lady of the house was birthing and mothering, her maidservant hung out with her and carried out a very noble role, but maybe not necessarily with the love and passion we modern doulas bring to our work because we do it from a place of free will and choice. To tend to women in their childbearing year is an honour. But the ancient maidservant was probably bought into the family and would have been stoned to death if she didn’t carry out her role, like it or not. I can’t think of one great other word describing what I do, but I must say it has never fell comfortably out of my mouth. Dooooouuuullllaaaaaa. It sounds kinda flakey to me..even a little romantic. Plus, half the people you mention it to say, “say what?” But hey, it is very deeply entrenched in our modern language, so instead of quibbling about it, I just go with it. It doesn’t really change my life so much. Whether I’m called a doula or a birth attendant or an accompagnante, I love the role I play. A doula, the essence of the work being summed up by this popular word, is what I choose to call myself, whether I dig the acutal term or not. It’s what people know and respond to. Really, “a rose by any other name would smell as sweet.”
Lesley
by MotherWit | Mar 28, 2011 | Uncategorized
I re-read Ina May’s Guide to Childbirth, and have read Spiritual Midwifery at least 10 times over the last couple of decades. The message that always resonates most with me is that culture helps to shape birth. It is true to a large degree how something is observed influences how that thing functions or “behaves”.
Ina May lives in a culture she has contributed to forming in which birth is a normal, natural, exciting, joyful, transition into motherhood…that women are powerful both in their birthing prowess and in the strength of the support they provide to the birthing women in their community. Her amazing stats bear this out, showing evidence for the efficacy of this woman centred rather than technological approach to birth. There is very little in the birth stories Ina May features in her books that cannot be remedied by the loving and strong support of the spiritual midwives and other women close to the couple. Of COURSE the unexpected and even the dangerous can and does happen on occasion, even on the Farm. But for the most part her statistics tell a much different story than standard North American birth stories, that many issues that come up in labour can be resolved with more emotional support and spiritual excavation rather than medical intervention (not eschewing, of course, good medical care when necessary). Again, bear in mind those phenomenal outcome stats before pooh poohing.
The birthing culture I live in now is way different. My “culture” when I was having my babies consisted of a community which favoured home birth, home schooling, natural approaches to health, bed sharing, etc.. The far reaching majority of us had pretty straightforward home births, easy breastfeeding, and good postpartum support from friends. I don’t think any of us had Cesareans, whereas now you can’t throw a stick without hitting someone who’s given birth surgically. What used to be considered a major thing is now becoming a norm. We held Blessingway ceremonies for each other during pregnancy and hung out a lot telling good birth stories and providing each other with emotional support. It was a beautiful time. Now these children we birthed and nourished are growing fast, many of them already grown. I pray our practices stick with them as they make their way through the ups and downs of today’s North American birth culture.
It has been said that form follows function and function follows form. As above, so below. When our culture has such an overwhelming fear of the birth process, it makes sense this seems to be reflected in our birth outcome statistics. For all our shiny technology, our outcomes are pretty poor compared to Ina May’s at the Farm. So many births seem to need epidurals and Cesareans despite the woman’s best intentions. Women are told they couldn’t have had a safe birth without their interventions. The poor old female pelvis is not the all powerful thing we seem to pay lip service to after viewing all those great birth documentaries, but apparently, according to our North American stats, an unpredictable lemon. When it works naturally, it’s an awe and triumph, not really the norm. A natural birth is a rarity. In fact, in our present birth culture, natural birth is often seen as radical, sometimes even held in contempt not just by some of the medical community, but by many of the women themselves. This breaks my heart as it demonstrates a terrible collective misguidedness.
