On my first experience as a doula.

Posted On May 27, 2009

I came out of the hospital just as the sun was setting. I spent just over 12 hours with my first doula client. A healthy baby girl was born at 3:30 that afternoon. Walking towards my car was a little surreal, all things familiar coming back into focus, the alien world that is the hospital swiftly fading into the background. My first thought after the key went into the ignition was how much I wanted to see my partner and my baby, and how grateful I am for my life and my home. I got home and dropped my carefully prepared birth bag like a weight to the floor as my daughter came squealing towards me for a hug. Life is good.

This was not the picture-perfect birth that I had admittedly hoped it would be. I arrived and they had already manually dialated my client to 3 centimeters with some balloon contraption, given her morphine, broken her water, and the anesthesiologist was already on her way to administer the epidural. Soon there was talk of pitocin to augment the contractions (which had already naturally dialated her cervix from 3 centimeters to 5 in two hours), spouting something about how the contractions were just not consistent enough, and how she would "only need a little". After a few clarifying questions and firey looks from a doctor, my client managed to bargain her way out of pitocin for a mere 45 minutes, on the condition that she’d try some different positions to get her contractions closer together and more intense. They soon checked her and solemnly reported that she was "still only at 5" and that they really needed to do this. She consented, and contractions quickly became stronger. They soon checked her again and administered an internal monitor to measure the strength of her contractions. Within an hour the nurse was in talking about how due the baby’s posterior position and my clients "dysfunctional labor", they needed to be prepared for a possible cesarean section (she was now 6-7cm). All the while they were telling her to notify them if she felt any pressure low down and when she asked about why she couldn’t stop shaking they told her it could be transition, but that it could be very hard to deliver this baby and to be prepared. My client spent the next half an hour crying in this position and that, desperately trying to flip the baby around. I reminded her that many people successfully deliver posterior babies, and that she had more power over this situation. Soon the baby’s heart rate had risen, and they were telling my client that the baby may just not like this labor. Unfortunately her temperature had then risen to 99.9 degrees, and there was talk of a possible infection. Six hours after I had arrived, a doctor came in and said "I think it’s time to have a baby." I watched as my client went into hysterics, I was told "We’ve done everything we can do…" and everyone was escorted out of the room so they could prep her for surgery.

I was soon with my client in the recovery room, and learned that the pain medication had not worked sufficiently through the procedure, and that she had to be put on a stronger drug immediately after delivery. She came out of the druggy fog and was in extreme amounts of pain. I watched as a nurse insisted on touching her wound after she said "Please don’t touch me, I beg of you!" I stayed with her through the next few hours- working to relax and breathe her through the pain, massaging her hands, commending her on her tremendous bravery. She expressed her anger, and I tried to validate her, reminding her that it is okay to be mad and that she doesn’t have to feel better right now. Finally she was feeling more comfortable, smiling here and there and looking tired. It was a small thing, but by the end of the night I was certain that she was glad I was with her, and that made the whole day worthwhile.

I think it would be impossible for me to not feel some level of grief over this experience. However, as clearly as my own unpredictable 2-day labor taught me, there is so much that pain and a change in plans can teach us. One of the first things my doula/midwife friends told me was that we cannot save these women. Our role is to empower and to comfort, to provide strength and information and clarification, and to sometimes just be there. I am not responsible for giving her a perfect birth, it’s not within my power. However, in this situation I truly feel that my client was severely wronged by a broken system. An already complicated life was further complicated through what I am certain was a traumatic birth experience. I can only help but wonder how things would have been different if they were able to be more patient, to stop intervening and scaring and bullying, to just wait and watch and let my client labor on her own, the way her body was built to. Perhaps in the end she would have needed the surgery, but I think that if she had been treated differently and not rushed, spoken to like she had a choice in the matter, like her opinion counted, then maybe when that time came she would have owned that experience and that outcome- perhaps with disappointment, but without the feeling that she’d been robbed.

This is a sad story, I know. I also know that working as a source of support for women, spreading knowledge and dissolving fear, taking back our own bodies and births- well that is work worth doing. I suspect that this experience will stay with me forever, if anything just as my "first" and as a reminder of why this crazy doula-thing is so important.

"Hope has two beautiful daughters. Their names are anger and courage; anger at the way things are, and courage to see that they do not remain the way they are." (Augustine)