I Think This is Why I Love Birth So Much

It's totally unpredictable. And you can't control it, no matter how hard you try.

I got a call last Sunday morning from a client's husband saying that his wife's water had broken. And she wasn't due until the end of September. Surprise! Luckily, I wasn't in Chicago visiting my sister, or in another state visiting friends. We were in town, so I dropped everything, grabbed my doula bag and put my DONA pin on my shirt, got my family situated with basic instructions and frozen pizza, and headed out the door. And despite the many interventions used to get this baby out, I loved it. It definitely wasn't an ideal birth, but I loved that I got called when I least expected it, and stayed up all night when I wasn't planning on it, and witnessed the absolute miracle of a child being born on a Monday morning when I otherwise would have been sleeping.

When people ask me why I am a doula, or why I love birth so much, I usually say something like, "I just love to push my body--it's such an empowering accomplishment!" or "I love trusting that my body can do what it was created to do!" But last night I was lying in bed thinking about it, and I realized that the real reason I love birth so much is because you can't control it. Unlike almost everything else in this on-demand culture, labor and birth cannot be manipulated to happen when and how we want it to. Not that people don't try, but when they do, a less-than-ideal outcome usually results.

Labor connects us with our bodies in a very unusual way. It just happens, and it doesn't stop until the baby is born! It takes a great deal of determination, focus, and self-discipline to come to grips with this fact, to turn inward, and let your body do what it was made to do. No matter how little sleep you're running on. No matter what time of day or night. No matter if you had plans to go shopping that day. Birth demands that you drop absolutely everything and come face to face with who you are in your deepest, most intimate parts.

At the birth last week, the mom said, "I wish I could just take a break from labor for a little bit, go out and grab some dinner, and then come back." I totally empathized with her, but the reality is that she couldn't! And that's the beauty of it.

There is a power in being powerless. In trusting that someone much greater than you has you in his hands. There is a beauty in giving up the control that we so desperately struggle to have every single day--in joyfully submitting to the power of labor and the divinely inspired design for birth. It is so empowering to be free of fear, in spite of the pain and your lack of control, and to embrace every single moment with thankfulness and trust.

And this is why I love birth so much.

A Birth Story

One of the many things that comes along with having me as a doula is a written birth story. Here is an example of one, from my last birth...

Madeleine’s Birth
28 June 2010

I got a call at around 5:45 on the morning of June 27th, saying that you had been having some consistent, albeit not too painful contractions since 2:30! You and Rob were both taken off guard because you were expecting the contractions to be coming more like 20 to 30 minutes apart, as opposed to the 5-6 minutes apart that you were experiencing. Since it was obviously early labor (and would be for a long time!), you labored at home with Rob all day.

I got another call that evening a little after 5. You said the contractions were becoming more uncomfortable, and we decided that I should come to your house in a half-hour or so. Christina (the doula-in-training) and I arrived there at around 5:45, and your contractions became more spaced out—up to nine minutes apart! We had a hunch that the new people in the room caused your body to slow down a bit, so you and Rob went for a walk at around 6:30 to try and get things moving again. It seemed to work, because when you got back at around 7:30 you were saying that your contractions were “not fun.” You were coping very well, though, standing up and pacing through each one, sometimes leaning on Rob or against a wall. You also started experiencing nausea around this time. Rob offered to get a saucepan in case you had to throw up. :)

At around 9:00 the contractions were getting more painful and closer together, so we decided to head to the hospital. We walked into the emergency room entrance, and the guy at the front desk tried to make you sit down in a wheelchair to go up to the maternity ward, but your contractions were much more painful when you were sitting, so you fought it. He eventually gave in and let you walk. When we got upstairs, they checked you in to triage, and our nurse, Gina, checked your cervix. Unfortunately and surprisingly you were only 1 to 2 centimeters dilated. This was super discouraging news, but you took it really well. After talking it over with Rob, you decided that you wanted to go back home to continue laboring there.

