Optimism
You wouldn't believe how many times I have said similar things to the women I work with. The conversation normally goes something like this:"Can I do this"Women need to hear that they are amazing, that what they feel is normal, and that they can overcome the obstacle that they are presented with. A doula should be the woman's best cheerleader, and most optimistic friend!
"You ARE doing this!"
"Please tell me I can do this"
"You are going to face this mountain and it will move. Just tell it to!"
Perspective
So many times, women in labor will find that they don't fully comprehend what their provider is saying. Or, they don't have enough information to make a true and informed choice about the course of treatment being suggested to them. It can be very helpful to remember what Yertle tells us.
This conversation normally looks like this (or some form of it):
"I think what Dr. Yertle is saying is _____. I believe the reasons that he recommends that course of treatment is because of _______. Is that correct Dr. Yertle? Did I leave anything out? Mama, did you have any questions? I have a question, Dr. Yertle, sometimes I have seen ____ work to help this issue, could we have time to try that if mom would like?"
Never forget, we don't work for their providers, but the women we do work for have asked us to support their choices and their rights. Two of their choices were their place of birth and their provider. We have to balance supporting those choices, with reminding them of their rights.
Choices, Choices!
Which brings us to our next lesson. As a doula, you should know her choices. As Diana Korte and Roberta Scaer said, "If you don't know your options, you don't have any." Use the prenatal period to teach her about options.
Her Brain needs choices to pull from during her pregnancy, labor, birth, and parenting time. When she can't remember those choices, your job is to gently remind her of them.
Her Feet need choices so that she can choose where she wants to take herself for prenatal care and for her birthing time. She might not have known there was in-network CNMs in her area. She might not have known that there was a birth center nearby that she would adore.
Autonomy, this can be a hard one. Every doula is opinionated. But knowing when to share your opinions and when to help her simply steer herself in the direction she has chosen is a fine line to walk.
Question Everything
Question Everything
Ask the hard questions prenatally. This allows families to really consider what they want during their pregnancy, birth, and parenting time. These questions might be hard for you to broach, but the more they consider it, the more parents will know what their hearts really desire!
Be Willing To Be A Birth Anarchist
This may only speak to some of you doulas out there, and not others. Some of you are natural born rebels, conspiracy theorists, and hippies. Some doulas aren't. I'm going to be honest with you. When I first chose to be a doula, I was afraid of being labeled a hippie or a conspiracy theorist. I worked hard on being politically correct and remaining in the 'main stream'. But the more I learned about the politics of birth and the violations of human rights that were occurring in pregnancy and birth to women all over the world, the less I cared about remaining in the good graces of friends, family, and peers when it came to my (out)spoken beliefs and knowledge of the facts.
Be willing to be a birth anarchist.
Remember to Balance The Body and Mind
Sometimes, we as birth workers can become so engrained in the facts and figures of birth, our education and training in how to talk to doctors and nurses, how to present information to the public, or how to teach left-brained childbirth classes, that we forget that birth is organic, it's meant to be done with the body, not the head.
Remember to fall back into your 'nonsense' when in the birthing chamber. Keep your own head out of her pelvis, and allow yourself to tap into the creative - after all, she's creating birth!
Protect the Babies Too!
Yes, we protect the woman's space during pregnancy and birth, but what about the babies? As doulas, we should keep a watchful eye, and tell partners the same, to make sure that the newborn is treated in a humane way, as the parent's have chosen for their welcome to be.
The best place for a newborn is in the mom's (and her partner's) arms. Well meaning extended family members, fussy nurses, and intrusive doctors can wait. A baby won't gain a huge amount of weight or grow very much in the first two hours, so routine checks can wait. Newborn procedures can also wait, as can excited family who want to get their hands on the moments-old baby.
Likewise, during pregnancy be sure to talk with them about their options like eye erythromycin, Hep B, Vit K, circumcision, breastfeeding, bathing, newborn capping, rooming in, suctioning, and the like. Remind them that a 'persons a person, no matter how small.'
It's OK to Do-Less
Many times doulas will find themselves in the trap of 'what can I do?'. Sometimes, oftentimes, we need to DO less.
Many times, I find myself suggesting that mom goes in the shower, alone to have intimate time with herself during her labor. While there, she will sing her birthing song louder, become a more primitive her, and open easily. Oftentimes, she will invite either her partner or I in with her after awhile, but it's important to allow women the space and permission to labor alone.
This is Her Show
Remember, you cannot empower her. But, you can help her to become empowered.
You don't do the empowering, this is not your job. Just as it's not
your job to tell her what to do or how to birth. Your job is to give
options, and then support those choices that she makes. Remind her that only she can control her future. Not you. If she chooses to let her doctor or midwife make those choices for her, she has STILL made THAT CHOICE.
The Juggling Act
As a doula, you will be juggling. Juggling the hats of massage therapist, counter-pressure provider, acupressure administer-er,
childbirth educator, cheerleader, medical translator, patient advocate,
friend, maternal figure, and so much more. In the midst of that juggling
- remember to hold the woman up high.
