Doula Training: My First Birth

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Pregnant woman on yoga ballMy title may be a little misleading. The birth I am referring to wasn’t mine at all. In no way was it mine. In no way did I do anything extraordinary. I didn’t feel any pain. I didn’t hold a baby in my arms seconds after birth. I really just stood there and uttered some words (to mom, dad, doctors and nurses), rubbed a back, suggested new positions, wet a wash cloth and shed a few tears when that sweet little girl entered the earth. This was my first birth I attended as a doula and a key milestone in my doula training. And, it was amazing! The rush I felt was second only to the birth of my own children. I’ll start from the beginning.

My First Birth Experience In Doula Training

I met S when she was about 34 weeks pregnant. She had 2 children previously, but was really wanting to do things differently this time. Her first had come unexpectedly around 35 weeks and she ended up with several interventions to get things going. It hadn’t turned out BADLY. The baby was (and is) fine. Her second child was induced due to increasing blood pressure that had the doctor “concerned”. She says that she always doubted this excuse for an induction because her blood pressure stayed stable during the entire labor and delivery, but she did what the doctor told her to do and, again, things turned out “fine”. Baby is happy and healthy. However, she was pretty determined to let things progress naturally this time – barring any valid medical reason. Her desire to have a natural birth was strong and she was determined to try to go intervention (and drug) free this time! So, she asked me for help.

Since I am in training as a doula, I decided to take on a few clients fee free. They are doing ME a favor by letting me attend their births and I need births to be certified as part of my doula training. I didn’t realize how hard it would be to find clients in South Georgia, even when offering free services, but that’s another story.

My best resource has been a natural childbirth Facebook page for South Georgia and that’s where S found me. We messaged back and forth, then we met and things seemed to “click”. I was nervous, but confident that I knew my “stuff”, that I could be a help to her and she had faith in me. I tried hard to instill just as much faith in herself because, really, ultimately, that’s where the will comes from. And, without one’s personal will, the pressure for interventions will be easily overwhelming to someone who is sick and tired of being pregnant and is 100% ready to meet her baby.

Mom’s Pressure to Give In to Traditional, Not-So-Natural Birth

It’s really kind of disturbing to me how much pressure is put on women based on a desire to keep one’s schedule as “normal as possible” (a little tip – don’t become an OB if you can’t handle sleepless nights. I have met very few babies who choose to start to make his/her entry during the day. Most labors start at night – not that that means the delivery will happen at night. But, you may get a call in the middle of the night. So, if you can’t handle that, you might want to choose another profession.) and to administer the “routine” of the pitocin and epidural cocktail. Most moms will give in when sleepless nights, back pain, swelling feet, …. (you get the idea) is your reality day after day after day. You are just ready for it to be over. I know. I’ve been there. I did NOT give in, but the temptation is very, very real. You just really want to end your misery and meet that cute little bundle that’s making you so miserable.

What is the Real Due Date of the Baby?

The doctors here in Tifton, Georgia were no different than those I have read about. In fact, they may have even been a little “worse”. Most OBs seem to be on board with the whole 41 weeks is the max we will let you go. It used to be 41 weeks, 3 days (10 days “overdue”), but that seems to have been pushed back to 41 weeks even for some reason. Apparently in Tifton, the doctors are somehow magically transported to a land where 39 weeks is the perfect time for a baby to be born because that’s when they start pressuring you to induce. 39 weeks IS the ACOG (American Congress of Obsterticians and Gynecologists) standard for the earliest SAFE date to ensure a full term delivery. That way, even if the dates are off slightly, baby should be fully developed and good to go. ACOG says c-sections and inductions should not be schedule prior to 39 weeks without a medical reason (and a medical reason means baby is safer out, than in – not just because you are miserable). If you don’t readily agree to an induction at 39 weeks, the doctors here start in with the “Well, they [the doctors] don’t like you to go past 40 weeks.” When you ask why, they can’t really give a good answer (and typically you are seeing a nurse practitioner at this point because the doctors are rarely in the office) and just repeat over and over that the doctor doesn’t like to go past 40 weeks. They may mention the word “risk”, but can’t answer what risk increases before 41 weeks. Statistically, the risks to the fetus/baby are the same at 39 weeks v. 40 weeks. In fact, post term is not even used in the medical community until 42 weeks*. There is zero medical reason to force induction on a woman who is 40 weeks pregnant as long as she having a healthy, normal pregnancy.

Back to My New Mom’s Story

As soon as S hit 39 weeks, the word induction started being thrown around, a lot. I went with her to her 39 week appointment and it was nearly every other word out of the nurse practitioner’s mouth. The pressure was clear. The pressure was strong. The problem in this case? One sweet little boy who had a very important doctor’s appointment RIGHT after mom’s due date. A doctor’s appointment that really needed Mom or Dad’s presence. So, the pressure came from the doctor, plus a desire to make certain that at least Daddy could go to the doctor’s appointment, a stubborn baby who was still comfy at 40 weeks, and suddenly an induction sounded like the best solution.

