It has been a long time--a really long time. It's been so long that the tiny baby has quadrupled her weight (reaching 24 pounds), learned to pee in the potty chair, and fully discovered her voice and sense of resiliency! Some people call this phase the "terrible two" phase, but I refuse. It's the phase where she is testing out boundaries, learning to express herself, figuring out her personality and growing. Yes, she gives me a run for my money from time to time, but that is exactly what a two-year old is supposed to do.
In addition to my baby blossoming into beautiful, vibrant two year old,
a lot has happened in my life as well! For those of you who saw my last 2011 blog, you know that my birthing experience, although natural, was somewhat disempowering. Like many women, I felt unheard, silenced, scolded, and the list goes on. My life mantra is that when life doesn't go as planned, it's best to embrace it as content (at first) and then do something about it. This philosophy ultimately led me to go to become a doula. I thought it would be a way for me to reclaim my experience and help other women feel heard and validated in a way that I didn't.
This week as I was with my client, who is also my friend and the mother of my daughter's friend, as she delivered her baby, I was reminded about how important doulas can be when navigating the system. After experiencing weeks of contractions and spending an entire night in the hospital at the 37 week mark, my client "Jane" and her husband decided that if their baby boy hadn't arrived by his due date, they would expedite his journey by getting induced. Although in the birthing room, it's up to the doula to support mama and her partner as they negotiate their options, while mama prepares to endure THE MOST excruciating pain a human being will ever experience and then when she actually goes through it. The doula's role is to present options, make gentle suggestions when solicited or welcome, to read the vibe, to coach daddy or support person, to help mama find and use her voice and know when to step in and when to step back. The role is never to speak to the doctor on behalf of the client. But, for the sake of this blog, this doula has some thoughts to share.
10 Tips for Doctors & Nurses from a Doula
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1. Instead of being dismissive, validate your patient. This might be "business as usual" for you, but the process of giving birth is one of the most vulnerable times in a woman's life. When she says, it's really important for me not to have a 'C-section,' don't say "I'm not sure that that's up to you," as you chuckle, "but it's highly unlikely unless something goes very wrong."
2. Lead with the positive instead of casually mentioning worse-case scenarios. Try saying, "I hear you. We'll do everything possible to help you have a natural birth. We would only do a C-section if there was an emergency. You've shared all of the information but framed it in a positive empowering way, which will make mom feel better about working with you and trusting you.
3. Don't pressure her. Jane got to choose between getting her water broken or simply getting induced with a little bit of petocin. She opted to get a low dose of petocin and continue to move around the hospital as she waited for her water to break naturally. The doctor returned an hour later (at 10:30 am) and said, "Ok, are you ready for us to break your water." When she said "no," he began rambling and asked her what her cut off time was. "If you're water hasn't broken by midnight, then will you have us break it?" Her husband was a champion and said calmly that they would let him know closer to midnight.
4. Empathize with mama. We all know that we are anxiously waiting for mama to go into hard-core labor because that is what has to happen for her to deliver her baby. But in the onset of back to back, breath-stopping contractions, empathize. Imagine experiencing the breath stopping pain, that pierces through your entire core, the worse pain of your life, as the people around you are casually chatting, discussing lunch plans or talking about their annoyances for hospital gloves. Try saying "this is hard, but you will get through this. Let your body do what it needs to do. We are here for you."
5. Communicate. More information is better than less. As my client was on all fours, feeling fully ready to push her baby into the world, the nurse prepared the room with blue tarps and got the medical instruments ready. Go ahead and tell the patient what you are doing. Although you are there and ready to take care of her, she doesn't know that. Assure her that you are getting the room ready and that the doctor will arrive soon. This will help prevent her from panicking.
6. Don't scold her. Even if you scold her and scream at her not to push, her body is telling her to push (especially if she is doing this naturally without drugs). Instead, remind her to breath and let her know that it's almost time to push.
7. When the baby arrives, acknowledge him/her. This might be the tenth baby that you've delivered today, but this is the precious bundle of joy that mama has been nurturing in her body for the past 40 weeks and already has grandiose plans for the baby. After you suction the baby and make sure that he/she is stable, take a second or two to acknowledge baby. "You've got a beautiful baby boy!" It doesn't matter if you actually think the baby is beautiful, to mama, that little child is the most amazing thing on the planet. Honor him/her.
8. Congratulate mama! Bringing a baby into the world is kind of enough said.
9. Listen to mama. When you are sewing mama up and she says she can feel what you are doing and that it hurts or it makes her feel scared, for god sakes, listen to her. Talk to her about what you are going to do and why. If it seems like a no-brainer to you, it's because you're a doctor. If you are a man, please remember that you are a man and that you have never and will never experience this. If it's possible to give her more local anesthetic, consider doing that. But, whatever you do, don't tell her it shouldn't hurt or she shouldn't feel it. She already told you that it does hurt and she does feel it.
10. Know that every mama comes with a story. Be compassionate. In the United States one in four women have been victims of sexual assault and one in three women have experience dating or domestic violence. That means that as many as one in three woman arrive at the labor and delivery room having their bodies violated. Imagine how triggering the experience of losing control of your body and then laying in place while someone is sewing your torn vagina back together could be. It has to be done, but be kind, listen, communicate and validate as you do what you have to do.