Shortly after we returned home, your body decided it was time to get down to business. Your contractions almost immediately picked up in both intensity and frequency (though they were never a consistent amount of minutes apart). At around 11 pm you noticed some bleeding when you went to the bathroom. Rob called Dr. Kruskol, who reassured you that it was most likely from the vaginal check at the hospital. You continued laboring upstairs with a fan blowing on you, while munching on frozen blackberries—it was HOT! We placed the exercise ball, which Rob had thankfully blown up earlier in the day, on the end of the futon. You got into a rhythm of lying down on the futon between contractions, and standing up and leaning over the ball during them. You and Rob were both so very tired, since you had been awake and in labor for almost 24 hours. You wanted so badly to be able to lie down during the contractions, but the pain was just too much! You had to stand up in spite of your exhaustion. You were also struggling with nausea, but were never able to throw up and relieve the sickness you were feeling. This was definitely active labor, and you were handling it so well in spite of the heat, your tiredness, feeling sick, and the intense pain.

At around 1 am, I suggested a shower to try and help with the pain, and you reluctantly agreed, but because of the heat it wasn’t much of a help. You and Rob got out after a short 10 minutes or so, and your contractions were becoming closer together, averaging at 4 to 6 minutes apart. We headed back upstairs, but after a several minutes of very frequent and intense contractions, we decided it was time to head back to the hospital.

We entered the emergency room entrance for a second time, and this time you could not talk them out of making you use a wheelchair. So you sat down, but every time a contraction hit, you made the guy pushing you stop the chair so you could stand up and lean on one of us for support. At around 2am, we arrived in triage and Gina checked you again—you had progressed to 7 to 8 centimeters dilated!!! There was a lot of blood, and your very intense contractions were right on top of each other. Your body was quickly approaching full dilation!

We were sent to room 2606, and you were hooked up to a fetal heart rate monitor and a capped IV was put in your arm. You were feeling a lot of pressure and shortly thereafter you began to feel an urge to push. Gina checked you and you were at 9cm. She told you not to push, but you couldn’t help it! I helped coach you through those contractions with light breaths, and finally, at around 3am, you were given the go-ahead to start pushing! That strong urge to push had gone away, though, and you were unsure about how to do it. But after a few good tries you were really making progress. Gina was checking you during one of those initial pushes, and she said she felt the baby’s head move down over an inch! Despite your tiredness and the extreme pain, you had so much power and strength!! The pain of pushing actually seemed to frighten you, but the nurse and I assured you that it was normal, and you buckled down to get your baby out.

At 3:12am Dr. Kruskol checked you and confirmed that you were fully dilated, and the baby’s head was moving down through your pubic bone. We could see her hair and her wrinkly little scalp! You were so focused and determined. Finally, at 3:36am Madeleine was born into the world, and was placed on your chest right away. All the pain and pressure of labor was immediately gone, and you were completely enraptured in your new little one. “Oh my god, she’s so little!” were your first words after seeing her. Rob cut her cord, and you and Madeleine were both anxious to breastfeed as the doctor was stitching you up. When he was finally through, you and Madeleine settled in for a nice, long nursing session. She latched on immediately and nursed contentedly for at least an hour—the first hour of your family’s new life together.

One more reason not to get induced...

Today I received the latest edition of DONA's International Doula publication, which I love. So I gave myself a much-needed break from mommy-hood (while Lucy was napping, of course) and sat out on the back deck with a glass of water and my new magazine, for what I thought would be a nice, relaxing little respite.

But after skimming through the opening pages, I came to the cover story, "Is Pitocin Associated with Childhood Autism?" and my mental state of relaxation quickly shifted to shock and alarm, and increased with each paragraph as I read.

I learned that in 1980, only one in 5,000 children was diagnosed with autism. Each year, this number has been climbing rapidly until today, when one in 110 children are diagnosed with the disorder. Shocking, I know. Extensive studies have been done on the possibility of a connection between vaccines, genetics, and environmental toxins and autism, but only recently have they begun to address the possibility that autism could be caused or triggered by the ever-increasing medical management of birth.

A letter written by an association of midwives was published in Autism Today, which stated that "...virtually 100% of medically managed births are subjected to a high level of pharmaceutical interventions that have never been approved for use in fetuses. It seems prudent to research the possible association with pharmaceutically augmented labors [with Pitocin] in an attempt to discover the cause of the rising tide of autistic disorders. It may be necessary to amend our current obstetrical practices..." Ya think!?

