One of the amazing things about being a doula is that I am a witness to new life being born into the world and parents being born as parents. It’s hard to get more hopeful than that. But as the hours tick by, the shininess of new life begins to fade into the harsh reality of the world we live in. Right now protests are churning across the country, mourning the horrific, casual murder of George Floyd, just the latest of so many lives taken too soon by a system built on racism.
Our country and our culture is founded on a system that oppresses black and brown people. In truth, there are degrees of oppressiveness for anyone who isn’t white and male. We simply cannot change this until we admit that it is there. And it is there.
Letting innocent people die, while we shrug and say nothing is wrong.
I’m white and I still have so much work to do. But I will not deny that this oppression exists. It is exacting a toll on black and brown people every single day.
Where does it start? Where does it end?
In my world it all starts with the parents and the babies. We know that black mothers and black infants fare better when they can have emotional support from people who look like them and can understand their experiences.
If you would like to support efforts that are already underway you can start with these organizations:
I will be spending the next weeks and months thinking, not only about how I can financially support efforts to mitigate and dismantle oppression and amplify the voices of black people, but how to make that support long term and how to build it into my business plan. I’ll admit, I’m more than a little bit bumbling and lost. But I will try. And I will fail. And I will try again.
This pandemic isn’t something I was prepared for. Yes, I knew it could happen in theory, but were any of us truly prepared?
I worried about what it would do to my work as a doula, what it would do to my clients’ ability to have doula support during their births.
But I care about life and death. I care about the vulnerable people in my life. I care about my clients and their families and the vulnerable people in their lives. I have no wish to endanger anyone unnecessarily.
Prenatal visits became Zoom calls. Postpartum visits became Zoom calls and phone calls. And birth support itself became virtual. This was strange, especially because one way that I often describe my work if I have to encapsulate it in “elevator speech” format is “I go with people when they have their babies to help guide them through their birth.”
So what happens when I can’t go with people as they are having their babies?
Am I useless? Or is my job description just a little flawed?
The truth is that my birth doula support begins way before the birth and continues well after the birth is over. It’s in the articles and information that I curate for my clients. It’s the way I answer their questions without judgment. It’s the positions and techniques I teach them for comfort in labor. It’s the validation I give them for how they are feeling right now. It’s the guidance I give to their partner about how to be there for them in the most meaningful way possible.
By the time they are at the end of their pregnancy some of my clients are excited about birth, when they used to be scared, some are just more confident because they know more. Some have unexpected challenges at the end of their pregnancy and need me to help them to know their options so they can pick the path that feels the best to them.
During labor, I may not be physically present, but I am still available for my clients every step of the way.
I’ve been a virtual birth doula for a couple of my clients now and do I love it? Not exactly. It feels strange to me not be able to provide that calming touch, grab that water bottle, or lock eyes during an intense moment, but there is still SO much I have been able to do while I am “at the birth”. Things like:
Listening to what discomforts they are feeling and suggesting a different position
Suggesting a massage, counter-pressure or acupressure technique for the partner to do
Letting a client cry and process some difficult moments from the birth
Talking over labor progress and thinking about possible options – everything from positions and non-invasive techniques to try, to medical interventions that may be available and pros and cons of all the options
Helping decide if and when to get an epidural
Helping to process the change to a cesarean birth and helping it to feel like a joyous and triumphant birth
Logistically, here are the things I have done to prepare for providing doula support when I can’t actually be present in the room.
Extra virtual prenatal visits to help partners feel like they have the chops to provide the physical support needed. This means trying out Spinning Babies techniques, Rebozo techniques, finding acupressure points, and trying out massage techniques with me watching so you can get comfortable doing them.
Technology – A laptop, phone, or tablet with Zoom, Facetime, Google Hangouts or any other video calling software. If using a phone, it can be helpful to have a flexible tripod like this one so you’re not spending time and effort trying to prop it up (if needed I can buy this for clients and then sanitize it for the next person). Another awesome technology tool could be bluetooth earbuds, so that partners can wear one earbud to get Cyrano-like direction from me without disrupting the person who is laboring and birthing. Clearly, those can be expensive, but if you wanted an excuse, this would be it!