The way we prepare women for birth is so intellectual. Breathing techniques often consist of counting. Women seek to hypnotize themselves out of a fear response to the normal sensations of birth! I see women reading all the right books and wanting the image of that dream birth yet still buying the cultural fear so much that they will almost always in the end go for that 41 week induction for terror of sudden fetal death, or go to that hospital with 24 hour on call anesthesia just in case they can’t handle it, but without exploring what “can’t handle it” means. They get mad at their doctors sometimes for delivering the information and treatment outlines to them (and I don’t blame them much of the time, as this information can sometimes be delivered in ways that make them feel like bad, neglectful parents if they don’t do what they’re told). In the end though, nobody goes to their houses, holds their faith in their bodies hostage, and takes them at gunpoint off to their intervention filled births. We must recognize that there is some choice here, and that we must own for the most part that which we make informed choices about. These choices shape our culture.
It is a hard thing for women in this culture to bear, and one that I believe to very much affect the mechanics and juicy hormones of birth: on the one hand you want a great natural birth inspired by the good stories and films out there, but on the other you ultimately feel you must trust Medicine as the last word and a very fear based aggressive approach, feeling backed into a corner and possibly resentful, yet unwilling (or in many cases unable due to lack of resources) to make different choices because of…you guessed it…the very fear that makes Medicine outline those choices. We are terrified of the unknown and for being responsible for choosing something that may ultimately make us suffer the horror of having hurt our babies. Medicine is afraid of the repercussion of uncontrolled choice as much as we are….thus everyone feeds off the fear and it continues to spiral out of control, to the extent that in some North American hospitals the Cesarean rate is over 50%. We keep choosing the more medical approach DESPITE the rather grim statistics (ie.: definitely not like Ina May’s)which seem to illustrate that the more we mess with normal birth the more problems we seem to cause. YES, Medicine saves lives, and God bless it! YES, sometimes things happen out of the blue that necessitate quick and immediate medical care. And for that reason, though those quick emergencies are pretty rare (I sound like a broken record, but I again defer to Ina May’s gorgeous stats), we continue to take calculated, controlled risks to our normal births, very likely causing more problems than would need to be treated if we didn’t interfere so much with this process.
It is very hard to bring the Ina May approach into the hospital. Her approach is about trusting ourselves, the process, and the support. Her brand of midwifery is certainly wise and vigilant (again, check out the great birth outcomes), but it is dynamic and views the woman as a whole, not a check mark on the all mighty progress chart or an alarm bell going off when anything is not “average”. Not that doctors are uncompassionate and uncaring…on the contrary, their choices are usually motivated by a lot of care. Ultimately, though, clinical responsibility and covering all contingencies is the absolute priority. That’s the way it is. The Farm midwives know the relationship of the couple, know who’s visiting whose hut, know the diet well….our doctors are not aware of these factors and cannot offer support that way. They are busy preventing and treating the many emergencies, which is not a bad thing.
So where do we find balance? While a doula certainly provides the loving, guiding aspect of support the Farm midwives do, we usually do so in the hospital. This is not the lovely home environment of Ina May’s birth stories our clients read about and are inspired by. Instead, their births unfold in an environment that is saturated with the fear of all the bad things that can happen, the fear of not making all the right choices to save a baby’s life, and an endless sea of strange faces coming and going and commenting. Having a doula present doesn’t magically erase the heaviness of this environment. Surely we help. It is true our clients have less Cesareans and epidurals, but to believe their births will be like the ones on the Farm with the support of a doula within the hospital environment is simply not true. Doula or not, the pervading institutional-ness of the hospital will have a profound effect upon more sensitive physiologies, potentially creating in the end what will be a real need for interventions.
A doula’s emotional support is powerful, it is true, and can reduce anxiety thus a need for many interventions, but our support can easily be undone by many different things….a shift change, another bit of information about the labour that requires a mom to be on a monitor more and frightened, an insensitive vaginal exam… A sensitive woman will definitely be thrown by a well meaning but misplaced comment or harsh word no matter the buffering power of her doula’s word medicine.
