I am a doula, professionally trained by toLabor. The following is a blog post I wrote about why I am a doula. Thank you for this contest!
The one question I get asked in all of my interviews is “Why did you become a doula?”
The answer to that question lies in the journey I took to and through my own birth experience, and the incredible support I received from my doula and wonderful husband.
When I became pregnant, I did what most women in the United States do. I made an appointment with an OB/GYN (who was recommended to me by the primary care doc I’ve been seeing since college). I went to my prenatal visits, the longest of which was my intake appointment. I did the early prenatal screening tests. And when the pregnancy finally started to “feel real,” I started to think about a birth experience.
At the time, I didn’t exactly know what sort of birth experience I wanted to have. I knew I wasn’t afraid of birth, and that I was definitely interested in an unmedicated and intervention-free birth. I asked around to see if anyone I knew had birthed without either of those things, and not many had. “Don’t be a martyr,” they said. “Just get the epidural,” I was told. “What’s wrong with a little pain relief?” I was asked. The only people I knew who hadn’t had epidurals and such were women in my mom’s generation. My mom herself, in fact. She’d had her babies (me in 1978 and my sister in 1981) with a forward-thinking female OB who saw no need for mamas and babies to do anything but work together during labor and birth.
This got me thinking. So, being me, I got to reading. I picked up Henci Goer’s The Thinking Woman’s Guide to a Better Birth. I devoured Ina May Gaskin’s Guide to Childbirth (just to name a select few). I read little snippets of information in magazines like FitPregnancy. And it was there, in the pages of a glossy, fairly fluffy periodical, that I first encountered the statistics about how doulas help to reduce the rate of epidurals, c-sections, and a number of other interventions in birth, simply by the virtue of their presence.
That information stopped me in my tracks. I had done enough reading to know that I didn’t want a surgical birth and a medicalized birth didn’t feel like the right choice for me, either. I wanted my baby to be born gently, sweetly, and surrounded by loving supporters who were committed to a mama having an old-school birth (with credit to Toni Negy).
We obviously needed to hire a doula.
Research, research, research. Read the Mothering.com forums, ask around for recommendations (no one I spoke to had hired a doula, and most had no idea what one was). Fast forward to June. I was five months pregnant and interviewing doulas. We chose three out of a larger list I had compiled and met our first candidate on a dreary early summer evening. Erin welcomed us into her space and I immediately liked her. It was an instant connection. The interview was wonderful. My husband asked as we got in to the car to go home: “Do we really have to bother with interviewing anyone else? I loved her, and I could tell that you did, too.” He was right, but I felt obligated to do our due diligence. We completed our interviews with the other doulas and then called Erin to ask her to be our doula. She said yes!
Prior to meeting Erin, I had realized that the OB/GYN I was seeing for prenatal care wasn’t the right fit for me, so halfway through my pregnancy I switched to a midwifery practice affiliated with a community-based hospital. I was happy with the practice, and felt very positive that I would be well-supported there. But as my pregnancy progressed, I became more and more interested in having a homebirth. The more I learned about birth, the more excited I got about it, and homebirth seemed the way to go.
Then I had my 30-week ultrasound to check on my low-lying placenta, and I learned that my baby was breech.
“Don’t worry!” said the radiologist. “Your baby still has lots of time to turn, and most of them do.” But I was worried, so I went home and I researched some more. To make a long story short, I spent hours trying to encourage my baby to turn. Anything you’ve heard about doing to try to turn breech babies, trust me, I’ve done it: lying on an ironing board, flash light in my crotch, music in my crotch, talking to my baby, listening to hypnosis scripts, moxabustion, accupunture, accupressure, shiatsu, walking, somersaults in a pool, homeopathic remedies, external cephalic version. The list goes on.
Despite my efforts, my baby stayed right were he was, content to have his head nestled up under my heart, all the better to hear it beat.
We continued interviewing homebirth midwives, with the idea that based on the information we learned about the safety of vaginal breech births with an experienced attendant, we’d still pursue a homebirth if we could find the right fit. But the midwives who were available for our due date and simultaneously a good personality fit, were not comfortable with a breech birth with a first time mom.
We were unable to find any information on doctors in our area who would remotely consider supporting a vaginal breech birth.
I began to realize that I was most likely facing the very birth I had most wanted to avoid: a cesarean. My baby would born out of an incision made through my skin, abdominal muscles, and uterus. I would be an inactive, immobile, and frightened participant. I began to feel sad, overwhelmed, and, quite frankly, cheated out an experience I very much wanted to have: labor and a vaginal birth.
Throughout all of this, my husband and doula remained hopeful that my baby would turn. They encouraged me to continue trying things that might get him to turn, so long as those things felt worth my time and energy. They asked me to talk with them about how I was feeling. Never once did either of them say, “The only thing that matters is a healthy mom and a healthy baby.”
In our second and final prenatal visit, Erin gently said to me that it seemed to her as though we had come to the decision to have our baby in the hospital, and in doing so, that we could be consenting to a cesarean birth. I remember tearing up. I remember feeling angry. I remember my husband rubbing my back, and holding my hand.
