When I was first becoming a doula, I was overwhelmed and intimidated with the task of getting my training births in for my DONA certification. Should I just go up to pregnant women at the grocery store and give them a card? That seemed to border on creepiness!
First of all, I made my website, with the hopes that someone would find it and hire me. After purchasing my domain name, web hosting service, and designing my first website, I began to offer free support to women whose military spouses were deployed at the time of their babies’ births. Fairly quickly, I had contracted with my first client, a young mom expecting her first baby while her spouse was deployed. I was so excited, starry eyed, really… I was going to be a doula! I was going to witness miracles!
None of the laboring woman’s desires had been respected. She was treated badly by medical staff, partly because doulas weren’t really welcomed yet. Medical personnel in my area were not yet familiar with the value of doula support. Apparently, there had been a couple of rogue doulas attending births in our area who were practicing outside of the scope for doulas, telling doctors and nurses not to do certain interventions, speaking for their clients, etc. These doulas put a bad taste in the mouths of the local hospitals, and they assumed we were there to sabotage any of their medical efforts.
Labor progressed slower than was allowed at that particular hospital. She ended up having a cesarean, due to “failure to progress,” in spite of being dilated to nine centimeters, and a diagnosis of macrosomatic infant (large baby). There were no late decels (decrease in heart that doesn’t recover quickly after contractions) or other signs of distress for the baby. She did not have any health issues, either, so I was confused as to why she needed a cesarean. She was told her baby could die if she birthed vaginally, because her baby would get stuck (shoulder dystocia), so of course, she agreed to the cesarean. After they delivered her baby, it was discovered her baby weighed under eight pounds. My client commented to them that her cesarean had been unnecessary. They ensured her that even though her baby was not as large as they had presumed, the cesarean had given her a healthy baby in the safest way possible. What!?
They wouldn’t let me go back to the OR with her, since I was not family. Like I said, they really did not like doulas. After they rolled her back, I broke down and cried. I did not want this. I did not want to witness women being treated poorly and disrespected at a time of extreme vulnerability. I had only done one birth, and I had had enough. I couldn’t help but feel that I had failed my client. It turned out to be a rather traumatic birth that nearly broke my spirit and I almost quit doula work.
I found out later that that particular hospital had a policy of doing cesareans automatically at the thirteen hour mark after admittance. My client was nine centimeters at the thirteen hour mark, and had had a cesarean purely for reaching that thirteen hour mark without yet giving birth.
Fast forward a few years and I can look back on that experience and smile. My client was well supported. Her birth was better for it, in spite of how she was treated, in spite of the outcome. I also understand the fear the providers had with regards to shoulder dystocia. Over the years I have witnessed both partial and full shoulder dystocia. It is very traumatic and scary when it happens. I understand now that if her doctors feared a shoulder dystocia, they acted to prevent trauma to her and her baby, even if the cesarean turned out to be unnecessary. It was a great learning experience for me, as well.
We doulas are not in control of outcomes, nor do we make decisions for mothers. We do not choose their place of birth, nor do we control the decisions they make together with their providers. We are simply there to serve… there to offer a kind smile, words of encouragement, comforting touch, emotional support. “You are strong!” I remember saying to that woman. “You can do this! You are doing this! Look how far you’ve come already!” At the postpartum visit of that first client, I was surprised to learn that she was happy with her birth experience in spite of the outcome, and she told me several times how grateful she was that I had been with her in the absence of her husband. “I could not have done it without you!” she said. My response to her, and to every woman after her who has said those same words to me, has been, “You were amazing and so strong! You did that! You!”
Here I am many years later, with over 400 births under my belt. I’ve experienced so many things with my clients and have learned so many life lessons as a result. That same hospital where I attended my first birth has made so many improvements and now has one of the lowest cesarean rates in the area. The nurses welcome me with a smile, the doctors who know me are happy I’m there. I do not say those things to toot my own horn. Providers and nurses have seen and now recognize the value of labor support because of the many wonderful doulas serving our area who do practice according to a certifying organization’s scope of practice.
Over the years, there have been wonderful improvements in the hospitals in this area. All have gone from taking babies to the nursery shortly after birth to implementing a “golden hour,” which is a time where routine procedures are delayed until after an hour or so of skin to skin bonding time with mom and baby. Hospitals have hired more lactation consultants, and doctors have eased up somewhat on routine interventions during labor and birth. Episiotomies are no longer routine. Women are getting more respectful care and are making decisions with better, more up to date information. Natural birth and doulas have been somewhat normalized in all of the local hospitals, and maternity care has evolved into something much kinder and less traumatic. Some of the hospitals have installed labor tubs, wireless monitoring, and all keep birth balls and peanut balls in stock. A couple of hospitals have begun using nitrous oxide.
While there is always room for improvement, it makes my heart happy and proud to have served birthing women all these years, contributing in the smallest part to a larger picture. Even though I am now retired from birth work, I count the 17 years I served birthing women and their families as some of the best years of my life.
If you are curious about what doulas do, or are interested in becoming a doula and would love to support a retired doula, check out Madriella’s article, What is a Doula? I highly recommend Madriella’s certification program for it’s thorough education, yet reasonable cost. I have taken three different doula certification courses over the years, and this one was by far the best, especially for the cost.
Madriella is always updating their current courses and adding new ones, keeping the material current. Since I am always recommending the Madriella Professional Membership Course (includes several certifications) to people seeking to become doulas or other childbirth professionals, they recommended that I become an affiliate. If you join using my affiliate code, you will get a $50 discount on the fee for the professional membership. My affiliate code is AVILA116, and you will need to enter that code in the coupon field when enrolling at Madriella.org. It is only good for the professional membership.
Active Duty Military: If you are active duty military (or an active duty dependent), you can sign up for the birth and postpartum doula program (level 1), or the professional doula program (level 2) for a 50% discount! You do not need my affiliate code for this, simply visit the military family tuition waver page and fill out the online form. Madriella will contact you to verify your military membership, and then send you the code. This is one of the biggest reasons I love Madriella. They make becoming a doula affordable and accessible to everyone, and especially appreciate our military service.