Also in the letter was cited the complete nonexistence of autism in children who were born under the midwives' care, with no medication during their mothers' labors (the practice is 20-years old).

The article went on to discuss further the probable connection between Pitocin and autism by addressing the fact that natural oxytocin is also called the "love hormone," and autism seems to be the absence of the ability to express or experience feeling, empathy, etc. In an article published in Newsweek in 1996, Dr. Eric Hollander (Director of an Autism Disorder program in NY) says that "Most of the mothers of patients we see have had Pitocin-induced labor," and that "Pitocin somehow messes up the newborn's oxytocin system, producing the social phobias of autism."

Actually, oxytocin is currently being used in autistic adult patients in a nasal spray. Benefits of the medication are an increase in "sensitivity, generosity, and trust," as well as inscreased "eye contact, facial recognition, social cues, and identification of emotions," which further demonstrates the hormone's connection with emotion and love. Research has already proven that autistic people have lower levels of oxytocin than normal.

Here's one more quote and then I'll wrap this up... Dr. Michel Odent, author and childbirth expert, states "we are learning that, among humans, the period surrounding birth is a period of dramatic reorganization of central oxytocin binding. Artificial induction of labour creates situations that undoubtedly interfere with the development and the reorganization of the oxytocin system in such a critical period." The information we glean from this quote, and the countless other studies and statistics on interventions during labor and birth, should be a serious reminder to us all that the natural birth process should not be tampered with unless absolutely necessary.

Now I know that this is pretty scary information, and probably almost every mother reading this has had Pitocin given intravenously at some point in her labor, either during or after birth. I also know that sometimes the use of Pitocin is necessary for a healthy outcome, and by all means the benefits of its use sometimes outweigh the risks. The last thing I want is for you mothers to feel bad, or guilty, or fearful for your child's future. But I DO hope that this encourages you to continue becoming informed and empowered for future births, and that you'll be able to spread the word to other mamas-to-be so that they can make the best choices for themselves and their babies. And by all means, get a doula, as their presence during labor has been proven to make labor progress more rapidly, minimizing the risk of your need for augmentation by Pitocin.

Crunchy Moms

Last night, I met with friend and former client, Natasha Gidaszewski, to discuss a new group we're launching--Crunchy Moms of DeKalb! How exciting!!

Natasha came up with the idea for the group, because as a "crunchy" mommy herself, she wanted a supportive group of moms to learn from and have fun with. She said that everything she had learned about natural parenting (ie cloth diapering, baby-wearing, breastfeeding, etc.)she had gleaned from forums and websites online, and she decided that we need a local resource for all this stuff! And I agreed.

So here we go! We have so many ideas and visions for the group it's almost too much! A big part of Crunchy Moms is the play group, so once or twice a week, at different locations, we'll have that. Sometimes there will be a theme or lesson for the moms to go along with the group, like making your own cleaning supplies, taking creative photographs of your families, budget home-decorating, cloth diapering, being a green mother, and more! Natasha says, "there will definitely be a healthy mix of child-focused things and mother-focused things."

Occassionally we'll line up a guest speaker for a more in-depth evening session/discussion sans children (topics could include breastfeeding, babywearing, natural childbirth, etc). And we're tossing around the idea of a book club, too!

Philanthropy, or "giving back," will also be a part of the group. We've discussed volunteering at We Care Pregnancy Clinic and providing meals for new mamas in need. Other ideas?

And yet another inspiration we have is to do a "Mama's Night In," where we'll congregate at someone's house, make granola, bake bread, have a potluck, have a crunchy movie night, or learn to crochet. Sound good?

Now by no means do you have to be a one-hundred percent certified organic crunchy granola mom to join the group. Heck, I'm not, and I don't really know anyone who is. But if you're at all interested in living life and mothering more naturally, then this group is for you. To stay informed and updated on all events and happenings, join us on Facebook. And don't forget to add your input on the discussion "First meeting/playdate!" See you there!

You Can Do It.

Let's face it: birth is scary. It's unknown. If you've never given birth before, and you live in America, you will, without a doubt, have apprehensions about your ability to birth your baby. I did, for sure. And I don't know any other mom who didn't question herself as she approached her due date.