Tools – I provide clients with a rebozo, which can be really helpful for squeezing hips when that’s too much for one person to do all the time and SO many other comfort measures. These Aculief wearable acupressure thingys can be good for pain relief without needing to have your partner wear out their hands providing it. I have some that I can lend to clients for use during labor and sanitize for future use. Also Sea Bands for acupressure to treat nausea can be used as intended or on the feet for an acupressure point that decreases anxiety (Kidney 1). These are fairly cheap to buy. (These ones cost slightly more, but are adjustable in pressure and length). A battery-operated fan (something like this) can be awesome too when you get to that part of labor where you’re working so hard that you’re HOT!
Old-fashioned team building – If my client is in the hospital with me on virtual doula support, I send them with a bio about me to give to their nurse(s) as an introduction to me and the support I will be giving during birth. If the situation allows, I love to “meet” the nurse to say hello and build that team feeling so we can collaborate to support you.
Following the birth, I’ve been able to continue to provide the postpartum follow-up similar to how I would do it in person. I was able to help a breastfeeding latch feel more comfortable over a Zoom call while my clients were still in the hospital. I help strategize about how to get more sleep and how much feeding and crying is normal and I can give referrals to specialists if needed.
Birth doula work is in many ways what it always was: It’s supporting my clients, the complex humans they are, as fully as I can given the situation we are in.
And it’s a comparison that goes a long way (see what I did there?)… but it doesn’t go all the way. I’ll tell you what I mean.
The analogy works when we think about the fact that labor is quite a journey and often takes a long time too. Coping with labor can be like coping during a marathon when we think about “staying in the moment”, “putting one foot in front of the other” or relying on breath and rhythm to keep us going.
But when we think of sporting events we also often think of “toughing it out” or “powering through” or “gritting your teeth” to get to the end. These are phrases might work if you’ve hit a wall while doing a marathon but they just aren’t helpful in labor.
Because labor isn’t something you tough out, it’s something you soften into.
Coping with labor–it’s bigness, it’s intensity, it’s unpredictability–works better when we can let go, get soft, and actually take away our tough layers until we’re loose, mushy, and vulnerable.
When we can stop tightening up to brace for the next labor wave, the labor actually becomes easier. For some it might actually feel enjoyable to ride those waves in the process of bringing new life into the world.
As a birth doula, I can help prepare you for a birth that you can relax into. I can sprinkle calm dust all over your room and help you to breathe out any worries and breathe in the steady, soft strength you will need.
Last year 2 years ago, at about this time today, I gave birth for the 4th and last time. How many times have I said it was my last? Well, 3, but this time I think it’s really true. I turned 40 41 this year, I have a teenager and another almost-teenager, and the last two pregnancies were for families other than my own. I’ve done more gestating than most!
I’ve wanted to write this last birth story for a while (as you might have guessed from my edits), almost since the day she was born. But I haven’t quite known what to say. It’s not that I am at a loss for words, more that I have too many thoughts and words all jockeying for the same spot. All wanting to explain why birth is important–why birth matters.
This is not just the story of this last birth. Because the story of the last birth encompasses all the births and pregnancies before it. It can’t stand alone.
I want to tell the story of how transformative those births were for me. How elated I was after each one. Stories are powerful and we don’t get to hear enough positive birth stories. But I also fear coming off smug or preachy and that’s the last thing I want. I know how lucky I have been, not only for the genes I was dealt, but also that the path of least resistance for me when pregnant the first time (for financial/insurance and social reasons) was actually to have a homebirth midwife. For most birthing people, the path of least resistance is to use with the OB they saw for their PAP smear, at the hospital their insurance happens to cover. It would be many, many years before I fully realized the impact of choosing a homebirth for my first birth. But perhaps that’s another story…
So, please, come with me on this rambling ride and see what you take away.