I have seen the environment shut down a great labour despite my attempts, and this can make us feel really powerless sometimes. Sure, sometimes you are very grateful as a doula you were at the hospital because of a truly unforseen emergency. But often you have a sneaking suspicion that a little privacy and a little time off the monitor would have turned a “stalled” labour around instead of the epidural that was sold so hard you’re all left reeling. And even though the labouring woman knows this on one level, fear of not doing what’s suggested often bears out and influences her choices…which influences her labour….which co creates the bigger picture of our birth culture.
Luckily, we doulas have FAR more great stories than not, but let’s face it….the books we write will never be like the stories they have on the Farm unless we live in a homebirthing culture. Yet we keep on slogging, praying that each great birth we attend contributes to a healing of this culture and the slow, slow swinging of the pendulum. For now, I seek to make hospital birth, which is the norm no matter what I have to say about it, as humane and as beautiful as I possibly can. If I didn’t see great success with that much of the time, I couldn’t continue doing this work. I would be walking around permanently wounded. So doulas, especially newer doulas who have been having their eyes opened to the reality of hospital birth despite their hopes and best intentions, though it sometimes seems overwhelming and impossible, don’t give up. We are making a difference.
Lesley Everest
www.MotherWit.ca
by MotherWit | Mar 12, 2011 | Uncategorized
It is official! MotherWit is hitting the East Coast of Canada this summer. Join the Doula Ceilidh from July 24th to July 29th as we get down to the nitty gritty, the earthy crunchy, and even the airy fairy of the science and art of being a doula.
This full six day/3 evening birth doula training intensive will take place at the beautiful WindHorse Farm in New Germany, Nova Scotia (windhorsefarm.org), which is about a 90 minute drive from Halifax and 30 minute drive from Lunenburg (home of the Bluenose). We are renting the Sunshine/Carriage House which will hold our hostess (Katrina of Cape Breton) and 15 live-in students (though our training will not be limited to 15 for those who wish not to stay in the house).
Our unique intensive approach is geared to eating, breathing, and sleeping birth. Our training last summer in Morin Heights, Quebec among the beautiful scenery of the Laurentian hills and living in close quarters for nearly a week created a life changing experience for many of the women who attended. In this tradition, we bring our training to you doula sisters and doula wanna be’s out east.
This course in holistic birth doula work is great for those who desire to serve their community as doulas, for those wanting to go on to study midwifery or nursing, for those wishing to expand their knowledge of tending to women in their childbearing year, or for more experienced doulas who wish to deepen their knowledge and wisdom. There are no prerequisites except a desire to nurture, educate, and support families during this special time in their lives. A doula has the potential to bring profound healing to a wounded birth culture with each family she serves. Evidence supports the fact that the presence of a doula in the birthing room reduces the risk of unnecessary interventions (as well as potentially mitigating the risks of those that could become necessary), and this training will show you how to do it.
We will talk about the tools women have used to help promote balance and healing since women have been birthing, as well as explore in detail how to create and hold the space conducive to normal, triumphant childbirth in different settings, as well learn how to support those having more challenging or even traumatic births. Learning how to deal with difficult situations and how to tend to ourselves as doulas is also emphasised in this course. Nestled within the shelter of Windhorse Farm and supported by the magical beauty of Nova Scotia, join us on this journey.
Women from Prince Edward Island, New Brunswick, and Newfoundland, it would be such an honour to have you. We realize doula training may be difficult to find in your areas, so this would be a perfect opportunity to learn to start generating crucial change to the birth culture in your town. It really doesn’t matter where you’re from. If you’ve always wanted to visit Nova Scotia, here’s a great reason to do it.
Join me and my teaching assistant Sesch Wren for a week you’ll never forget!
Details will be put up on http://www.motherwit.ca/ soon.