Why is this? Why do we question our bodies' abilities to give birth, when millions of other women have gone before us and have done just fine?

There are lots of reasons, I think. There are the notorious and unhelpful horror stories told to us as pregnant women, about how unbearably painful labor is. There is the media. The countless pictures of "perfect" bodies we encounter every day certainly do not serve to help our self-images or to boost our confidence in our bodies. There are our doctors, who treat us as if we were a problem to be managed medically, and not as the powerful and truly capable women we are. And the list goes on...

But here's the good news--what no one tells you and what they don't want you to know:

YOU CAN TOTALLY DO IT!!!

If you're educated about the process, well prepared, and have a good support system (doula!), it's not nearly as scary as they say it is. Labor is totally manageable.

I was talking to our local Bradley Method instructor, Susan Booker, about it after observing one of her classes. During the class, she walked us through an average labor--how long your contractions are compared to the amount of resting in-between. I learned that in the typical labor, your uterus is contracting only 11% of the time. ELEVEN PERCENT! So when you hear one of those horror stories about the 20-hour-long labor, she was actually only having contractions for a little over two hours. The early ones don't even hurt! And by the time your labor is really getting going, you have hopefully gotten yourself into a good rhythm and wonderful endorphins are pumping through your veins. You've had a chance in early labor to experiment with what feels good and what makes it worse. And your loving and supportive partners are surrounding you, helping you get through every second.

And contractions aren't normal pain. As many natural childbirth advocates say--it's "pain with a purpose." Labor pain is not sudden or severe, like getting your hand smashed with a hammer or stubbing your toe. It is intense, and in the heat of labor it's honestly quite crazy. But your contractions ebb and flow like a wave. They start soft, build up and then peak, and once you've made it over the top, you sort of float back down to several more minutes of rest and relaxation as you prepare for the next one. As your labor progesses, the contractions get "longer, stronger, and closer together" (as my childbirth ed teacher, Beth, always said), and you get less time to rest. It gets so, sooo hard. But that means it's almost over :) As soon as a laboring mom feels like she doesn't know how much longer she can go on, she's usually minutes away from pushing her baby into the world.

I remember when I was pregnant, worrying about whether or not I would be able to give birth without an epidural or other interventions, talking with my good friend, Lauren (seasoned momma of 4). I told her that Greg and I were going through the Bradley book together, and had been practicing relaxation every night before bed. She said casually, "Oh, you're gonna be fine." I was so surprised at her surety! Her almost nonchalant confidence completely went against all the doubt that had been instilled in me, and gave me that much more belief in my body's truly awesome design.

And I did it. I totally did it! And it was AMAZING!! I have never experienced a higher high than what I felt after going through labor and giving birth to our beautiful daughter.

So don't listen to the doubters and the nay-sayers. Our bodies are powerful and beautiful and totally capable.

You can do it!

Eat Your Placenta

From experience, I know that the first few days post-partum can be crazy in every way. You've just gone through the most physically strenuous event OF YOUR LIFE. ALL your muscles are sore from labor and pushing. Your bottom is sore from all the stretching, tearing, or cutting that happened to make way for your baby. Your stomach went from cute, firm, pregnant belly to a squishy, blubber-like pouch. You are bleeding. You don't even want to think about trying to poop. Your boobs get HUGE, solid as a rock, and oh-so-sore (not to mention they're squirting milk everywhere). You don't get any sleep, because you're up all night trying to figure out the needs of your precious, albeit alien baby whose sudden arrival has thrown everything into utter chaos. And on top of all this, you're trying to figure out how to breastfeed, which is usually much more difficult and painful than expected.

And then there are your hormones. Your raging, out-of-control, PMS-times-ten hormones.

Three days after Lucy's birth, I remember coming home from her 3-day check-up, trying to pull up the driveway, and SCREAMING at my poor husband for not shovelling properly. Now I am usually a very reasonable and laid-back person. But something was happening inside of me that I couldn't control. My emotions were all over the charts, and I was not myself. And it's not just me--practically every mom I know has experienced some version of this emotional upheaval, without realizing that it's normal, and that it can actually be avoided...