S called to tell me and said she felt like she was disappointing me. This birth is not about me. This is HER birth. She needed to do what was best for her family. I wouldn’t look at her any differently if she went ahead with the induction. Honestly, given the same circumstances, I can’t say what I would have done. I fully believe babies WILL choose their birthdates given the chance, but life happens. S knew she’d had good results and healthy babies from prior inductions, so why not give it a chance. She was, however, determined to do as natural an induction as possible and try desperately to avoid pitocin. She agreed to come in early in the morning to have a cervix ripener (in this case cytotec – please do your research on cytotec. S had had cytotec before with a prior delivery, so she knew how she reacted to it. She was NOT informed in this prior birth of the risks, so she’s fortunate that she did NOT have the horrible side effects that some women experience. It is NOT approved for use in labor and some women’s bodies react very, very strongly and negatively. S knew she did not because it had been successful in a prior labor, so she agreed to it.) and to break her water.

I arrive at the hospital around 7:45 am. We hung out, walked the halls (monitored the small contractions that were started), had some snacks (the hospital even let her order lunch – overall, I was very impressed with the hospital and how they handled everything), joked, laughed…

Around 11:00, her nurse came in and suggested she do a second dose of cytotec, see if she could progress a little, and then break her water. She, begrudgingly, agreed to that plan (she confessed afterward that she was not so sure about the second dose of cytotec and wonders how things might have gone differently had she not agreed to it, but while the nurse gave it to her as an option, there was no alternative suggested. So, really, it wasn’t an option. It was their plan.). Very soon, contractions really kicked in and things went from zero to, oh, 200 mph VERY quickly.

A Great Husband Can Be Awesome Support for Mom and the Doula

S’s husband, J, is pretty awesome. Very supportive of her wishes and supportive of her. I am so glad for men who aren’t afraid to manhandle their women when they need to! I don’t mean this in the way that it sounds. But, when you are in hard labor, you cannot physically move yourself from one position to another and she clearly, a few times, needed to move. I ran around getting things that might help comfort her (it turned out a wet washcloth and her birth ball – a yoga ball – were probably the 2 crucial items we needed and neither one of them came in my bag, but you never know…), used encouraging words (and, they naturally come out when you are in the situation because you REALLY do mean them! I told her she was a rock star because she WAS a rock star! Women are amazing!), and reminded her to breathe while he was physically present for her. He was her rock and you could feel it in the energy in the room. I was so glad he was able to be emotionally present for her since that, in my opinion, is a huge reason for having a doula – so that Daddy doesn’t have to be the one making her change positions, reminding her she didn’t want any drugs, making her open her eyes and focus,… He can just be there and be the good guy; the supportive husband and father. It was a beautiful thing to watch.

When the Baby is Coming

Within about 45 minutes of giving her the cytotec and about 20 minutes of breaking her water (No pitocin! Woot!), it was clear that her body was pushing and baby E was ready to come. J helped her (read as quickly propelled her) from the birth ball on the floor into the bed (which she did say she wanted at that point). She curled into the fetal position and we pleaded with the nurses to hurry up. Every contraction, you could hear her body pushing. She couldn’t control it. The nurses start screaming, “Don’t push! You can’t push!” If you’ve had a baby, especially without an epidural, you know how impossible this is. When it’s time, it’s time. To give the nurses credit, they very quickly broke down the bed and got the doctor in the room (who was out of breath from running from across the street at the doctor’s office – so glad she used a close doctor!). Side note: I learned that the breaking down of the bed is entirely for the doctor’s convenience. They put a nice little (well, big) bag at the end of the bed to catch all of the icky stuff and then put the drapes and gauze pads and all of that in with it and just throw it all away. Quite convenient for them, but pushing while laying down on your back is far from ideal. In this case, it really didn’t matter because that baby was coming fast, but it was still eye opening as to why they break the bed down and try to insist that women push in the flat on the back position. Less than an hour after S’s water was broken, her beautiful baby GIRL entered this world (which was really exciting since they didn’t know what they were having ahead of time!).

The rush I felt was instant and overwhelming and I did tear up – a lot. S’s labor was fast and furious, but she handled it with grace, her baby was here and was perfect, and, if we could just get the 10 people who decided to watch to leave the room, all that was left to do was to bask in the beauty of the moment (sadly, they didn’t leave until S and I both – and I think HER asking made the difference, not me. She mentioned that she might be more comfortable with skin-to-skin and nursing if a few people could hurry and get their booties out of there. There was plenty of time to clean up later. She needed to bond with her baby.). Overall, it was a beautiful, perfect moment and I was thrilled that they allowed me to be a part of it.

On Top of the World as a Doula

When I walked out of that hospital from my first live birth in my doula training a while later, I felt on top of the world. It was a pretty amazing feeling. I knew, without a doubt, that I had chosen the right path in life. I still feel strongly that I want to eventually be a midwife so I won’t focus so much on what is going WRONG in the hospital, but will be a part of making the routine less routine and the natural more the norm. For now, though, with young children still at home, this doula gig is a better fit. I feel strongly that each birth will help me to learn and grow as a person and as a doula. And, most importantly, it makes a difference in the life of the mothers , fathers, surrogates, and babies that I help to bring naturally and peacefully into the world! What a beautiful way to be able to contribute to the world!

*Source: //www.nlm.nih.gov/medlineplus/ency/patientinstructions/000515.htm

Mother of four boys and the wife of a minister in Georgia. The world is full of medical “miracles” but over time and lots of experience, this mom has discovered that raising a natural baby creates the most wonderful bonds and lessons for her children.

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