Doula? What’s a Doula?

Recently I left my mostly warm, swampy, coastal, North Carolina for the windy, mountainous cold of northern Nevada.  Brrr…February in Reno is NOT warm.  Not at all.  Normally I would never travel somewhere colder than where I am unless it was an emergency.  Or a momentous occasion.  And fortunately, this was a momentous occasion.

My brother and his wife were expecting their second daughter any day and I desperately wanted to be there for her arrival.  Now, it should be known that we are a family of “moderate hippies”.  Growing up in the Pacific Northwest, you are subject to crunchy granola-ism by proxy.  Like it or not, you will be more “green” than people from, say, Detroit, just by default. So I was confused, but not surprised when my sister-in-law announced that she would be using a doula for her second child’s delivery.  “A what?” I asked…”a doula.” was the reply. “What is that?  Is that like a midwife?”  “No, it’s like a birthing coach or a mother’s helper.” “Huh.”  I was picturing a stern matronly woman that smelled of patchouli and wore Birkenstocks.  Someone that espoused the virtues of going drug free while standing on your head and breathing like an Iditarod racer through contractions…no thank you.  With three children to my credit, I have always been happily pro drug, pro hospital, pro doctor.

But when my scheduled arrival and departure flights to-and-from Reno came-and-went with no baby in sight, I was disappointed.  I hadn’t given one more thought to this doula business, but I wanted to meet that baby for sure.  And I am convinced that the universe responds to desire.  You see, on the day I was to fly out, I was positive that my flight left at 4:00 PM.  I arrived at the Reno Tahoe Airport at 3:00 PM only to discover I had been booked on a flight that had already left at 12:30 PM.  This left me just two options:  buy a whole new ticket and leave at 5:00 PM that day, or stay another night and leave on the 12:30 flight tomorrow.  I chose the latter, convinced that this SNAFU was the universe trying to tell me to wait it out. Bingo!  Contractions started that very night!  (Upholding my belief that the universe knows what it is doing.  Mostly.)

By 6:00 AM on February 20th, it was clear there would be a baby sometime that day.  My brother called the doula.

Despite the fact that I have given birth more than once, I still became quite excitable as we timed the contractions.  My sister-in-law braved the pains from the comfort of her upstairs bedroom as we waited for her doula to arrive at the house.  I was timing them  at three minutes apart and was wondering why we weren’t just meeting this delivery person at the hospital.  I harbored secret fears that my niece would be accidentally born at home and I don’t know if I could’ve kept from passing out if she had tried that business…

The doorbell rang and I was quite surprised to meet the woman that (I still thought) was coming to deliver this baby.  She looked fresh from a yoga workout and she drove a Volvo. What happened to the flowing mu-mu and the hippie mobile, I wondered silently.  Brief introductions ensued and Ashley the doula was ushered upstairs.  Right away, I was impressed at how she commandeered the situation.  She went directly to Carla, asked a whole series of questions in a very calming way, and the whole mood in the room changed.  I fear that between my hushed anxiety, and grandmas verbal duress, you could have cut the tension running through that house with a knife.  In came the doula and palpable anxiousness lifted from the room like a fog.  In its place, there was a quiet calm punctuated by breathing and gentle coaxing.  I think I could actually see the colors of her aura, that’s how calming her demeanor was.

Calming Doula

 

It was also interesting to watch her “work the crowd”.  You could tell she had assessed the situation (slightly hysterical grandmother, worried sister-in-law, sick husband – did I mention at that very moment, my brother, the father-to-be, had been struck by a gastrointestinal bug?) Ashley diffused all that was ramping up.  Focusing on mom, but speaking to all present, she assured everyone that the baby would not be there in the next hour and that we would calmly work our way to the hospital.  I’m certain that my sigh of relief was audible when she made it clear that this baby would not be born in the upstairs bedroom of their family home.  Chalk it up to having watched too much TV, but I just knew that I could not be the “go-to” person if someone started yelling “BRING ME ALL YOUR TOWELS AND A TUB OF HOT WATER!”  I have absolutely no problem with home birth, I just know my own limitations when it comes to remaining conscious for events of that sort.  And as three minutes came and went with another contraction, we all headed for the stairs.  As luck would have it, another contraction hit as we made the descent…

Contractions on the Stairs

…and it was calmly managed under the doula’s guidance.  I stopped perspiring when it became more-and-more clear that this gal knew what she was talking about.  So far the baby had not fallen out en route, despite my misgivings about contractions that were three minutes apart and our not being hauled by screaming ambulance to the emergency department. Remain calm faithful reader.