I learned a few weeks ago (at the 1st Annual Chicago Doulas Conference!), that all mammals (except for humans) eat their placenta immediately after birth. I know. Gross, huh? But here's the scoop: while you're pregnant, your body, through your placenta, produces this incredible coctail of feel-good hormones that increases as your pregnancy progresses. After you give birth and your placenta is suddenly detached and thrown away, your body sort of comes crashing down. It's literally like going through withdrawal. So on top of everything else (see above), you have to deal with this.

Enter placenta encapsulation specialist! I know that this may seem incredibly gross, but once you get past that "eww" factor, it's really pretty cool.

The specialist will take your placenta, dry it out, and make it into a powder form. Then, she'll put it into little pills. That's it! Just take a couple each day postpartum, and you won't experience such extreme emotions--your body will have a much gentler transition to motherhood. There are other benefits, too. Moms who take their "placenta pills" have more energy postpartum, greater milk supply, and a faster recovery. And if you don't need them all, you can freeze them and use them for menopause!

There are many specialists in the Chicago area, and they usually charge around two hundred dollars. For more information, click here. Let me know if you'd like a referral!

I think those other mammals are on to something... When I'm pregnant with number two, sign me up!

A Natural Approach to Fertility!

My husband and I host an open mic at the Arcedium Coffeehouse in St. Charles once a month, and last month I was perusing the big bulletin board with posters and business cards. I came across one that caught my eye. It read, "Jennifer Mercier-Bone, Doctor of Integrative Holistic Medicine."

I was intrigued.

So I took one, brought it home, and ventured to her website (check it out). WOW! As I poked around, I couldn't help but become thrilled about her ideas and her practice! I was so excited, in fact, that I sent an e-mail AND a voicemail to her office right then and there. She got back to me the next day and offered to meet me at Arcedium for coffee!

So we met last Wednesday, and had a lovely time chatting about home decor, homebirth, fertility, medicine, babies, birth politics in our state, and all things chilbirth. Throughout our conversation, I just couldn't get over the fact that there was a fertility specialist like her so close to home! (She lives in S. Elgin).

She told me a little bit of her story, and how she used to work with Reproductive Endocrinologists and Gynecologists, observing all sorts of medical procedures, especially infertility treatments. She said that she noticed two things about each and every women who came for fertility treatment. One was stress & anxiety. The other was a misaligned uterus. The stress was obvious--women trying to get pregnant without success (which is much more emotionally difficult than most realize), and the cold, sterile environment in which they were being treated. And then there was the uterus. Since she has also had training in massage therapy, she began to come up with her own ideas about massage and how it could help women with their infertility, and she created Mercier Massage Therapy, which involves several sessions of massage around the uterus and in the pelvis region. Somehow, this helps to get everything in order down there, and makes conception much more likely. She had actually just finished a book on her techniques the night before! Her website says, "It is gentle and noninvasive and has a success rate of 71% (IVF's success rate is as low as 20%)." Again I say, WOW! Thank you, God, for a practice like this, so close to home!

I was just so thrilled about the fact that there is a doctor like her in our community. Not only is she gentle, caring, and compassionate toward women and their families, but she also knows her stuff. I was so impressed by her knowledge and insight, AND by her trust our bodies' design. How refreshing to find another like-minded soul! And what a blessing it is to have Dr. Jennifer's practice to refer future mommies to.

A Whole Life Event

"Birth Matters: A Whole Life Event" is coming up! On March 27th from 11-3, at The House Cafe in DeKalb, I am taking part in a birthing/holistic living open house! Greg (my husband) and I, along with another singer/songwriter, will be providing music throughout the day, and I'll be sharing a table with two other doulas. It should be a great day of communing with like-minded friends and professionals!

Stop by to meet me and other doulas, childbirth educators (including the Bradley Method!), yoga and pilates instructors, massage therapists, accupuncturists, photographers, breastfeeding specialists, members of our local ICAN (International Cesarean Awareness Network) chapter, and more! I'll be giving away a gift certificate toward my doula services, and there will be other great prizes, too!