For you ladies farther out West, you are not forgotten! The amazing Tracey from Birth Source Inc. (http://www.birthsource.ca/) and I have been having some very interesting chats about bringing this new approach to doula training to Edmonton. We are also discussing bringing the MotherWit Doula Mentor Training to Edmonton as well, which is intended for experienced doulas (certification not necessary) who have a strong desire to reignite the ancient approach of taking apprentices, which is ultimately the very best way to learn how to be a doula: from other experienced doulas. No dates have been set yet and we’re still in the planning phase, but just so you know we’re thinking of you.
And for you ladies across the pond, the sweet Rebecca Wright (http://www.durhamdoulas.com/) and I have been doing some planning of a birth doula training intensive for UK doula sisters, as well as the mentorship workshop for experienced doulas. Irish, Scottish, Welsh and English doulas/doula wanna be’s, keep checking back for more information as our plans develop.
If you’re from anywhere else and are wishing so much you could join us but just can’t because of distance, consider hosting us. We LOVE to travel.
by MotherWit | Feb 11, 2011 | Uncategorized
When I meet people who are interested in working with me as a doula or childbirth educator, one of their burning questions is: “Are you going to teach me about positions to use in labour to make me more comfortable?”
While I may do the briefest of overviews to show what many women enjoy doing positionally with their contractions, asking them and their partners to try them out so they can feel comfortable knowing what they are doing is totally normal once they’re in labour, positions for comfort is actually something I don’t focus on a lot. I tend to find most women know what to do in normal, ummedicated, physiological labour to make their contractions more efficient and comfortable. If we provide fancy charts of positions that are helpful to birthing women, it assumes they will be using their intellect during labour to mentally bring up the image of the “menu” of positions (or check their notes while actually in labour), and select which might work for their particular scenario. While this may help in early labour (or not, as I tend to recommend the “don’t focus on early labour and find something to distract yourself with” approach rather than the “focus on the early sensations with all kinds of positioning and massage so you’re at a loss as to what to use to help when things really get cooking” approach), the kinds of contractions that have you drifting away on an endorphin cloud to lala land are simply not conducive to the mental gymnastics of cross referencing.
I have actually not seen a labouring woman with back pain NOT lean over or go on her hands and knees to take that desperate pressure off her sacrum. I often see women who are being monitored while lying on a bed rip off the transducers and stand up because they simply cannot lie there any longer. They can’t tell you why, they just know they cannot bear that position anymore. Their bodies are guiding them intuitively, their babies whispering from the inside, “Mama, I need some more space…move this way.”
I have had women yell in transition, “Tell me what to do! What do I do?!” and I’ll make a suggestion, but inevitably they do what they want. I remember a woman asking her midwife what to do and the midwife suggested she sit on the toilet. It’s a great suggestion…the opening of the legs, the safety of the toilet, the squatting position putting pressure of the baby’s head on the stretchy cervix, helping it to open perhaps more quickly. There’s no need to explain all of that to the labouring mom , as it’s too much information for her to process. All she wants is some direction on which to anchor her hopes that this will all be over soon. Despite the midwife’s simple suggestion, the mom just stood over the toilet. All she wanted to do was stand, so finally after being asked several times what she should do, the midwife validated that clearly what this woman wanted to do was stand, and to trust that. When she started grasping and pulling down on the shower rod, we guided her out of the bath (where she was standing) so she could grab onto the trapeze bar provided for that purpose. She birthed beautifully hanging from the bar. That would have happened whether she had been educated about positions in advance or not.
Labouring mothers often do some strange things to comfort themselves in labour, and it’s all good. I’ve seen women lie down on the bare hospital floor because it felt cool, stand up on a chair because the floor felt too hard, or walk like an elephant on all fours swaying to and fro with their heads. All a mom needs to know is that if it feels good, she can go for it.
Where positioning education comes in very handy is when the mother has an epidural. Because many of her body instincts are numbed by the medications and positioning of the baby can become misaligned with the pelvic structure, suggestions of position changes help a lot. And because the mother is capable with the reduction or absense of pain and endorphins to draw upon her intellectual capacities, a check list she’s learned in advance of positions to increase labour’s efficacy can be extremely useful if she doesn’t have anyone around to guide her with this.
