I had dinner on Friday night at a friend’s place where, entirely by chance, half of the women were trained birth doulas. I was thrilled. I love doulas. So much.
There is a ton of research showing how beneficial it is for women to have doula support during labour and birth, and yet most women still don’t hire them and, from the sound of it, many prenatal health care providers still aren’t recommending them to their clients. I don’t feel like I’m exaggerating when I say that this is a terrible situation. I try not to reduce every situation to my own experience, but then again, I also care about this particular issue because of my own experience, so…
I had a doula with my first birth. I first learned about doulas soon after I got pregnant, although I can’t remember where, when or from whom. At the time, an old friend of my husband’s was in midwifery school, and the plan was for her to attend our birth and act as my doula. Since she was commuting a long distance for school, she also arranged a back-up doula for us (another friend of hers, who had been a doula for some years by then) just in case she wasn’t able to get to us in time. In the last few weeks of my pregnancy, both our friend and her back-up came to my house a number of times to talk, to help me write my birth plan, to give me massages, to help me cope as my EDD passed and day after day after day after day I remained pregnant.
When I was finally in labour, as luck would have it, our friend was busy attending the labour of her sister-in-law, so her back-up came into play.
13 and a half years later, Lolli still holds a special place in my heart. When I think about my labour with Clea, her image comes to mind every time. It’s not that I think she made the birth a good birth—it had its own path and its own energy, and it was just good in and of itself. But she helped me, a first-time mother, to experience it in the most positive way.
That was no mean feat. My labour with Clea was induced with Cervidil at 41 weeks 3 days. There was no medical indication for the induction; I was just done with being pregnant. Leaving aside the problems with that line of decision making (of which I was not aware at the time and I’m grateful didn’t materialize), inductions tend to stimulate harder contractions. Many women are not able to manage labour unmedicated after an induction for exactly this reason. Sure enough, for much of my labour, the contractions were hard and strong, piggy-backing one on top of the other for three or four hours.
I remember sitting on the kitchen floor when I realized it was time to call Lolli. (My doctor gave me a dose of Cervidil and then sent me home to labour in peace.) My mum and dad were there, with my husband. When Lolli arrived I was just drifting into that labour zone where time no longer has any meaning and the whole world kind of disappears. I remember being on the couch, feeling mildly anxious, when she came in the door sometime around 10 or 11 pm. The first thing she did was send my mum and dad home (“time for everyone to go now”) and walk around turning off lights and closing curtains. “It’s night time,” she explained to me, simply.
I have no idea about chronology after that point, what happened when, in what order. All I know is that Lolli was there. She ran me a bath and sat quietly beside the tub as I slept between contractions, and she was ready and waiting to pour water over me when each contraction crested. Out of the tub, at some point, I remember that she took my hands, put her face close to mine and said firmly, “Open your eyes. Look at me. Don’t let the contractions swallow you up. Keep your eyes open and look at me.” I remember that moment like it was a lifeline, locking eyes, re-centering myself. I remember her tucking Paul and I into bed at some point, telling us to try to rest—again, “It’s night time.” And I remember being woken by the “pop” of my water breaking, having no idea what the sound was, and Lolli laughing gently, and explaining to me with a smile what had happened.
Of course, that was the point at which the piggy-back contractions began. Transition—those last few centimeters of dilation, which most women experience as the most intense part of labour—came soon afterward, and I really went far into the alternate realm that is hard labour. Lolli wiped the toilet seat lid when I barfed on it, unable to wait till—frankly, not caring if—it was open. She helped me down the front stairs to the car when it was time to go to the hospital. She instructed my husband to run the red light at the intersection of 25th and Oak as there was no traffic anywhere in sight, and the backseat of a car is not the best place to manage transition contractions.
She laughed with the labour and delivery nurses about my choice of music to play at the hospital—a mixed tape (please—this was 1997) that included everything from Duran Duran to The Smiths to the soundtrack to Evita (London cast). She didn’t laugh at me when I requested an epidural, even though she knew it was way too late for that, and she saved the waiver that I signed during a contraction—my signature drifting up and off the top right hand corner of the page—and gave it to me the next day to tuck into Clea’s baby book.
She called my mother when I decided, at the last minute, that I wanted her there. During the pushing stage, I was absolutely focused, totally unaware of anything outside of my own body. Lolli was conscious for me. At one point, she poked me in the shoulder hard enough to jar me to reality, just long enough for me to hear her say, “Your doctor is going to cut you. Your birth plan says you don’t want an episiotomy.” In that brief moment of clarity, I sat straight up, told my doctor, “Do not cut me.” And she didn’t.
Lolli helped me nurse Clea right after she was born. She made sure that the hospital kept us together. “But,” the nurse said, “we have no free beds in postpartum yet—we’ll take the baby to the nursery until we can find a bed.” “No,” Lolli told her, “keep them together.” “But we have no diapers!” “It doesn’ t matter. Keep them together.”
She stayed with me while Paul went home to shower and change. She stayed until I fell asleep, snuggled up with my newborn. She came to my house the next day when I was home again, to talk about my labour, to go through it all with me, to make sure Clea was nursing well. She returned a few days later to check in again. I remember sitting on the living room couch with her—the couch where I’d been sitting when she first came in the door—and the way she gazed at my baby and put her arm around my shoulders, and just feeling like she was this incredible gift.
I still feel that way now. I didn’t hire a doula for my second birth, as I didn’t think it was necessary. I was planning a homebirth, and would have two midwives there; a doula would be redundant, right? Wrong. So wrong. I can’t say that a doula could have prevented the complications that arose or the surgery that resulted. And our midwife (since the labour/delivery ended up being at the hospital only one midwife was there) was incredibly attentive not only throughout the day, but through the stress-filled, complicated week that led up to it.
But I could have used a doula. I could have really used someone who was there only for me—not for my baby, just for me. Who had nothing more invested in the scenario than to support and help me. Who wasn’t watching monitors or checking dilation or recommending any procedures, but who would have been watching my face and hearing my voice, doing laps around the hospital with me and my husband, or maybe urging me to stop doing laps, stop trying so hard to make things happen and instead just look me in the eye and help me experience each moment for the moment it was. Who knows what a doula might have been able to help me do?
Doulas are indispensable. Hospital birth, home birth, birth centre, midwife, doctor…doesn’t matter. Hire a doula. If I could do my second birth over, that’s the first thing I would do differently. I can’t say with any certainty it would have made a difference to the progression or outcome, but I am pretty sure it would have made a difference to me.
Hire a doula.