So come on out to The House (corner of Rte. 38 & 3rd St.) and enjoy good company, good food, and good music. :)

Lucas, Your Mama is Amazing

Posted with permission.

This is me holding Lucas Isaac the day after his incredible birth. Chrissy labored like a pro for eleven-and-a-half sometimes peaceful, sometimes very crazy hours on February 24th, two weeks before her due date! Her labor contractions began at 5:30 a.m. and she called me around nine to let me know she was in labor. She sounded amazing--I could totally tell by her tone of voice that she was handling everything very well. She had a little bleeding so she decided to call the doctor's office and they told her to come in. So she did... and she was already several centimeters dilated!!! Dr. Atkins was really shocked by how well she was handling her labor at this stage!

After Chrissy called me to tell me the good news, I met them at the hospital at around 11:30. We got settled into the room and met our awesome nurse, Tara, who would stay with us for the remainder of the day. The next few hours were relatively uneventful, as Chrissy was doing a beautiful job relaxing through each contraction. At one point, Tara said to Chrissy, "we should bring a video camera in here and record you--this is how it should be done!"

At around 2:00, Chrissy was checked and she had reached 6-7 cm in dilation. I suggested a shower, because the contractions were getting more intense and water works wonders for bringing comfort to laboring moms. So she spent about a half-hour under the warm water as she entered the transition phase of labor, which is by far the hardest part. After the shower, she settled back into the bed for some serious hard work. We discovered that moaning with each out-breath helped her to deal with the pain, so Seth and I moaned with her as we stroked her body in rhythm. Chrissy became very serious and focused as the difficulty level was increasing rapidly with each contraction. She decided to go to the bathroom, and afterwards labored standing up with Seth, leaning on him for support. I cannot describe how difficult this part of her labor was. There were tears and moans and cries out to God for help. And he was surely there with us, helping Chrissy through the most physically and emotionally strenuous moments of her life.

She had reached 10 cm by 4:00 and she was ready to be done. "I'm so tired of this!" she said. "I just want it to be over!" By 4:30 she was able to start pushing, and she did an incredible job. During her first few pushing contractions, Dr. Atkins could literally see progress with each push! After she got used to the new and crazy sensations that come with this phase of labor, Chrissy got herself into a beautiful rhythm--pushing, pushing, pushing, and resting in-between. We could see his hair! He was so close! But the doctor couldn't get a good reading on the baby's heart-rate, and there were a few moments of concern... she ended up cutting a small episiotomy because this baby needed to come out. And sure enough, his cord was wrapped around his little neck, which is what was causing the drop in his heart-rate. Dr. Atkins quickly cut the cord, and Chrissy pushed her baby OUT!!! All was well and Chrissy was SO relieved that her labor was over and her baby was in her arms!

What an absolutely amazing day. I feel so blessed to have had the privilege of helping Seth and Chrissy welcome their firstborn into the world. They did an incredible job, working together through the difficult but joyful experience of labor. Seth was such a strong support to his wife, and Chrissy was so strong through it all. We have been blessed.

The Big Essay

Down to the wire, I'm getting all my papers and documents in order to send in to DONA after my final birth, which is coming SOON!!! I co-hosted a shower for Chrissy this past Saturday, which was so fun and made me realize how soon her baby is coming!! We'll have our final prenatal meeting within the next week or so, and then we wait... I CAN'T WAIT!!! I'm so excited that my final certification birth will be for one of my best friends--I know she's going to do great!

So I started and finished my big essay today, which will be handed in with a plethora of other documents. Here is it:

The Purpose and Value of Labor Support

A. The benefits of labor support to the mother and her family

For the laboring mother, the advantages of having a doula are great. The mother feels more comfortable with her labor knowing that a kind and knowledgeable woman is constantly by her side. She is able to relax more freely and let go of fear, which decreases pain and speeds up labor. Statistics also show that having a doula present can decrease complications, such as the need for oxytocin and cesarean section.1 In one study, having a doula present showed an 11% decrease in the use of oxytocin and a 10% decrease in cesarean sections.2 Doulas can also greatly benefit the mother’s partner. Though he may love his partner dearly and want to support her as best he can, he has never been through anything like this and may not know what to say or do to help her best. When the couple chooses to have a doula, “the pressure on the father is decreased and he can participate at his own comfort level.”3 And astonishingly, having a doula even has benefits for the baby. In one study, 51% of babies whose mothers had a doula were breastfeeding at 4-6 weeks, as opposed to only 29% of babies whose mothers did not have a doula.4 Furthermore, significantly fewer mothers suffered from post-partum depression, and more reported a positive birth experience in the weeks following their baby’s birth.4 It is very clear that doulas are extremely helpful for not only mothers, but also for their partners and their babies.

