Doulaing For Friend’s Births

Feb 25, 2016 by

DoulaingForFriendsIt’s so thrilling to imagine being a doula for your friend’s pregnancy and birth! For some doulas this is what draws them to the work from the beginning. They want to make sure family members and dear ones have the best experience possible and to help make that happen. But underneath these altruistic desires is the reality of what going to our friend’s births really means. Sometimes it’s a harsh learning.

Ever since I started doulaing, I wondered what was different about it. I thrashed the topic over with my fellow trainers and experienced doulas for years, and then I started asking about it in my doula interviews. Eventually I had enough data to analyze (stories to pick apart!) to get to some core truths. Author Julie Brill, in her compilation book, “Round The Circle: Doulas Share Their Experiences” graciously invited me to write my findings for a chapter in her book. Along with 22 other experienced doulas, we offer advice on unexpected home births, surrogacy, encouraging the mother-baby bond, self-care, and supporting religious belief that is not your own, as well as many other topics. But here is a sample of what I learned:

1. Despite your best efforts, you have an agenda. Pregnancy and birth are times of tremendous life change and shifting of identity. When you walk alongside your dear one, you are attached to them. You want things to go well and you will do what it takes to get a positive outcome. Contrast this with your clients. You care about them and want the best, but our role is to support their efforts and not be invested in their choices. You will likely see them a few times after the birth, but your role is to see them through this transitional period. With your friends, you expect to be in their lives and their child’s lives and to see them grow up. This attachment to a particular outcome shifts and changes your support and you can’t get around it.

2. No matter what happens, you will be associated with that birth and its outcome. Forever. Because of your expertise, you may be blamed if something does not go as expected. In order to get distance from the birth, the family may need distance from you. This need may be expressed by the partner or grandparent, not your friend. However they need to honor those feelings. That may mean not being invited to gatherings or even not having casual visits. It’s so easy to blame the doula, which is not a problem when it’s a client. We shrug it off. But when it’s your friend, you want to explain or work it out, but some feelings you can’t work out. They just are. Often it’s a big surprise to the doula when this happens.

If something goes really well, you may be assumed to have “magical powers” that you know you don’t deserve, which can also be disconcerting. What really matters is how closely the laboring person’s labor and birth expectations meet the reality. If expectation and reality are a close fit, then it is usually a positive for your friendship. If they don’t, it can have negative consequences.

3. Your relationship will change and neither of you can control it. Beyond the rollercoaster ride of many friendships, which have ups and downs and varying levels of intensity, birth does not bring out the best in us. It isn’t supposed to. It brings us face to face with who we are – our strength, our weaknesses, our fears, our beliefs about the world and our place in it. When a stranger is with you, you are able to be intimate, understanding that knowledge is held in a special private place and will not have repercussions for your future relationship. When your close friend sees you, they will know you that way forever. That knowledge and intimacy can make some people really uncomfortable afterwards (including you).

You will also see their partners and family members in a new light, which may or may not be a favorable one. As doulas of friends, we have a much greater emotional load to bear. When we care deeply, it’s very difficult to hide our feelings about a partner’s actions or a care provider’s options. We are more transparent. They aren’t used to our doula mask, and they know when we’re upset or hiding resentment. It can be done, but it’s darn hard.

So what’s a doula to do?

First, buy Julie Brill’s book and read the two chapters on attending the births of friends!  (BTW, I get no money from the sale or promotion of this book. I just think it’s a great resource so you should know about it.)

Second, contribute your baby shower, birthday and holiday gift money towards a doula’s fee and encourage other people to do the same thing. Your friend or family member still needs a doula, just not you! Imagine what a fabulous supportive friend you can be: a sounding board for feelings, an extra resource for information, and all without the full burden of responsibility. You get to show your excitement and your disappointment honestly, offering an extra set of hands whenever they’re needed.

