I attended my first birth for doula certification last week! It was an amazing experience. I wrote a birth essay to encapsulate the experience. Here is my essay for certification, with names removed.
Birth Essay – Baby Levi
Mama called at 10:30am. She was admitted to the hospital after a scheduled visit that morning showed a low fetal heart rate. The physician warned mama of the possibility of a cesarean section – but wanted to monitor and see if this could be avoided. We spoke again at 12:00pm and she happily told me the baby’s heart rate had stabilized and they were planning an amniotomy at 1:30pm. She said she would call me when labor began, and at 4:00pm I was invited to join them. I arrived by 4:45pm and assisted with her ever-intensifying contractions. We tried a variety of position changes and coping techniques during this time. Mama’s birth plan included her openness to an epidural, and at around 7:00pm she asked for one. She was tired and wasn’t keeping fluids down so they introduced IV fluids. Afterward she did not feel her contractions at all, but her nausea continued. She expressed tremendous gratitude for my aromatherapy techniques. At 10:20pm her cervix was checked and she was told to push, although she wasn’t feeling the urge. Beginning at 10:42pm she pushed for 2 hours (the nurse timing her contractions) before deciding to labor down while the epidural wore off. By 1:15am the urge to push was strong, and she began pushing again. After 30 minutes of pushing, her baby was born at 1:42am. Mama and baby experienced skin-to-skin contact immediately and were nursing within 45 minutes.
My role at this birth was to provide a calm, collected presence and offer suggestions for the father. Early in labor they had some questions and appreciated having me present for distracting conversation. When Mama experienced nausea and vomiting, dad and I took turns swapping and cleaning out vomit trays for her. I suggested essential oils on a damp washcloth and showed dad to hold it near her face during bouts of nausea, which really helped. I also suggested a variety of position changes; those she found most helpful were the birth ball, swaying, sitting, and semi-prone. Mama was not set on avoiding pain medications, and my role was to provide information and nonjudgmental support for her decisions. When she asked for an epidural I encouraged her to take some time to think about it and make sure it was her decision. I reminded her of other coping strategies we could try, and when she wasn’t interested I reminded her that she had the right to make this decision for her birth.
When Mama was admitted earlier that day she was nervous for the baby’s health and a c-section. We spoke briefly about this over the phone and she said that she accepted if this needed to happen, but she hoped it could be avoided. She was extremely grateful to hear that she could proceed with a vaginal birth and seemed to take this as a good sign. When I arrived she was talkative and chatty between contractions, but liked to go inward during contractions. She seemed to be coping well for a few hours, then as her contractions intensified she asked, “is this contraction going to end?” and I reminded her to focus on her breathing. Breathing and counting really worked for her as a ritual, but in-between contractions she had difficulty relaxing. Dad and I took turns massaging her shoulders and helping her release the tension. Once she got the epidural she was surprised by how good she felt. She said repeatedly how glad she was for the opportunity to rest and seemed satisfied with her decision. She was pleased that she “only needed the epidural and nothing else”. During pushing she said, “I thought this was going to be the easy part!” but she pushed like a champ anyway and kept her spirits up for many hours until she had her beautiful baby. Immediately after the birth she experienced shaking and chills for an hour. She said, “thought it would be over once he was out” and that she felt guilty that she wasn’t “enjoying him yet”. I reassured her that this was normal, that she didn’t need to feel guilty, and talking about it seemed to help. Within an hour she was visibly happy and enjoying her nursing baby. Afterwards Mama said she was especially grateful that I was there to help her relax and focus on her baby during this time immediately post-birth. Overall she seems tremendously proud and satisfied with her experience.
The main thing I learned during this birth was the power of flexibility to enhance the birth experience. Mama went into her birth well-educated, with a vague outline of what she wanted, and a lot of flexibility and openness to the experience. Her openness to pain medication and interventions helped her feel successful and powerful in her decisions regarding her birth. She didn’t view it as a failure when she ultimately felt she needed an epidural. I learned that being an effective doula isn’t about avoiding medications and interventions, but providing nonjudgmental support for someone to experience a great birth the way they define it.