The Birth of a Doula (How do you spell that?)
Many people stumble over the word “doula”, wondering what it means, (and how on Earth to spell it) and when I explain that it means “one who serves” and further simplify it as a labor and birth coach, people are generally satisfied. However, there’s always someone who makes the statement “Oh, like a midwife!” Admittedly, in the past to save time and lots of confusion I’ve responded with “more like a midwife’s little sister” which tends to satisfy most curiosity. However, it is truly not as simple as that, and to be completely honest, It’s not a fair statement. (My apologies to my sister doulas!) In my “defense” it’s been a struggle to find a way to quickly explain what it is we “do,” to what do we compare our duties and position that would make one understand? Professionally, there is honestly no comparison. Emotionally, we “mother the mother” physically we’re trainers, socially we’re friends, and professionally we’re advocate educators.
To truly do justice to the description of our duties, its necessary to break down how we become doulas. Doulas are paraprofessionals that can be trained and certified through multiple governing bodies. Such as DONA International, ICEA or CAPPA to name a few. Doulas participate in an intense training in person, to begin learning about pregnancy, childbirth and breastfeeding as well as the effects of interpersonal relationships, social issues, and medical interventions on the mother/baby dyad. We then have a battery of tests, multiple required readings, fieldwork and evaluations to submit to. It is an intense (and rewarding) initiation into our field.
Though doulas are educated on medical procedures and their effects on mother and baby, medicines and comfort techniques as well as nutrition and hospital protocols, to help families navigate labor and delivery, we are NOT medial professionals. We cannot diagnose or give advice. We’re trained to “read the room” and charge the atmosphere during labor and delivery to help relieve the anxiety and fear the mother (and partner) may face. We are charged to educate women about their bodies, and how to present each phase of pregnancy as a natural and successful step towards a healthy baby and growing family. We have the responsibility to present mothers information that will enable her to make choices that will have life long effects on herself as well as her baby. We’re required to be present physically as well as emotionally to diffuse doubt as she deals with the psychological factors affecting birth outcomes, especially those that health care providers are often not privy to. We inevitably become a sounding board for issues that adrenaline and oxytocin pull from her psyche and we must “ground” her as she’s navigating the next contraction.
During labor, the issues with her partner, her goals as a woman, her fantasies as a wife and dreams as a mother collide and sometimes crash as labor progresses.
“Nobody told me it would be this bad” is often heard when the doctor leaves the room and a sweaty mom with dry lips and messy hair turns towards me with teary eyes, ready to “change her mind”.
As we meet with families to discuss their birth plan, we are often told family history as we’re given the reasons why “Aunt Emma is allowed in the birth room, but if my mother in law comes, tell her I left.” In cases where moms tend to have more physical responses to pain, doulas often bear the brunt of the release.
I have a certain song reserved, tucked tightly into the recesses of my mind to be used the next time I find my face pressed tightly to a mother’s cheek, eye socket gouged by her gorgeous high cheek bones and my ponytail wrapped tightly around her fist as she screams obscenities. (This particular client truly did have a beautiful birth, and we laugh about it often, I did also agree to attend the next birth with her and I wore my hair in a bun).
Doulas are essentially “shape shifters” engaging the healthcare team and translating medical jargon for clients, as well as diffusing family drama that makes it’s way into the birthing suite, and helping mom breastfeed for the first time.
We are scribes, recording the entry of a new life into our realm from eternity to mom’s breast, and keeping the event tucked tightly away, to be drawn upon by only that family. We receive birthday party invitations, pictures, and then we meet that six year old we delivered again as she welcomes her new baby sister into the world. We become fixtures in the labor room, often ignored by (well-meaning but busy) medical staff as they make rounds, until they look to us to answer questions when mom is mid-contraction and can’t speak. Often as doctors and nurses prepare to perform minor procedures, they’re not aware of the first sign of the impending contraction. We’ve learned mom’s mannerisms and other “isms” that may signal that she’s not safe to be tampered with at the moment. We are often the only thing standing between a nurse and a pinch, punch, swear word or most commonly a death glare. I’ve adapted the “warning glance”, alerting a nurse that this is NOT the time to apply the blood pressure cuff. Though there is inevitably a nurse that will throw off a patient’s sock that lands in my salad, or ignores my request to let mom finish her contraction before she administers a shot, I’ll leave her to her own devices and walk mom through coping and recording measures. More recently, nurses who are familiar with our role will beckon me out into the hall to have a short consultation about the mom to get my take on what would help. This is when labor becomes a synchronized dance. The three - fold cord is not easily broken. The combination of the healthcare team, families and doulas can have an overwhelmingly positive and successful outcome in the delivery room and beyond.
Emotionally, we “mother the mother” physically we’re trainers, socially we’re friends, and professionally we’re advocate educators.
Now if we can just get the spelling right…