When labour is NOT going normally and clearly the baby needs to do some shifting to create a better fit with Mom’s pelvis, positioning can be extremely helpful. I had a mom once whose back was so sore and stiff from a long hard labour that she couldn’t sit down. She wanted to, but the aching prevented her from acting out her intuition. Her husband and I tried to guide her to sit on the toilet, but she just couldn’t bend her knees. Her poor back was raw from all our rubbing. Her poor bum muscles were so tight from all the pain, so my instinct was to grab them and shake them out. I did this for a good minute, just jiggling those bum cheeks. We were all giggling a little. Finally the mom sat down, and things got moving immediately. She ran to the bed, got on all fours, and was found to be fully dilated. Again, we could teach all that in childbirth ed, but really, when in the throes of labour, without some skilled direction, she and her stressed out partner probably won’t think about all the possibilities or receive support. This is why good childbirth education AND good doula support create better outcomes than just education.
Positions for rest are something I like to talk about. Sometimes moms get really tired, but cannot stay in a position during contractions that they really like between them. So knowing how to rest and contract in one position for a bit while she regains her energy is useful. I like using a yoga ball and edge of a bed or counter to lean over on for resting and contracting, or hanging out in the bath. It’s important that the skill of how to rest and chill out in labour is as important as riding the waves of contractions.
Another area in which discussiong positions is useful is when it comes to the second stage of labour. I love to watch people’s faces as I demonstrate what a normal labouring woman often loves to do when that fetal ejection reflex kicks in…butt juts outward, arms reach up to grasp, torso leans way forward. I gently and slowly tip myself backwards without moving any limbs, just letting my hands grasp my knees, and it really hits home how, when you adopt the stranded beetle position, a woman is asked to do the EXACT opposite in most OB assisted births of what Nature asks, effectively mobilizing the sacrum (which dearly wants to be able to stretch and yield to the babe’s extending head), perhaps necessitating circus style pushing to compensate for the smaller space created in the pelvis, and potentially wreaking all kinds of nasty havoc. Telling women that there is a good possibility of their not feeling great being on their backs while pushing (as many don’t know this is not the real “way” the body likes to deliver babies), and that their instincts to do otherwise are spot on regardless of what they’re directed, helps them to know they’re not “bad” patients or somehow abnormal. And it’s also helpful for them to know that there is no black and white, and that if they do happen to feel good on their backs, then this is absolutely fine too. Just because it may not be an ideal position for some, it may certainly be for others. I have seen women whose babies are exiting with great speed (myself included) throw themselves spontaneously on their backs. Perhaps this is how we are intuively guided to slow things down a little.
It is important to remember that birth is not intellectual from the birthing woman’s point of view. The more charts and diagrams a woman has to look at and follow, the more she gets caught in wondering, “okay at what point do I do this, what sensation necessitates this position, etc.” This is exactly where we do NOT want labouring ladies to be…in their heads worrying about what is “right”. If they seem as happy as they can be in super active labour and things are going well, then it’s right. The most useful tools in childbirth education are not the fancy tricks that are learned involving balls and positions, but the practice of relaxation, release of tension through whatever means the mother prefers, and the ability to stay with the sensations confidently as opposed to reacting to them with fear.
by MotherWit | Feb 8, 2011 | Uncategorized
Scary things can happen in birth sometimes. It’s not something we like to think about, but the fear of emergencies in birth is something that lurks in the corners of the minds of pregnant women and their caregivers alike.
As doulas, occasionally we are front row centre witnesses for someones trauma. It can feel powerless watching those scary things unfold. We are often grasping at straws in our minds wondering, “What do I do? How can I help fix this?” Well, sometimes we can’t. As much as we try to prevent birth trauma by guiding people to empowered choices and as much as we hate for bad things to happen to the couples in our care, the unexpected can occur. We can end up feeling very powerless when an emergency takes place, and it’s crucial to know how to anchor ourselves in the eye of the hurricane so as to create the optimal space for healing to begin as soon as possible.