Our doula (yes, at this point she has become “our doula”) was as steadfast in her calm and patient demeanor as I was borderline hysterical.  When things get tense, I get behind my camera.  It’s my only defense.  Like a wall between eminent chaos and my unwitting involvement.  What had I gotten myself into?  I snapped pictures.

Laboring on the way to the car.

And more pictures.

En route to the hospital

Until I was met with this, the universal look of annoyance given by family members to their aggravating, camera toting relatives.

Grumpy Mother-to-be

I backed off just a bit as I watched this magical, gift of a woman do her thing.  Yes, at the risk of sounding like a crazy, hippie-dippy, magical loving, fruit loop of a nut job, I will put it out there. I will say it.  This magical gift of a woman, this doula was wonderful.

Labor Support

In what was, for me, the comfort zone of beeping machines, copious hand sanitizer and droves of personnel equipped with advanced degrees and special badges, I watched the most basic of all things natural unfold.  A woman, comforted, coached and calmed a laboring mother while she brought her baby into the world.  It was a revelation for this mother.  How a delivery could go so smoothly…

Transitioning Labor Support

Because we are led to believe that laboring women need monitoring, constant checking, IV’s, medications, interventions and whole carts of instruments to bring a human being into the world.  When maybe the most effective, and dare I say, most important vehicle to assist in delivery is a calm companion.  Someone who knows, with unshakable conviction that women were designed to have babies.  That birth is not an instantaneous process.  A person comfortable with the fact that labor and delivery take as long as they take, a person adept at soothing a laboring mother through the pain and anxiety of childbirth.

Labor Support Team

Volumes have been written about how to have the best possible birth.  And I’m sure I’m not really qualified to tell anyone anything about a “great birth”, seeing as how mine were high risk and fraught with complications that required interventions of every possible sort.  But I can speak to what I have personally witnessed and what I have personally gone through.  I wish I could’ve had a doula.  Without raising the ire of every father out there, I’m going to stick my neck out and say it.  Dad’s are not much help in the delivery room.  There.  I said it.  They are too emotionally invested themselves.  They want to watch the delivery and ask boat loads of questions.  Then they get all nervous and queasy.  They get their feelings hurt, and, at least in my case, they are suddenly, in that painful moment, as contractions are raging, incapable of doing anything right.  Am I right, or am I right?  Sorry dads.  Honesty is the best policy.

Having seen it for myself, watching a team work with a laboring mother in that hospital room, it dawned on me what a genius arrangement this was.  Dad was watching the progress, eagerly engaged, free to ask questions and procure ice chips while mom was fully tended by a constant, unwavering support person.

Dad at delivery

During my own delivery, six years ago, the assigned labor nurse whom I had grown to love, had her shift end smack dab in the middle of my laboring!  And she left!  She went home because her work day was done.  The second shift came on as I was transitioning into hard labor and I hated that second delivery nurse.  She was loud and obnoxious, interjecting her belligerent opinions with every breath.  And I was too wrapped up in birthing a baby to tell her where I really wished she’d go.  What a different experience that could’ve been.  If I’d had a doula, as a personal support person at my side, “Nurse Ratchet”, as she’s become infamously known in my birthing story, could have gone away.  Or at least shut up.  But I had not known there was this option.  I only knew what the hospital staff told me…