Lastly, as an older woman I want you “youngers” to know how precious your friendships are! Having people in your life who knew you from decades ago doesn’t happen without conscious effort and cultivating compassion, caring, and humility in each relationship. As doulas we often have a leg up on those qualities – but sometimes not with our friends. There’s you, and your friend, and your relationship that all need tending – make sure that you’re looking after each one before deciding to be their doula.

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Doulaing At Midlife

Oct 2, 2014 by

flowersmall“When my 60 year old mother insisted she was middle aged and I wasn’t, I replied, “Mom, how many 120 year old women do you know?”    -paraphrased from Postcards From The Edge by Carrie Fisher

I went to my first birth when I was 20 and my first birth as a professional at 24.  Most of my clients were older than I was, some by more than a decade.  As I aged it seemed that my clientele youthed.  At first I was their hip, knowledgeable young friend.  Then a sister, then a companion, and now their mother.  My experience is respected and my perspective has changed.  Overall, I am more patient and more understanding of the stresses on medical care providers.  Obstetrical trends have come and gone and returned again.

Doulaing at midlife is precious and different than at any other age.  Among my research participants and friends there seem to be a few common markers.  Rather than seeing ourselves giving birth, we see our children or nieces and nephews reflected in our clients.  This shift in perspective is subtle but one day you realize it’s not your generation in the bed anymore.

For those of us in female bodies, once menopause is assured, the passing of our fertility comes home to us neon loud at a birth.  There was a time when each of us decided that our family was complete and that we would have no (or no more) babies.  But there’s a difference between the inner feeling of “I’m not going to do that (again)” and “I will never in my lifetime be able to have that experience (again)”.  It is a bittersweet moment, like losing an appendage you didn’t know you had.   The surprise is almost as challenging as the grief – haven’t we traversed that terrain already?

It’s a moment unique to perinatal professionals, but more poignant to doulas.  We’ve got nothing to distract us when we’re at the bedside.  We’re there to feel, to relate, to be sensitive to everyone else’s needs.  So the surge of grief, of personal realization may catch us by surprise.  This moment may be harder if our menopause arrived early or was the result of a medical condition.  If we have lived in service of women’s reproductive bodies, why didn’t our own work perfectly?

Another common experience is acknowledging our physical limitations.  Our bodies are not quite as cooperative adopting odd labor positions.  We don’t recover as quickly from a long birth.  Some of us develop health issues that have to be accommodated.  This means our practices have to change, taking on partners and mentee doulas to help share the load.  But first we have to sit with the emotions that come with those realizations.  We are aging in a culture that spotlights only the drawbacks of growing older.

We have a huge store of knowledge to draw upon – having seen generations of children come into the world.  We’ve seen doctors come and go, inductions rates plummet and surge, and believe in the power of VBACing women.  The third marker is recognizing our own value.  If our majority culture does not see our wisdom, we must see it in each other and in ourselves.  The doctors, nurses, and midwives may be much younger and eager to dismiss us.  We have perspective and history – the lines on our face garner respect if we know how to use them.  This challenge is in acknowledging what we know – and what we don’t. While young women are the future of birth culture, we have already learned many lessons the hard way and can spare them much pain.

With our clients we know that this time is unique and scary and full of growth.  We can say, “Yes, its not what you expected.  But you know, it never really is.”  From a midlife maternal perspective, many firsts have come and gone: first baby, first child in kindergarten, first night your child doesn’t call, and the first one leaving home.  It never really feels how we expect it to – the fulfillment or the angst.  We can join our kin doulas without children in appreciating our clients as pseudo-daughters, dispersing wisdom and reassurance while not replacing their own mothers.

This is also a time of introspection and reorganization.  If they haven’t already, many doulas at this life stage become leaders in their communities.  They may move to parallel careers that are less demanding.  We need growth but we also need rest.  Rest does not mean stagnation.  Indeed periods of rest and introspection are often followed by frenzied creativity.  We give birth to books, to workshops, to programs, to businesses, and to new doulas.

So midlife doula kin, there are similar signposts on our individual journeys.  Look in the mirror and see your value.  I do.