She can easily feel like she becomes lost in the whirlwind of what her birth is. Be her holder, her anchor, her witness. Be the one who pays attention to all of the little details and rallies for her.
Hindsight is 20/20
Be Willing To Be A Birth Anarchist
This may only speak to some of you doulas out there, and not others. Some of you are natural born rebels, conspiracy theorists, and hippies. Some doulas aren't. I'm going to be honest with you. When I first chose to be a doula, I was afraid of being labeled a hippie or a conspiracy theorist. I worked hard on being politically correct and remaining in the 'main stream'. But the more I learned about the politics of birth and the violations of human rights that were occurring in pregnancy and birth to women all over the world, the less I cared about remaining in the good graces of friends, family, and peers when it came to my (out)spoken beliefs and knowledge of the facts.
Be willing to be a birth anarchist.
Remember to Balance The Body and Mind
Sometimes, we as birth workers can become so engrained in the facts and figures of birth, our education and training in how to talk to doctors and nurses, how to present information to the public, or how to teach left-brained childbirth classes, that we forget that birth is organic, it's meant to be done with the body, not the head.
Remember to fall back into your 'nonsense' when in the birthing chamber. Keep your own head out of her pelvis, and allow yourself to tap into the creative - after all, she's creating birth!
Protect the Babies Too!
Yes, we protect the woman's space during pregnancy and birth, but what about the babies? As doulas, we should keep a watchful eye, and tell partners the same, to make sure that the newborn is treated in a humane way, as the parent's have chosen for their welcome to be.The best place for a newborn is in the mom's (and her partner's) arms. Well meaning extended family members, fussy nurses, and intrusive doctors can wait. A baby won't gain a huge amount of weight or grow very much in the first two hours, so routine checks can wait. Newborn procedures can also wait, as can excited family who want to get their hands on the moments-old baby.
Likewise, during pregnancy be sure to talk with them about their options like eye erythromycin, Hep B, Vit K, circumcision, breastfeeding, bathing, newborn capping, rooming in, suctioning, and the like. Remind them that a 'persons a person, no matter how small.'
It's OK to Do-Less
Many times doulas will find themselves in the trap of 'what can I do?'. Sometimes, oftentimes, we need to DO less.Many times, I find myself suggesting that mom goes in the shower, alone to have intimate time with herself during her labor. While there, she will sing her birthing song louder, become a more primitive her, and open easily. Oftentimes, she will invite either her partner or I in with her after awhile, but it's important to allow women the space and permission to labor alone.
This is Her Show
Remember, you cannot empower her. But, you can help her to become empowered.
You don't do the empowering, this is not your job. Just as it's not
your job to tell her what to do or how to birth. Your job is to give
options, and then support those choices that she makes. Remind her that only she can control her future. Not you. If she chooses to let her doctor or midwife make those choices for her, she has STILL made THAT CHOICE. The Juggling Act
As a doula, you will be juggling. Juggling the hats of massage therapist, counter-pressure provider, acupressure administer-er,
childbirth educator, cheerleader, medical translator, patient advocate,
friend, maternal figure, and so much more. In the midst of that juggling
- remember to hold the woman up high.She can easily feel like she becomes lost in the whirlwind of what her birth is. Be her holder, her anchor, her witness. Be the one who pays attention to all of the little details and rallies for her.
Hindsight is 20/20
And finally... the after birth part. Oftentimes it is helpful as a birth worker, to have a peer review. This will help you to process what happened during difficult births, or births that left you befuddled. We need to be able to process, grow, mourn, and learn from births just as much as the women that we serve. For more information on peer review, see here. Similarly, as a doula, you might become that peer reviewer for the mama at postpartums. If she wants your honest feedback, give it, tempered in love and compassion. Likewise, if mom is not ready to ask the difficult questions about her birth, then she is not ready to have that information. Don't offer it. Wait until she is ready to acknowledge the value of that moment and what it might mean for her and her baby.
Conclusion
And there you have it, how to doula Dr. Seuss-style! And to wrap us up...
Can I labour over there?
Can I labour on the chair?
No! Don't labour over there!
You cannot labour on a chair!
Lie on the bed and you will see
We have to insert this IV!
I do not like this sharp IV!
I need to move, to dance, to wee!Obstetrician, let me be
Get your Pesce hands off me!
No! You can’t move, dance, or wee!
We must attach the ECGNot over there, not on the chair,
Not with the ball, you’ll have a fall!
Can I labour with a doula?
Can I use some calendula?
Can I push on hands and knees?
Can I birth just how I please?
No! Not with a doula! What’s calendula?
Lie back, legs up and count to ten,
Hold your breath and push again!
No thank you, doctors, nurse, and crew,
I’d rather labour without you.
I’ll walk and labour here and there!
In the shower – everywhere!I’ll labour standing, squatting, sittingTry them! Try them! You will see!
I’ll labour on my couch while knitting!
I’ll have a doula – I’ll have three!
They’ll let me eat and bring me tea.
And you can shove that darned IV.- Source Unknown
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