My first birth taught me that no one needed to tell me how to birth. I knew what to do from somewhere deep inside. My midwife watched me and my baby carefully, but was very judicious in offering me advice or suggestions. Of course she stepped in when I needed her and offered the kind of subtle guidance that midwives tend to, so I came away feeling that I had figured it out all by myself. I also learned what an amazing afterglow you can get from a really good birth. Despite being weak and depleted in my body, I felt strong beyond belief. It’s not logical, but was a tremendously wonderful way to begin motherhood with my new daughter.
My second birth, with my son, taught me that birth can be sensual and enjoyable. This birth was almost easy. During very early labor, (shh, this is taboo) my husband and I even had intercourse because it felt right and it felt good. It didn’t seem radical at all. Contractions were still far apart (10-15 minutes) and quite mild. It was sweet and deepened our connection. Afterwards, my husband had a sudden inspiration for the middle names (yes names, we picked two) for a boy and it clicked. We had the girl name figured out, but we finally knew what the name would be if we had a boy. A few hours later, labor picked up and progressed, but it never really felt hard until I reached the pushing stage. This part was terribly short (under 5 minutes) and rather shocking, I must say, but it was really the only hard part about the labor. The same day (or the maybe the next day, I can’t remember), I was already sad that I wouldn’t ever birth again, since we had only planned to have two children.
Besides teaching me that birth could be sensual and enjoyable, the other thing that my second birth taught me was that I had an intuition, and that I could begin to trust it. My contractions started around 2 am. By 7 am, they were stronger, but still very far apart. We decided to call the midwife and let her know what was going on. Towards the end of our conversation she asked me, “What does your intuition say?” and, somewhat confused, I replied, “About when the baby will be born??” And she said, “Yeah.” And only in that instant, did I realize I had an answer. I said, “Early afternoon?” and she said, “That sounds about right.” My son was born at 12:45 pm.
My third birth was a surrogacy. I had more worries about this birth for many reasons. The first was that I’d had my first ever miscarriage with the first pregnancy for this couple. Losing that baby at about 10 weeks in a missed miscarriage was very challenging. I took medication at home to complete the miscarriage and lost what felt like a scary amount of blood. We went on to do a second embryo transfer, which stuck, but I had early pregnancy bleeding (common with IVF, but scary nonetheless) that made everything feel more uncertain for almost half of the pregnancy. This third birth was my first hospital birth and I was apprehensive about what that would be like. I don’t mind hospitals, and I’m in them all the time for my work as a birth doula, so I felt like I knew the lay of the land, but like all birthing people I was apprehensive about when would be the right time to go into the hospital and what the process would look like for me in this new environment.
What this birth taught me was that my labors are “shy” and that the hospital providers didn’t trust my body the same way my midwife had. With this birth my water broke before labor contractions started. We went to the hospital on medical advice, but labor did not get active despite waiting through the night and then trying nipple stimulation in the morning and afternoon. About 18 hours in, with no labor to speak of, the nurse and midwife began to talk about Pitocin augmentation. I knew that Pitocin could be helpful, but I was still skeptical that I needed it. After talking to my doula and my husband, we decided to ask for one hour of uninterrupted time. Everyone left the room except for me and my husband and we hopped into the shower together, where with privacy, warm water, and a few drops of clary sage essential oil on the bottom of the shower, labor began to roll almost instantly.
About 5 hours after getting out of the shower, surrogate baby #1 was born.
It was only after this birth that I remembered how in my second birth, my contractions had disappeared for stretches of time, when I was talking to a friend. It didn’t happen in my first birth, but then again no one really tried to talk to me! I realized that even calm, casual chatting was enough to make my body push the pause button on labor. I didn’t need Pitocin, I needed to turn off my brain.
