The doula as a witness

I love that I learn from every single birth I have the privilege to attend. Each family and each birth requires different things from me - different words, different actions, different energies. Part of the skill in being a doula is knowing when to use which words, actions and energies. 

At times I stand by as a quiet presence, at other times I am in constant contact. Some moms prefer silence, while others want distraction. I rub feet, hands, hips, legs, backs and shoulders, I stroke hair,  I whisper encouragement, I turn down the lights, I turn up the heat, I fill the pool, I bring cool washcloths, I hold the space, I keep everyone fed and watered - doing my best to remove any hindrances to the birthing mother. 

I do all these things, but I feel they are all secondary to my role as a witness.   Of anyone involved in the birth process this one is almost unique to doulas. Partners are present but the birth is their own birth experience too. The midwife, the nurse, the doctor - they have their own responsibilities that often involve papers, numbers and tools - they have additional concerns that I don't have to carry. I am able to be there - truly present - with all my energy and attention focused on the birthing mom. I know midwives who choose to be fully present with the birthing mother, but these are rare.

And so I often get to see the things that others don't. I witness a birthing mother glowing serenely through yet another wave; the gentle interactions between a mom and her partner; the dad's face as he marvels at what he and his partner accomplished. I witness the mother's triumph as her dreams and expectations are clothed in flesh.

I am there for the disappointments too. I witness the moment when the gynae orders a second caesarean section after a long battle for a VBAC. I am there when her wishes are disregarded and her body violated with impunity by those with greater authority than me. 

In those moments something in the depth of me rages.  I don't dispute the medical justification for their actions, but too often there is little to no acknowledgement of her desires, her struggles, her strength, her autonomy, her personhood. 

Something in me rebels at the idea of being complicit in a system that routinely disregards evidence-based care in favour of convenience, that favours policy over personhood.

While this system rolls on, someone has to mop up the emotional fallout after institution has done its work. While there is little I can do on my own to improve the care women get while giving birth in our birthing institutions, I can bring empathy - the ability to sense, understand and share the feelings of another - because I was there.  

So to all my doula moms, thank you for the privilege of allowing me to witness your journey...

I was there when you believed you couldn't go any further but you did anyway. I was there when you felt your body would split itself apart but you kept it together. I was there when you found and accessed that primal power deep inside. I was there when you pushed past exhaustion. I was there when your hopes were shattered, when your deepest healing was won, when your darkest moments were met, and overcome. 

I saw what you did. 

Your triumph. Your power. Your vulnerability. Your pain. 

I saw it all.

And I want you to know: you are magnificent, you are fierce, you are breathtaking. 

I know because I was there, and I remember. 

For Love or Money?

Is this doula worth the moola?

Find it here.

So as I'm nearing the end of this doula course I'm contemplating the possibility that I get to earn money doing what I love. That is a very privileged place to be!

High School teaching, ballet teaching, lecturing Art History at three different institutions, importing amber teething necklaces and hazel necklaces - I enjoy all of these things. But, with ballet teaching for instance, I never started my own studio because something in me just knew that as much as I love dancing and teaching, it's not what really gets me up in the morning. If I did force it just because it was what I'd always done, I think it would have eaten me alive.

Working with bellies, birth and babies on the other hand... Now this stuff keeps me up at night! I will sit and read journal articles on the benefits of one birth position over another for hours, or sit with a mom while she labours for as long as it takes and feel more alive at the end of it than I did at the start.

But I read someone the other day writing about how she found a doula who 'isn't in it for the money, but does it from her heart' and while I understand her point, I get a bit frustrated that it's seen perceived as an either/or situation - you do it for the money OR out of your heart...

I'd love to be be able to offer my doula services for free, all day and every day. 

I'd love to be be able to offer my doula services for free, all day and every day. But when I am helping a mom in labour, I need someone to help look after my girls, and that sometimes costs money (or bribes). I want to do extra courses in hypnobirthing and aromatherapy and massage and breastfeeding (and and and) to be able to help my moms even more - but they all cost money and take time.

Furthermore, being a doula can be really inconvenient! For instance, I have a glass of wine with dinner sometimes, but when I'm expecting a mom to go into labour I won't drink at all, because I am quite sensitive to alcohol and I don't want my driving to be compromised and I think it's disrespectful to pitch up smelling like you've been drinking.

I can't organise holidays or travel too far away when I'm expecting a birth soon - or vice versa, I can't take clients due two weeks on either side of a holiday. If you think it's tough not knowing when you're going into labour, I have the buildup every time I have a birth! Don't get me wrong, I'm not complaining, I just think people need to know.

