The longer I work as a doula the more I realise my work is not about solving specific problems with predefined solutions, as if every stalled labour requires the same position changes, and every massage oil requires the same mix.
It's more about defining the philosophies and motivations that underpin my work as a doula, and learning how to apply those in each situation.
Doula training can be quite overwhelming in that you learn a large variety of tools and techniques but in truth no one can really teach you precisely how and when to use each one - that is where experience comes in.
Imagine these tools and techniques are like the notes of the musical scale. They are of no use to you unless you know when to use them, for how long and at what intensity, and which to use together, and most importantly, when not to use them. Silence is the other half of music.
But what is more important than know all the right tricks for all the right moments, is your demeanour, how you carry yourself. Let me explain further.
The root word from which we get the word doula means 'servant' - as a doula, my power is in my service. I am at a birth to serve the mother and her family and no one else.
I was thinking about this one day and remembered this clip from the musical 'The King and I'.
"You shall observe care that head should never be higher than mine. When I kneel you shall kneel, when I sit you shall set, etcetera, etcetera etcetera!"Problematic aspects of the movie aside, I got a picture in my head of the birthing mother as the 'King' (or rather the Queen!) and myself as Anna, and as a servant of the Queen, I resolved to not allow my head to be higher than hers.
This has physical and psychological implications. Obviously it's not always physically possible; sometimes my head is by necessity higher than hers as I'm helping her, usually when I'm beind her applying counter pressure or doing some belly-sifting. But what I try to avoid is that sense of 'looming' over a birthing mother which so often happens when she is on a bed in even in a birth pool.
Our human brains tend to associate vertical height with power and authority. We tend to see taller people as stronger and as inherently carrying more authority. In public forums, the most important person is often isolated on some sort of raised platform so that they are the tallest person in the immediate vicinity. To 'look up to' someone is to admire and respect them; climbing the hierarchy is an 'upward' movement. We 'lift up' the downtrodden. Up is somehow stronger than down.
Let's take this to the birthing room - it's hard to feel powerful when you are on your back, and possibly exposed, surrounded by fully clothed persons, sometimes wearing face masks, looming over you and telling you what they are going to do to your body. This is not an easily defensible position and I wouldn't be surprised if our human brains read this as a dangerous situation and start releasing adrenalin accordingly.
It seems to set up a combative atmostphere, rather than a communal one - telling the mother that we are here to do this to you rather than with you, or for you. To comfort someone, or empathise with them, or listen to them, or even get their attention, we sit, stoop or squat down beside them. This is how we serve.
Psychologically, keeping my head lower than hers reminds me that 'the Queen' is the highest authority here. She is the mother of the child, and it is from her body that the child emerges. It would do birth attendants well to see themselves as 'advisors' to the Queen, rather than the highest authority themselves. Like any Queen she employs advisors to supply information so that she can make an informed decision. No one is more invested in the health of her baby and herself than she is - her word is paramount.
So that's it, my top doula tip - or should that be my bottom doula tip? Generally equivalent doula tip? Whatever - I'm sure you get the idea.
If you are a doula, have you thought of this before?
If not, do you think it's something you'll use?
If you've given birth, how did you experience the demeanour of your birth attendants?
Tell us below, then share and follow us on all the socials!
Etcetera, etcetera, etcetera!