Labor and Delivery DrawerLabor Monitoring

And let me tell you another story where a doula could have quite possibly changed the course of history.  A couple of years back, I was invited to photograph at a delivery.  Not a National Geographic type assignment, but a tasteful, photo-journalistic capture of the first moments of life.  Mother laboring, father cord cutting, baby weighing in, all of those moments.  This was a first-time mom that I had photographed in other situations.  The daddy and the grandma were to be the labor coaches and mom had a strong support team.  That is until she was three centimeters dilated, with her water broken.  At three centimeters, this laboring mom was beside herself with the pain and she became petrified at the prospect of having to birth a baby.  She screamed frantically until an anesthesiologist came in and gave her an epidural.  She was dilated to four centimeters.  As her contractions continued, the epidural was not enough and she became terrified about her imminent delivery.  Her mother could not talk her down, the daddy had to leave the room – everyone was asked to leave the room.  The epidural was turned up, medication was administered intravenously.  The shrieking subsided as we all waited in the hall.  She was dilated to seven centimeters.  Her labor progressed.  Before she was ready, she was at ten centimeters and there was no more medication to be given.  This birthing woman screamed and cried and swore and shrieked and there was nothing more to be done (pharmaceutically) as she endured that transition into active labor.  The doctor arrived amidst chaos and hysteria while a crowd stood, wide-eyed, in the hallway.  The doctor closed the door to the delivery room and the screaming intensified.  She could be heard wailing at her OBGYN “DON’T TOUCH ME” along with many, many expletives and verbal threats.  Suddenly and abruptly, all of the ruckus completely stopped.  Dead silence.  Minutes later, a nurse emerged with a silent, swaddled infant.  I will never know what actually happened in that delivery room in the wee, wee hours of the morning, but I do know there was no audible first squeal from that baby, there was no “war cry” as that laboring mom delivered her infant with her own body.  I can speculate that when her practitioner walked in, he evaluated the hysterical situation and whacked that mom up with something akin to the old twilight sedation that women in the 1950’s delivered with, and he pulled that baby out before things got any crazier.  That is what I honestly believe happened, but I will never really know for sure.

The Hand of a Doula

The two experiences I’ve been witness to, (outside of my own personal deliveries) were so vastly contrasting that I’m not even sure they were the same situation.  Granted, the outcome was akin – a baby was born – but one was a controlled, comforting example of what every expectant mother hopes for, and the other was an uncontrolled barbaric experiment in hysteria.  Seriously.  I would go that far.  And I can tell you without a shadow of a doubt that they both could have been calm, satisfying moments.  I will tell  you that I am now the spokesperson for doulas.  I will shout it from the rooftops.  If you could have a personal, private labor coach that helped you to implement your birth plan, kept the hospital personnel on track (or at bay, if that’s what you needed), kept your pain levels down, utilizing natural methods – visualization, massage, quiet coaching, positioning, breathing instruction, even aromatherapy – and acted as a liaison between you and the delivery personnel, why would you do it any other way?

“Our doula” as I like to think of her (she was, after all, a huge part of a tremendous family event) met with my sister-in-law for weeks prior to her delivery; she got to know mom and dad.  She knew their wishes, their preferences and mom’s plan B if things were to change.  Ashley the doula made sure a birth plan was on file and that the hospital stuck to mom’s wishes.  She was invaluable in getting Carla through the tough transitions, sans epidural since she knew Carla’s previous back fracture would be an impediment to epidural placement (as it had after three attempts during the delivery of her first child).  My sister-in-law knew what she wanted, and she knew from previous experience how hospital staff struggled to keep up with the wishes of patients from room-to-room.  She knew how tough it would be to go without that epidural and I believe Ashley got her through it with confidence and an empowering sense of control regarding her own body.  From the time she arrived on the scene, Ashley did not leave Carla’s side.  She massaged, coached, offered sips of drinks and held the emesis basin.  She kept the nursing staff informed when things changed regarding contractions and transitions.  She was a relief for every person involved.  I haven’t had a chance to talk to my SIL in-depth about her version of the doula experience since the arrival of their new bundle, but from what I witnessed, a doula is a real birth saver.  And if you need to know more about finding or using a doula, please check with Ashley or visit this site….or this one…and don’t forget about World Doula Week, March 22nd – 28th.

New Baby

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