B. The purpose behind providing labor support

The birth of her baby is arguably one of the most memorable and life-altering days of each woman’s life. Throughout history, women in labor have without question been supported by other women throughout the journey of childbirth.5 Sadly, the normalcy of this natural and beautiful support system has disappeared from the highly sterile and cold environments of American hospitals. The doula recognizes the need for women to be supported emotionally and physically during labor, and her goal is to provide this support to any woman who desires it. She also understands the need for families to experience intimate connection on the day of their baby’s birth, and her services empower them to have that connection.6

C. The doula’s responsibilities

The doula’s primary responsibility is for her client. She must do everything in her power to ensure that her client has all the support possible, and everything she needs for the most satisfying birth, according to that mom’s expressed desires. As a professional, she also has certain responsibilities she must abide by. She must possess a strong work ethic and sense of commitment to each client. For instance, she should return calls promptly, be committed to sticking to pre-arranged meeting times, and make every effort to assist the mother during the prenatal weeks, labor, and the first few weeks following the baby’s birth. She should have a respectful and courteous attitude toward her colleagues and her clients, and should respect each client’s privacy. She must also remain up-to-date with new developments in her field by continuing education, actively networking with others, and being involved in related organizations. Her fees must be fair, and she should strive to offer discounted or volunteer services when possible.7

D. The doula’s role

The role of a doula is very special and unique because of the intimate nature of the birth process. She offers a minimum of one prenatal meeting, though usually more, to get to know her clients, establish rapport, educate them on the birthing process, and to learn what she would like her birth to be like. During labor, she is with the mother at all times (except for short bathroom or food breaks), providing any support the parents need. This could be giving a massage, counter-pressure, hot/cold compresses, or instructing the partner on how to do these things. She provides reassurance that her body knows what to do, and encourages the mother to trust in the process. She could help with visualization or relaxation techniques that have been discussed at a prenatal meeting, or facilitate the spontaneous coping methods the mother may begin. The doula does not perform any medical tasks, but may guide the mother to ask questions or speak up to her care providers. She provides “support, information, and mediation or negotiation.”8

1. Table 1 in DONA’s Position Paper
2. Klaus ’86, Table 1, in DONA’s Position Paper
3. DONA’s Position Paper, page 2
4. Hofmeyr ’91 & Wolman ’93, Table 1, in DONA’s Position Paper
5. DONA’s Position Paper, page 1
6. DONA’s Position Paper, page 1
7. DONA’s Code of Ethics
8. DONA’s Standards of Practice

I Love Birth.

My doula certification is coming along--I have one more birth to attend, a couple of papers to write, and a few hundred pages left to read. I have learned so much, and am realizing I have so much left to learn.

But mainly, I'm realizing more and more, that I love birth.

I love that everything about it is unpredictable--so different from everything else we can control in our day-to-day lives. If a mom is well prepared for labor, she will know that ultimately, she must surrender to the power of her surges. She must have complete trust in her body and its ability to birth her baby, and let go of any fear. It's scary at first, to relinquish control, but in the end, it is so empowering.

I love how the intensity of it brings out the reality of who we are. There is no hiding. No pretending. As labor progresses and becomes more intense, the modesty of the laboring woman becomes less and less of an issue, along with any walls she has built up around her personality. The underlying message through the groans, the breathing, and the depending on those around her is, "This is who I am!" This is the most vulnerable she will ever be.

I love that, in the best births, it's about community and togetherness--people gathering around the laboring mom as she works through the most intensely beautiful experience of her life. People imparting to her strength and courage, and helping her to draw those qualities up out of the core of who she is.

This is beauty. This is community. This is what we were made for.

And I love it.