This 3rd birth was intense. I really thought maybe I couldn’t do it. Maybe I would need the epidural after all. But that turned out to be the transition talking. And just like with my second birth, pushing came on suddenly and was over in under 5 minutes. I felt and sounded like a wild animal, I’m sure. And then it was over and the euphoria kicked in. (For more on this birth, see this blog post)
So finally, when it came to having surrogate baby #2 (birth #4) I knew some things. This time I was carrying for a close friend who was, amazingly, agreeable to having a homebirth, provided the pregnancy stayed healthy and low risk. It had taken a few embryo transfers before we successfully achieved pregnancy, but somehow, even though this was the last embryo and a lot was riding on it, I felt completely calm and reassured that everything would be ok. We hired a homebirth midwife and began to have visits. This was a new midwife, as my midwife for my first two births had moved away and was semi-retired. Unfortunately, despite trusting that she had solid skills, I was not clicking with her. Something felt like it was missing or off.
As a doula I tell people all the time that it’s okay to change providers, but it still felt uncomfortable to do it. I had talks with the mother-of-the-baby and she was feeling the same thing I was. We interviewed another midwife team and decided to switch care right around the start of the 3rd trimester.
I knew these new midwives professionally and I also knew a lot about myself as a birthing person, so I felt pretty confident expressing that I didn’t want a lot of hand-holding during the birth, I really just wanted experienced midwives who would recognize if something was not-normal and needed intervention. They took me seriously and when it came to the birth I felt completely in control of my care.
My first baby was 41 weeks when she was born, but the last two babies I had birthed (the boys) came at 39 weeks 1 day and 38 weeks 2 days respectively. I got the impression that I had just gotten more efficient at growing babies! My due date was 12/15 for this girl, so I assumed that I would be giving birth in the first half of December. But 38, 39 and 40 weeks came and went and still we waited. Finally at 40 weeks and 2 days, I woke up to mild contractions about 10 minutes apart and some slight bloody show. YES! I knew we were close.
Our plan was to have the baby at my friend’s house, the home of the baby I was carrying. Both of my kids wanted to be there to witness it. There was going to be quite a crowd at the birth. It would be me, my husband, my two kids (aged 11 and 15 at the time), my mom (to attend to my kids if needed), both intended parents, the sister of the intended mother (who would take pictures), the two midwives and a midwifery apprentice. It was a Sunday morning and my daughter had a volunteer shift at a Christmas tree lot from 12-3. We debated whether she should try to get someone to cover her shift, or try to arrange for someone to give her a ride if we needed to go to the birth place before she was done with her shift.
There wasn’t a really good option presenting itself, so we decided to wait and see. All morning contractions continued, but stayed very infrequent and very mild. Around midday the contractions slowed waaaaaay down. My daughter went to her shift and I attempted to nap–I’m not a stellar napper, but I did get some rest. I counted one contraction in that time, about an hour from the previous one. It was safe to say I felt comfortable waiting for my daughter to return. Clearly the babe wasn’t in any great hurry.
But, as I noted, I know my body and I knew that my body has a tendency to wait if all the ducks aren’t in a row. So we made the plan that we would pack up, head to the IPs house around 4 to get settled in, thinking that labor would pick up once everything was ready.
So when we got there, we said hi and I opted to hop in the shower with my husband. It had worked with the last baby! But… while the shower was nice, and we succeeded in getting more frequent contractions, they were only every 8-10 minutes, hardly active labor. We took a break, ate some pizza and then I went to the room that my IPs had set aside for me. I was a little discouraged, but also determined. I think I tried some nipple stimulation. No dice.
Not quite ready to give up on making labor happen, I texted my midwives in the impatient way one does when labor isn’t doing what we want it to do.
Me: “Hey, we’re all settled in at [Intended Mother’s House]. I spent some time in the shower with [husband]. We laid down for a little bit. I got out the breast pump for a little bit, but contractions are still pretty spaced out. Active labor hasn’t magically manifested like I had hoped. Still having plenty of mucus and light bleeding. Do you think a membrane sweep would help at this point? Any ideas?”
They responded appropriately, of course.
Midwife 1: Hi Scarlett… that all sounds promising 🙂 Are you worried things aren’t going to pick up or are you just wanting them to pick up now? I’m sure your body knows what it’s doing and is gearing up… I’m kinda thinking this may be a middle of the night birth? Maybe rest is the best idea?????