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Why It’s a Calling

Mar 17, 2014 by

Doula work is hard!  It is physically challenging, emotionally draining and requires a personal connection that leaves life long impressions.  Doulas sacrifice to be there for their clients.  They prioritize other people’s birth memories above the needs of their own families.  They get paid less than what they are worth – often wages are barely above the poverty line.  There is a limit to how many clients one can physically and psychically manage.  Yet, this work is something that so many of us cannot imagine not doing.  It fulfills some part of who we are – it expresses our life essence.  To help another woman through childbirth – as she is physically going through the process of giving life to another human being – is what we feel we are called to do.

A calling is often referred to in religious terms because that is our most familiar cultural reference.  But a calling means that there is a purpose within us to connect to others and improve their lives.  We want to ensure that another person’s journey is eased by our presence.  What we give is not only a skill or a service, but the essence of our own humanity.  Doulas in my study said it was a passion, a priority, without doulaing they would feel that a part of them was missing.

Ten of the sixty doulas in my study described or mentioned the word “calling”.  Tracy said, “Being a doula is a part of who you are.  You can’t try to be a doula…you either have it in you or you don’t.“  Nancy shared, “It’s my passion and it tests my compassion.  In my real life, I’m a banker!  But that’s a career and this is a passion.”  Sadie said, “It was in my heart.  For so long before I took my workshop I knew it was in my heart and I’ve never been happier even though it’s been so hard.”

The calling of birth doula work often comes at great cost.  I’m not talking about the missed birthday parties or band recitals, although those certainly matter.  It cost us when we sit holding hands of a woman who is being victimized by her own choices, or who is not respected because she is young, not white, or doesn’t speak English.  When we SEE that infants are whole human beings with a full consciousness and no one else acts in a way that acknowledges it, it costs us.  When we know a physician feels he cannot trust the system and acts in a way that is self-protective rather than letting labor continue without interference, it costs us.  When we trust birth but no one else in the system we are working in does, it costs us.

We don’t do this work because we are martyrs.  We do this work because we are willing to pay the price.  We know it makes a difference to this mother, this baby, this family.  We know that our presence will reassure nurses and doctors to allow this mother to labor another hour because she is cared for.  We know that the price we pay is a drop in the bucket to what is gained by everyone else by our presence.  We do birth doula work because we are called to make a difference in the world.

Our spirit yearning for expression in the world says, “Yes!”

This is your role.

Be of service.

Make a difference.

Hold the spirit alive.

Like a soft spring breeze it whispers, “Doula this world –it needs you.”

 

 

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Doulas! Charge What You’re Worth!

Jan 28, 2014 by

In support of the effort made by YourDoulaBag.com, I’ve decided to repost the graphic from their blog this week.  Feel free to post it on your web site to help prospective clients understand how doulas set their fees.

blog_DoulasChargeWhatYouAreWorth1

 

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Another Reason Why Birth Is Sacred

Jan 1, 2014 by

Long ago I learned that rescuing people from their own actions is often a trap, one that ensnares us as well as the person we are trying to help.  When it comes to my client’s birth it can be really hard as she makes decisions that are not going to take her in the direction she previously desired.  As a doula I want to grab her and say, “No! Nooo….No!”  The more attached I am to her personally the harder it is…until I shift my thinking.  Once I remind myself to respect the transformation and challenges of pregnancy and birth as a sacred path it becomes much easier to support and serve this mother.

Several decades ago there was a lot of interest in vision quests* and understanding the deeper spiritual nature of existence.  These journeys of challenge and hardship were entered into to discover one’s strengths, weaknesses, inner nature, and relationship to the Divine.  For some groups it also involved the risk of death.  Joseph Campbell wrote extensively about the “hero’s journey” and the meaning and interpretations of this myth in contemporary society.  (Today we have Frodo and Harry Potter.)

Early on in my path as a doula, I saw the potential of birth to hold these same meanings for today’s women.  Women faced these same challenges by gestating, giving birth, and nursing – they didn’t always need a vision quest in the wilderness.  While our culture has not adopted the idea of a ritualized journey, the experience of childbirth still holds this potential for women.