While trauma is occurring:
1) Acknowledge it. We need to look those parents deeply in the eyes, take a breath, and in our own gentle, loving way say, “Yeah. Here we are. That scary place nobody ever wants to go. Breathe, and hold on.”. Trying to “make it pretty” when the proverbial poop is hitting the fan, minimizies the experience and only leads to dissociation.
2) Stay present. Breaking down emotionally, getting caught up in those bubbles of fear and drama, and freezing up is not an option. You cannot “check out”. You need to open your heart up, waaaayyy up, stay anchored within the chaos, and stay there strongly with your clients. Be totally present, surrounding them with as much love and calm coming out of that open heart space as possible. It may sound flaky, but the emotional tone we set can have the power to keep others calm. As doulas are very much “space holders”, what we energetically broadcast into the room can influence how the parents and caregivers respond to the trauma.
3) Reassure when possible. If a woman has to go through a tough obstetric procedure, while we can’t make it rosy, we can definitely let her and her partner know all the positive aspects of what is happening, like “You are doing GREAT!”, “We can see your baby now, hang on!”, “This is the hardest part and it’s almost finished.” If Baby is an issue, repeating the positive things you hear the caregivers saying can be helpful to parents, such as, “They say your baby’s heart rate sounds great.” or “Her breathing has improved a lot in the last minute.” A blue floppy baby is all a parent will see, and if it is appropriate, letting them know the good stuff that is going on with their newborn while the caregivers are busy focusing on their tiny patient can help promote calm. Often, parents will not receive this information, and their terror of the unknown could otherwise exacerbate their sense of trauma surrounding the memory of their child’s first moments of life. Being informed and reassured whenever possible is comforting to parents. The look on the faces of new parents when nobody is actually telling them the baby is breathing with a good heart rate is enough to ensure you as a doula are on top of this.
4) Be loving. Touch the mom, speak to her lovingly, stroke her hair, coo to her. Be loving to her partner. This helps to promote oxytocin and reduce too much adrenaline response. Doing whatever you can to keep that mother/baby hormonal connection intact, even when the baby needs to make a fast birth exit or has just had a difficult passage and is not able to be in the room with her, may help improve her future memory of her birth experience.
5) Trust. Give caregivers ample room and support in their important job of dealing with a medical emergency. Trusting doesn’t create the outcome we want, but staying connected to the trust whenever possible that everyone is doing their best, promotes calm, often helping the best care come about. As doulas, our spiritual beliefs are definitely something to draw from at this time, if we are so inclined. The idea of trusting that as we hold the space for our clients and everyone else in the room, all of us are also being held by a loving source, even if what’s happening is something we can’t make sense of, is something many doulas and caregivers seek comfort in. Knowing deeply we have no ultimate control and that our power lies simply in doing the tasks required, being present, and living this moment as fully as possible, no matter what, is often what helps us all to heal more completely when the emergency is over.
Once trauma has occurred and everyone is left picking up the pieces:
6) Beware of magical thinking. I had a sweet, lovely student end up attending several dramatic C-sections for her first mentored births. After the third, she broke down in sobs, asking, “Is it ME?” The doctor present was loving but firm and gave her a great reality check: “Ah, Sweetheart, you feel like you’ve earned the black crow award because all you’ve been present for so far is emergencies. We can all feel like this. Really, though, you’re not THAT powerful that you can bring on bad outcomes just by your presence.” This is a wise and straight to the point wake up call on those days we are stuck in the past traumatic experience, trying to envision what a different outcome might have been had we heroically jumped in to do the impossible to spare a woman from turmoil. Know what to own, know what to let go of as magical thinking. Help your client avoid falling into this trap too.