So I am in the situation where I will need to charge precisely because I love what I do. And you know what, I think that my time and skills, and my heart, are worth it.

Get the T-shirt here.

The stats back me up and the moms that I've already helped would agree, continuous care in labour makes a big difference! But, on the other hand, I do believe that every woman deserves a doula and I'm not saying that I won't ever take clients who can't pay, and I most certainly will do volunteer work as well, but in order to have the space and the finance to do that, I need to charge those who can pay for the service.

Perhaps I could offer discounted services for special cases, or barter my services for car repairs, or set aside a small amount per birth to put towards moms who aren't able to pay the full fee; I'm not sure, I'll have to see how it goes!

So what can you do to make doula care more accessible? If your medical aid doesn't already pay towards doulas (Fedhealth and Momentum do, and Discovery should be signing up soon) then write a letter to them saying why they should pay for doulas! If they do, write and thank them and let them know how much you valued your doula! We, the doulas and midwives, don't have as much clout as you do when it comes to getting medical aids to pay up...

If your hospital doesn't allow doulas as an additional birth partner, find one that does and give birth there and write to the original hospital and tell them why you aren't giving birth there. Or have a home birth and have as many doulas as you like...

Hospitals are very precious about their maternity wards as in the bigger cities women have a choice as to which hospital they want to birth at, and maternity wards bring in good money for hospitals, so if they are losing patients because they don't allow doulas, they would love to know about it! If they do allow doulas, write to them and thank them and let them know how much you appreciated your doula!

The same goes for medical aids that won't pay for home births and hospitals that won't allow private midwives. You as the paying client have the power to make a difference in these institutions!

Was your doula worth the moola? Comment and tell us about it!
Have your writtena  letter to your medical aid or your local hospital? Are you going to? Let us know!

Another First: Doula Experience at an MOU

My first MOU doula experience...

For the uninitiated, an MOU is a Midwife Obstetric Unit - run by midwives, sometimes attached to a hospital and designed to serve low-risk women with little or no doctor intervention. It sounds like an ideal situation, and this specific institution is quite unique in South Africa, but does have it's own set of challenges...

Image from here.

As part of our training we need to observe some births and, fortunately one of the ladies doing our course, Hayley, conducts workshops for lay doulas and those who are contemplating professional training. These workshops include an opportunity to serve underprivileged women through labour and birth, so it made sense to join her to get a chance to observe and support some births. So, myself and my friend, who was still not sure as to whether this doula thing was right for her, again made sure the littlies were taken care off, donned our aprons to identify us as childbirth companions, and made our way to meet Hayley and another trainee doula at the MOU.

I had already been at one home birth and one labour (a home birth transfer) other than my own two births before I started the doula course, but I had no experience as a doula in a hospital environment. Eeek!

The women there very seldom have partners with them, so we were welcome to help whoever needed us. One lady had already been booked for a caesarean so I was able to sit with her while we waited for the OT (operating theatre) to become available and was able to go with her into theatre. You can read more about that here.

When I got back to the ward, there was a lady who was quite close to giving birth who my other two trainee doula friends had been supporting, so I was able to join them. It seems that it is standard practise for the women to have catheters, and she also had a drip so she was on the bed for the birth. She kept wanting to reach up and grab a rail above her to pull on it. I have read that pulling on something does help to push, and lifting her weight off the bed would have helped her have more of a squat position, which would have been great, so I thought it was incredible that she knew just what her body needed, but unfortunately the rail was not designed to hold a labouring woman's weight so we let her pull on us instead...

I realized why we were advised to take rings off. The vice-like grip of a woman in the throes of transition is not to be underestimated!

She also gave birth to a boy, and you could just see how happy she was that her little one was finally in her arms! I did take a photograph but wasn't sure if I was keen to post it without asking her permission, so I will make sure I do that for future births!

After this, my friend who hadn't been sure was convinced that this was definitely something she wanted to do - and I thought she was doing a great job! It has been really lovely to have a friend to walk this journey with, I am so grateful!

The other trainee who was with us was so hyped up by the birth! I completely understood where she was coming from, and I expected to feel the same, but I felt more sobered than anything else. I think the fact that my hubby forgot to fetch my daughter from school had something to do with it, as I was awakened to the realities of dashing off to support women at unknown hours for undetermined lengths of time. Don't get me wrong, he is VERY supportive; it was an honest mistake, and my mom was nearby to help out, but mom is moving 3 hours away in the very near future to start a bed and breakfast in Hluhluwe, so it looks like childcare is a one of the bigger challenges to be overcome in this Durban Doula's journey...