If we appreciate a woman’s birth story as her own personal myth it has the potential to reveal to her deep truth and knowing about herself.  It can be a mirror of who she is.  Within her birth story is how she deals with challenge, how she deals with authority, how she supports herself, what strengths she brings forth that she didn’t know she had.  It reveals her relationship to what is unknowable and undefinable in human existence.  She must give herself over to a process that may be unknown to her that she is not in control of.  How does she respond?  What allies does she call upon?  When the crisis comes, what does she do?  How does she deal with her deep fear as it faces her in the mirror?  How does she experience pain and what does she want to do about it and what does she do about it?  How does this mother see the world?  How does she see her place in it?

To me, every laboring woman I am with is traversing this terrain.  My role is to guide her to finding her own way not to show her which way is right.  There is no way I can know her inner experience or how her history has shaped her to act in these moments.  I don’t need to know – I just need to trust that this journey is unfolding as it should for her.  Women have taught me to trust them to find their own truth.

This doesn’t mean it’s easy.  This doesn’t mean I don’t speak up; it means I trust her to let me know she wants me to.  It means I have developed an automatic questioning in response to my “No! No!”: “Is it about me or about her?”    It means I trust that when she whispers, “I think I want an epidural.”  I whisper back, “Do you want to talk about it some or do you know that’s what you want?”  If she nods “yes”, I get the nurse.  I believe she KNOWS and I do not rob her of that power of choice.  To dither about her birth plan is to diminish her as being able to know what is best for her in that moment.  My service is to trust her unconditionally as the heroine on her own quest.  She will find herself whether she wants to or not.

In my decades of doulaing I have found that many women come back to me and say that their birth taught them so much about themselves.   They learned who they were.  They faced their fears and lived the consequences of their choices.  When a woman has support, true support without an agenda, she finds her voice.  We amplify it so others can hear it too.

Women change their lives based on their births.  They end bad relationships, become fiercer mothers, move across the country, yell at their obstetricians, yell at their midwives, hug and cry with their obstetricians and their midwives, grieve for not knowing.  They grieve for the woman they left behind and embrace the woman they now are.  Who am I to know what is best for that woman in the midst of her birth?  I know nothing!

This acknowledgement of the deep spiritual nature of birth and the risks it contains for crisis and change, keeps me humble.  It also frees me.  I am a chosen companion for the journey, an ally who will respond as needed. Sometimes offering wisdom but always offering patience and calm.  I follow her lead because this is Her Story, the myth she is living and creating with each breath.  I trust Her and I trust my service to her, which is why birth and the path of doulaing when practiced this way is sacred.

 

“It is by going down into the abyss that we recover the treasures of life.  Where you stumble, there lies your treasure.”   -Joseph Campbell

 

* The term “vision quest” has different historical and cultural meanings in Native American or First People cultures.  I’m using a popular culture definition of the term.

 

If you wish to explore these ideas further:

The Women’s Wheel of Life, Elizabeth Davis* and Carol Leonard, Penguin/Arkana, 1996     (*midwife and author of the midwifery textbook, Heart and Hands)

The Wholistic Stages of Labor by Whapio Diane Bartlett    http://www.thematrona.com/apps/blog/the-holistic-stages-of-labor-by-whapio

The Woman Who Runs With The Wolves: Myths and Stories of the Wild Woman Archetype by Clarissa Pinkola Estes, Ballantine Books (1993)

Joseph Campbell and the Power of Myth DVD Documentary, PBS, 1988, 2013

Transformation Through Birth, Claudia Panuthos, Bergin and Garvey, 1984 (still being published!)

Birthing From Within, Pam England, Partera Press, 1998

 

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Doulaing With A Disability

Sep 16, 2013 by

Often becoming a professional doula is an achievable goal.  But for others becoming or continuing as a doula with its physical demands is extremely difficult.  In my thirty years of doing labor support I have met several doulas who were able to maintain their careers.  After thirty years, I have had to make adaptations myself.  As my colleague Cory Silverberg once said, “If you live long enough you will end up with a disability.”  Here are some helpful steps if you receive a diagnosis that will significantly change your abilities.