I remember Erin saying, “Nicole, I know this is the not the birth you wanted for your baby. It’s not the birth I wanted for you. I know you wanted him to enter the world vaginally. Though a cesarean is not the birth you envisioned, it may be the birth you will experience. And remember, it is still your birth. I am here for you. Zac is here for you. Babies are wise, and perhaps there is a reason yours is so happy head’s up. I encourage you to honor your baby’s wisdom, and to work on making peace with the birth you will experience.”
Erin suggested that we spend some time reading about cesarean births. She told us it would be a good idea to ask lots of questions (if we wanted to do so) at our upcoming prenatal appointment with the midwives. She reminded us that there were still things we could do to personalize our cesarean birth. Did we want to request music in the OR, ask for silence during the procedure, ask that the doctor’s not announce the sex of the baby (even though we already knew it), find out whether or not it would be possible to initiate breastfeeding during the repair, or at least have as much skin to skin contact as possible.
She was right. Zac and I knew that and so I began making preparations for the birth I didn’t want. I told my midwives that I would not be scheduling a date for my son’s birth. It felt cosmically wrong to pick his birthday. One midwife in the practice actually had to present our request for a “trial of labor before cesarean” during a staff meeting to get “approval” from the backing OB/GYN. Ours was not a common request. We were informed of the very short list of “risks” of not scheduling our cesarean: 1. Not knowing the doctor on call (which didn’t matter anyway, because I’d only met the OB/GYN in the practice once and had no real relationship with her). 2. Having to experience a significant amount of labor if labor and delivery was particularly busy that way and couldn’t get us in to the OR in a timely manner. 3. The possibility of a cord prolapse should my waters release in labor.
We reviewed the risks, did not find any that were reason enough to schedule our son’s birth. I spent the final weeks of my pregnancy settling in to the apartment we had recently moved to. I worked full time up until the night my waters broke at 1:00 in the morning on October 16, my son’s official due date.
After my waters broke, I called to Erin to see what she thought we should do, and after speaking with her my husband and I decided to go back to bed and that we would meet Erin at the hospital at 9 a.m. Erin met us at check-in, and rubbed my back while we answered all the questions we’d already answered in our pre-admission forms. She massaged my hands and feet in the ante-natal room, while I was hooked up to the monitor and leaking amniotic fluid into the chux pads beneath me. We joked, told stories and laughed together while we awaited a visit from the OB. Erin reminded us to ask questions that had come up in conversations at our prenatals about pain medication options. She took photos of me and my husband’s last moments as a family of two.
When the time came for me to enter the operating room, I was walked down the hall by one of the surgical nurses. I remember feeling scared, anxious, and ready to see my husband’s and Erin’s faces again as soon as I could. I remember really not wanting to lay on the operating table. I remember feeling very alone.
The prick of the needle in my back was startling, and the numbness that followed was anything but a relief. I hated the sensation of feeling nothing. I lay on my back, staring at the ceiling, listening to unfamiliar sounds: machines, voices, the clinking of surgical instruments.
“We’re going to begin now,” the doctor said.
“No!” I exclaimed. “You can’t! Where is my husband? Where is my doula? I’m all alone in here!” I started to cry. Someone hustled out the doors to usher in my husband and Erin. It still amazes me that no one noticed that I was a woman about to have her baby, and that I was alone. It hadn’t occurred to anyone in the room to bring them in.
Though I’m sure it was only a matter of moments before Zac and Erin were in the room after my saying something about their absence, it felt like a lifetime and I was quite upset when they got there. Erin immediately showed Zac where he could sit so that he could get in very close to comfort me.
To be honest, I don’t remember much that happened between the time they entered the room until the time I was recovery. During the procedure I went inside myself and focused on the feeling of my husband’s hand on my cheek, the sound of Erin’s breath. The warmth of my tears. I mostly kept my eyes closed. I remember my son crying when he was born. I remember Zac going to be with him. I remember Erin by my side, telling me, softly, in my ear, what she could see of my baby. When I expressed upset at the noises I was hearing during my repair, she asked me what was bothering me, sounds, smells, or sensations. I told her the sounds, so she spoke to me, telling me how wonderful things were going, how beautiful my baby looked. How close I was to having him all to myself.
Erin stayed with us for about an hour in post-operative recovery. She helped us with breastfeeding. She did all the things a doula is “supposed” to do. But what I will be forever grateful for is the human connection she forged with me and my husband in a maternity health care model that has all but done away with compassionate one-on-one care and support.
Erin encouraged us to follow our instincts, to trust ourselves, to trust our baby, and to educate ourselves on our options. She told us to ask questions, get answers, seek advice. She fostered communication between me and my husband, and shared with us an enthusiasm and appreciation for family, pregnancy, and the transformative power of labor and birth that is often forgotten in our “What’s on your baby registry?”-focused culture.
And I loved all of that so much, that I wanted to pay forward that same care and support to other mamas, babies, and families. That is why I am a doula.