Saturday, February 20, 2010

Birth with a doula

Two weeks ago I attended a birth as a doula for one of my students. It is probably the biggest rush in life to be present at the birth of an amazing and wonderfully created new little person. It is the second birth I have attended and as hard as it is to go through labor with the Mom, seeing the tears in the new Mommy and Daddy's eyes as they gaze at their precious new babe is simply beautiful. Nothing like it in the whole word!
I served as their doula for free as I am still a student in the doula world. I am not sure if I will ever get to the process of becoming fully certified by the leading doula organization (DONA). Perhaps one day down the road. Being trained as a Bradley instructor, the Academy of Husband Coached Childbirth tells us we are qualified to work as doulas so I have offered the free service to my students in order to gain more experience.
Studies have shown that the continual presence of another woman while you are in labor can significantly improve the outcomes for both Mom and baby. After witnessing two births I can honestly say that while some may be skeptical of this claim I believe it is very true. As much as we might try to prepare a father for what his wife will experience in labor, he can not ever be truly ready to see his wife in that state and simultaneously handle his own feeling of helplessness and respond appropriately to her needs. A second-time Dad will be better equipped for this, but then a second-time Mom is also more prepared for the experience. Some women may be so in tune with their bodies that managing labor and birth on their own is quite easy for them, especially if they are already very committed to a natural birth. But my hunch is that the majority of women need the support and guidance of someone who has been there and done that.
Here is the scene - I walk into the room and Mom is sitting in the hospital bed, Dad sits beside her in the armchair trying to catch some Zs after being up all night. Mom is a little discouraged after laboring all night to only reach 3 centimeters dilation. She is already tired and is in need of reassurance that she can do this. I encourage her to get up and move around which almost instantly brings on stronger contractions. As she leans on the back of the chair, she starts to take the shallow chest-breaths of one in a state of panic. I remind her to take deep breaths and make low noises. She calms down and finishes the contraction. Her husband knows how she likes her back rubbed and holds her arm as they walk around the room. A little while later I let Dad lay down in the chair to take a quick nap while I help Mom through a few more contractions. He may have only had five minutes rest before her contractions really picked up and required the two of us helping her through them. At some point Mom looks at me and needs to know if what she is experiencing is normal. I reassure her that it is very normal and she is doing fine.
This experience is very similar to the first birth I witnessed. Both Moms wanted me to tell them at some point that this was normal. In our culture today we do not grow up with any sense of what normal birth is like. All we know is from the movies where women are always screaming and out of control and the baby seems to fly out a few minutes after labor starts. No wonder most women get to the hospital too soon!
Both Moms also needed reminders with each contraction in hard labor to take deep abdominal breaths and make low noises instead of high pitched screams. The low noises move the diaphragm against the uterus creating a soothing sensation against the powerful contractions. It is amazing that that one thing can get a woman through every contraction until the minute the baby is born!
There came a point when the doctor felt Mom was not progressing quickly enough (and to think this Mom did a ton of research and picked this hospital in a rural area because she was under the impression that interventions would be less). They were telling her she needed antibiotics and pitocin and they needed her decision soon. At that point, 18 hours into labor, Mom was not in a frame of mind to make the decision on her own and Dad was feeling helpless. I talked them through the pros and cons and let them come to a decision. The blessing of being in that rural hospital was that they actually did give us time alone to talk it over. As we talked, I also talked with Mom about what might be holding her back. It is very common for Moms to 'bottle up' due to fears about the physical act of giving birth or emotional fears about becoming a Mom. The mind is so connected to the body that this can slow down a birth (or stop it altogether). As I talked her through letting go of whatever fear she may be harboring, something amazing happened and she hit transition.
Transition, as we tell our students, is the hardest part if you are in the one third of women who experience it but it is also the fastest part. So she had contractions that seemed to never end, one on top of another and as they were hooking up the IV for the antibiotics and pitocin, she reached full dilation.
By the time she could push she was so tired that she could not hold her own legs back, so her husband held one and I held the other and we cheered her on.
After about a half hour of pushing, the head was starting to emerge and the doctor said that she could have the baby in just one or two more contractions. On the next one, she gave it her all and the head slowly emerged quickly followed by the body. The doctor lifted baby up to her Mommy's tummy. She opened her mouth and for a split second the whole room was silent, waiting for the first cry. And it came, a tiny little wail of life. Pure and beautiful and simply amazing.
I helped Mom lift baby to her breast and start nuzzling. As I turned, I caught the tear escaping Dad's eye as he rubbed his wife's head in awe.
They thanked me as I left, but for me it was an incredible honor to be invited in to the most intimate event of becoming a family.

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