  1. Feel your feelings.  Anything that is significant enough that you will have to adapt your life around it will bring up a mix of feelings.  Relief, fear, anger, anxiety, sadness, and other emotions are all important.  Take some time to grieve – your body and your life are no longer the same.  It is when you push away your emotions that they control you.
  2. Adjust to the diagnosis.  Will any medications or health care regimens have unknown affects?  Are there any procedures that need to be planned for?  Remember you are a person with an illness or disability, not the disability.   Utilize your doula skills:  seek out resources, confide in those your trust, enlist others in your support circle, and advocate for your own needs.
  3. Be realistic about your circumstances.  How does your condition affect your ability to fulfill the doula’s responsibilities?  How do your changed circumstances affect your client and her labor support experience? How do they affect you?  Examples:  If you have a joint ailment, you may not be able to support a larger mother in her positioning or while walking or dancing.  As a cancer survivor, you may tire more easily.  With multiple sclerosis, you may have a flare that requires a cane or wheelchair.  Perhaps an endocrine condition requires at least five hours of sleep each night.  A benign tremor may mean your pictures are usually out of focus.  As a postpartum doula, arthritis may mean it is unwieldy to pick up a baby.
  4. Brainstorm possible solutions.  You might not be able to pick up the baby, but you’re fine if someone hands you the baby.  Maybe it is time for you to take on an apprentice doula who can do the more physical tasks.  Perhaps attending births together or in overlapping shifts with a doula partner would work for you.  Maybe you just don’t take photos.  When you look at your solutions, which ones would you need to choose and which might be up to your client?  For example, maybe your client would get to choose the second doula from three you like to work with.
  5. Readjust your marketing. You want to emphasize the positive while not misleading potential clients.  On your web site show a photo of you holding a client’s baby at a postpartum visit with your cane on the chair. At the introductory visit, state the adjustments that are required and how you intend to address them.  Focus on what you uniquely offer and don’t apologize for yourself!  Emphasize that prenatal planning affects birth outcomes tremendously and is not affected by your disability.  Maybe instead of three prenatal visits, you offer four.  Maybe you can turn a problem into an opportunity –  offer an incentive for a particular birth photographer which benefits both businesses.  It may be that if you work with an apprentice or a partner, no explanation is needed.  Your potential clients will choose based on your business model and feelings of safety with you.  Depending on what you are asking of clients and how open they are to your solutions, business may stay the same or even pick up.  “Two experienced doulas for the price of one – that’s great!”
  6. What if my business drops off?  Birth and postpartum doula support are market driven businesses and also relationship based businesses.  It may be that potential clients prefer not to make adjustments to work with you.  May be your confidence has declined or your grief over these changes is coming across.  Mothers may decide you are not the best fit because of your disability.  It always feels bad to be rejected  – and this may be your worst fear.  Less or no business may stimulate the grief process all over again – which is entirely appropriate.  In thirty years there have been many times I could not attend births even though I wanted to.  This was due mainly to my life circumstances and needs of my children. But eventually it was due to a health condition.  I swore a lot and then went through the process I have outlined here.
  7. Shifting your doula energy.  Maybe you can’t attend client’s births or postpartums anymore.  Notice I did not say, “can’t be a doula anymore”.  You’ll always be a doula – it is a way of being in the world.  Maybe you’ll open a mentor doula business:  attending a few births with novice doulas, and have monthly educational and support meetings.  There is a huge need for this type of additional education and support for emerging doulas.  Some birth doulas become postpartum doulas.  Some become childbirth educators, birth activists, support group leaders, parenting educators, home visitors, or run doula programs.  Some go back to school and get certificates and degrees that enable them to affect birth in a positive way.  There is still a place for you at the table it just has a different setting.
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