One of the doula research interviews that influenced me profoundly happened at a 2004 conference. That morning a birth colleague, Sophie*, came striding in to my hotel room with coffee and her breakfast on a plate. We’d met in 1988 at a retreat for birth professionals.
“I didn’t think you‘d mind if I ate while we talked,” she said as her plate clunked down on the glass table. When I transcribed the interview later, I could hear her chewing and cutting her lox and bagel with a knife and fork on the recording. It was so like Sophie to assume my loving acceptance of her quirks; just like she would about mine.
I turned on the recorder. With her first story, Sophie said, “Amy, the most important thing you do isn’t a double hip squeeze. It’s not whether she gets drugs. It’s showing up. Showing up is 50% of what we do as doulas.”
As the interview progressed, she told more stories and reflected on what she’d learned. Sophie said, “I change that! Showing up is 75 % of what we do as doulas!”
By the end of the two hour interview, she changed her mind again.
“It’s 99% of what we do as doulas! The rest is just fluff. Showing up for her, that is what counts.”
Showing up is an approach of non-judgment and a series of continuing actions over time that support the mother wholeheartedly even when others are unable to accept or support the mother’s needs (Gilliland, 2004).
In my research, doulas who had been to a hundred or more births usually told stories about this deep level of acceptance, or what Sophie called “showing up”, being the most important and most significant service that the doula can offer. Many proficient and expert doulas mentioned the need to accept mothers whatever they are feeling or doing, and to believe them when they say they want something, even if it is different from their stated wishes prior to labor. Here’s the excerpt from my original interview with Sophie:
“In my life there is always compromise, always negotiation, always other people in mind. I have to take everybody else into consideration. So I think when someone shows up for me one hundred percent, supports me one hundred percent, hears everything I have to say and amplifies it, that’s what I mean by showing up. That to me is the greatest gift. That’s it. I think that’s 99%. I’m going up to ninety-nine. [laughs heartily] I think that’s huge. I really do. Because I think very few women get to have that.”
Women have to compromise for everyone in their life. They have to compromise for their partners, for their kids, for their pets, for their parents, bosses, and on and on. Women shouldn’t have to compromise for their doula at their own birth! Instead our role is to be present and mindful in the moment, and do that for hours and hours. answering her needs so she is free to labor. What she says she wants, even if it’s surprising, isn’t there to be challenged. Explored and confirmed, yes, not challenged. Additionally, when women feel that whatever they do or say or behave will be acceptable to their doula, they will feel free to enter fully into their experience of birthing their baby.
What does that look like? Let’s say I’m at a birth, with a mom who had previously been adamant about not using pain medication. She looks at me and for whatever reason, says, “I think I want an epidural.” The doula’s “showing up” thought process prompts me to consider the mom and ask, “What can I do to best support her in this moment?” The attitude of the doula has to be one of caring detachment. If we get caught up in our clients doing things a certain way or having certain things happen, the experience becomes about us and not about them. Effective doulas need to find a way to be caring and loving of the woman and her intimate family, without being attached to what she does, how she makes decisions, or what choices she makes. It’s essential for our own mental health, but also for our effectiveness as labor support.
What do I say to that mom? “Would you like to talk about it more or try something first, or do you want me to get the nurse?” If she says to get the nurse, then that’s it. I’m there to support the woman in labor, not her birth plan.
But the reality for us is that we WANT things for our clients, we WANT them to have great births, we DO get attached. What helps me is understanding that the birth is her journey; she is the leader, she tells me the route. If I think she’s making a “wrong” turn, that is me comparing her journey with some idealized one I have in my head. I know birth influences the course of women’s lives forevermore. So who am I to judge what’s best? I don’t know her path. When I can say that inside of me and really own it, I am much freer to support a wide variety of women making a wide variety of choices, and to truly show up for them.
*her name has been changed “Just Show Up” image courtesy of Edward Tufte. http://www.edwardtufte.com
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