7) Don’t entertain the “why” and “what if” too much beyond getting to the basic physical reasons something may have happened. Spending hours conjecturing “why” is not healthy, and with doulas/caregivers sometimes even arrogant as we try to throw out many hypotheses that will usually only ever remain hypotheses. It soothes our egos to have a tangible reason for those unexplained traumas, but healing isn’t about soothing our egos. Sometimes things are just mysteries, and what’s done is done. Sure, when there is evidence for something, it can feel good to know actions were completely justified. However, often there are many pieces of the puzzle missing, and will always be missing. An amazingly wise Abenaki Grandmother told me once, “Every time you ask why, Spirit takes a step back. Who says you get to be privy to why something happens the way it does? Instead, ask, ‘What is it I can learn from this experience? Spirit will take a step forward.'”
Many clients after trauma will ask if you think the outcome could have been different had they done something else, for example, let’s say, birthed vaginally had they avoided the epidural. You cannot possibly answer this question. Gently point out that wallowing in the whys and what ifs are fodder for self flagellation, and not healing. Embracing the experience for whatever it was, good or bad, making meaning of it, and living fully is usually a better choice for healing. This may only come about after a long period of grieving.
8) Debrief with your clients about their experience. Let them pour out their pain without trying to pretty the experience up for them. Don’t join the ranks who say, “Well, at least you have a healthy baby.” (if the baby is indeed healthy). Women need to feel “allowed” to grieve the loss of the experience they wanted. It’s not selfish to have hoped for a lovely birth. It is heartbreaking to have suffered trauma. Grief is totally appropriate. My dear friend says when something has gone badly, “Dude, that sucks.” She says it with absolute compassion, and there is comfort in knowing that someone acknowledges that something plainly sucked as opposed to having someone be chirpy and sunshiny when the real emotional landscape is so obviously grey. We want people we care about so much to feel better, but it’s not always possible for a while. Sparing someone from authentic feelings and creating dissociation by interjecting niceties is more about our being uncomfortable with their feelings, and it’s the same pattern that contributes to such high epidural rates, “Oh, poor dear, you’re suffering. I can’t stand to see you in pain. Let’s just make it go away.”
When the whole thing is talked out and there is more emotional space for perspective, connect them to where they were amazing and graceful in dealing with such challenging circumstances. It’s not the same as trying to make it pretty. It’s honouring the person’s role in authentic and powerful living. They may have felt totally “weak” because they cried and couldn’t “get on top” of things. Crying and feeling scared is emphatically NOT weakness. Just as the icon of the Zen woman breathing easily and painlessly through her contractions is not an appropriate image of birthing, neither is the stoic stiff upper lip image for someone who is softer and more sensitive.
Deeply honour how a couple moves through the unique emotional terrain of their unique births.
9) Provide resources. If couples need to seek more counseling about birth trauma or reactions of anxiety and/or depression, knowing which professional avenues to send them down is important. Be very aware of your limitations. Doulas are not therapists, and owning all of your client’s emotional process is not appropriate, potentially blocking their healing by not sending them to the proper resources. You can always be available for support, but support doesn’t mean owning their healing.
10) Doula heal your Self. When you have been traumatized, it is your mandate to deal with it. You cannot bring past trauma to the next birth and be fully present for the clients in your care. Doulas can and most certainly do experience Post Tramatic Stress Syndrome, whether it be from a true birth emergency to witnessing violently harmful and disrespectful behaviour towards a client. Whatever the reason, it is our responsibility to take the time we need to heal. Write it out. Connect with your own spiritual practices. CALL YOUR SISTERS! A community of doulas is the best way to help each other heal. I’m all about doula-ing the doula and without the support I receive from my community, I would most likely be a gibbering mess today. Reach out, talk it out, and embrace the incredible richness of this life of birth attending. Connect, ultimately, with your Love, as this is what grows when we remain present and seek to heal our own wounds. This Love can serve as a light to those healing their own traumas.
