Thursday, 22 March 2012

Guest post: All you have to do is be there

My next series of guest posts is from my friend and fellow doula, Chris. Chris and I became friends and doulas at the same time, on our AmeriCorps maternal and child health team. She has remained my friend and doula sister ever since - years later I still sometimes call her to process a tough birth. Chris is an awesome doula, a great friend, and a smart cookie! She's is expecting her first baby now (hooray!) and her posts for this blog are on her experiences with prenatal care, birth preparation, and (eventually) her birth story.

Before that series begins, I asked Chris if I could introduce her with a piece she wrote at the end of our AmeriCorps service. As part of the intro for the incoming MCH team, we each wrote up one birth story to help them get an idea for what our doula work was like.

Chris' story was really beautiful and I have found myself retelling it often recently as novice doulas have sought me out for advice about being a new doula. These newly trained doulas are expressing their worries about how they won't know how to help or what to do in the birthing room. I remember these concerns so clearly, along with the worry at births that I should always be doing and/or saying something because if I wasn't "doing something", I couldn't be doing anything, right? Yet like Chris, often the births where I felt most useless or helpless were ones where I was thanked effusively later by the mother and her support people.

The more births I attended, the more I realized the value of presence alone. I started to let my presence be enough: if something needed to be done, I did it; the rest of the time I could just be - be positive, be calm, be present. I tell new doulas this story to help them work through those concerns about knowing what to "do" and help them feel more confident that their presence is perhaps the single most important thing they bring to the birthing room. It is also a great story about the importance of doula support for all women and how we as doulas need to work hard to make sure we support programs that offer doula support to those who need it the most.

Some details have been changed to protect the client's privacy.


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I was on my way out of the hospital after being a doula at a truly amazing birth when I got the call that a doula was being requested at a different hospital. Coming off such a beautiful delivery, I was still feeling great - energetic, excited, and in love with my job. By the time I drove across town to the other hospital, I was feeling the weight of the day and starting to drag.

The birth I had just come from was wonderful - very natural, lots of labor support from family, a wonderful midwife. When I walked into the second delivery room, the atmosphere could not have been more different. Instead of a sunset coming in through the window, there was fluorescent light. Instead of soft music, there was beeping from the IV pump and thumping from the fetal monitor. The mother, Elena, was all alone, hooked up to Pitocin, receiving IV pain meds, and thrashing and moaning through contractions. Just as I walked into the room, the nurse gave her another dose of medicine.

The thing about meeting a woman for the first time when she is in active labor is that she doesn't talk much. In fact, women in active labor without an epidural usually don't want to talk at all - they've got something much more important to focus on. I took Elena's hand, and helped her breathe through the next contraction. I didn't feel like I was helping - I figured that the reason she was calmer was the pain meds. She slept in between contractions and moaned when she was in pain, and for hours I sat next to her, holding her hand and rhythmically stroking her belly through contractions. She hardly spoke to me; the extent of our interaction included waking her up to say (in Spanish) "Elena? The nurse wants to know if you want more medicine." The nurse told me that Elena's husband was in jail, and that this was her first baby. I had no further information about the situation.

Elena progressed steadily, and sometime after midnight she was ready to push. She pushed out a healthy baby girl she named Stefania Espiritu. As they took the baby away to be examined and cleaned, Elena burst into tears. They seemed to be more than just tears of joy over the birth of a baby, and I asked her what was going on. "It's my husband," she said, "I just wish he could have been here. He's in jail. He got caught driving without a license and they were going to deport him back to Ecuador today." Her husband was an undocumented immigrant who happened to get caught doing something many other people do. But now he was separated from his family and had no way of even knowing about his new baby girl.

As I spent more time talking to Elena, I realized what a big moment this was for her and how important it was that I had been there. She had previously thought that she couldn't have children, though she had tried and tried. When she finally conceived, she and her husband were overjoyed. She kept repeating, "I didn't think I could ever have a child, and here she is." Her mother worked the overnight shift and couldn't be with her at the hospital, and she had no other person to support her. She looked to me and said "Thank you so much for being here! You helped me so much - with the breathing, and with the pain - I couldn't do it before you got here."

For hours I had felt pretty useless - the whole time she was in labor I thought I wasn't helping at all. To hear her thank me and to find out that I was such important support for her was incredible. I was so glad I could be there so she could share that moment with someone, so she could show off her baby, so she could tell someone her story. The staff at the hospital, while competent and sympathetic, couldn't be there for her in the way I was as a doula. I may not have done much, but my presence made a difference.

I spent several hours with her postpartum, just letting her talk. She had so much to share! By the end of it we had established a strong connection and I realized what a valuable service I had provided. Being a doula isn't just about breathing through contractions or changing positions or massaging through back pain--it's about being there, believing in a woman, and listening to her. A midwife once told me that doulas always help, every time. The more births I go to, the more I believe what she says.

I will never forget Elena or her story, and I am sure Stefania Espiritu will grow up to be as strong and beautiful as her mother.