Midwife 2: I was thinking the same.
Me: I guess I’m wanting them to pick up sooner than later since everyone is here and waiting. You know, all the good reasons…
Midwife 1: Well… they’re not going anywhere. And we all know what happens to the watched pot!
Me: I have been resting a lot of the day, so that’s good!
Midwife 1: I think the bloody show is a great sign that it’s gonna happen soon!!
Midwife 1: You could try nipple stimulation or breast pump 15 min on, 5 min off for an hour… that’s a pretty intensive pumping schedule
Me: That is pretty intense. I’ll think about it!
Midwife 1: K!
Midwife 2: Ok 🙂 this does all sound pretty normal so far for warm up labor. If there isn’t a baby yet in the morning I could come over first thing and check you and do a membrane sweep.
Me: That sounds like a good idea. We’re gonna try some posterior baby stuff and see if that changes anything, but if nothing much is happening by bed time we’ll just go to bed.
Midwife 1: Sounds like a good plan.
Midwife 2: Sounds good.
So we did try some “posterior baby stuff” for good measure. I think I had my husband help me with a sidelying release. And then there was nothing left to do but remember that labor cannot be forced.
We went upstairs where my mom was watching the first Star Wars movie with my kids and the intended parents (IPs). We watched the rest of the movie and told everyone that we were going to go to bed and they all should too.
My mom went home (she didn’t live far), we put the kids to bed on the couches upstairs and the grown-ups went downstairs to chat a bit more before turning in. As we were talking, I was on my knees leaning over the ball and the labor contractions were starting to get stronger and more frequent. I went with it and took notice. They were beginning to come 6 minutes apart. I had this exchange with my midwives:
Me: Contractions are about every 6 minutes for the last 45 minutes and feel like they’re getting more intense.
Midwife 1: That’s sounding like the right direction! Keep us posted… How long are they lasting?
Me: Just under a minute. Like 55 seconds-ish.
Midwife 1: Great!
At around 11 we wrapped up chatting and went to bed… or tried to anyway. About the time I turned off the lamp and tried to settle in I found that I couldn’t quietly breathe through a contraction anymore. I went to my old, familiar low moaning sounds. But the contractions weren’t getting noticeably closer together so I was reluctant to call in the midwives. My husband on the other hand, well, he knows me and he knows how I birth so he began texting the midwives.
Husband: [Husband] here. Contractions are still about 50 seconds long, and coming 5-6 minutes apart, then a few that are 10 or so. BUT they are getting more intense/strong (she is vocalizing more and more).
Midwife 2: Ok- I’m going to head over.
Midwife 1: Hey [husband]. Sounds like she’s moving in the right direction. Does she want us to come over now?
Husband: She’s indecisive. She’s hoping it’s not a false alarm, but it does seem to be picking up. It may be baby’s position? Maybe one of you could come check in?
Husband: Sorry for the delayed response- rode out a strong contraction in the middle of typing.
Midwife 1: It’s not a false alarm 🙂 Good work! We’ll make our way over.
Husband: (“ok” emoji symbol)
One of the student midwives arrived first and checked my vitals. Then Midwife 1 arrived. Contractions were very strong, but felt like there was lots of space between them. This made me nervous that everyone was here way too soon, but also it felt an awful lot like my second birth had.
When Midwife 1 checked in with me, I explained my reservations and asked her if she wanted to check my cervix to find out where I was in the process. She happily obliged. When she checked me, she said I was 6 to 7 cms, further dilated than she would have guessed by looking at me.
We were filling the tub already and I was happy about the prospect of getting into it. Before the tub was ready, I started to feel my body shaking and I wondered if the birth would be very soon. My mom was on her way back, or maybe she had arrived already.
Once I got into the tub, everyone was in the downstairs room with me. My kids were on the couch with my mom. Midwives were camped out on the floor. Husband was holding my hand from the sidelines. IPs were sitting quietly. And Auntie was taking photos now and then.
The tub was hot. I took long drinks out of cans of coconut water that had frozen slightly in the fridge and it was heavenly.
I used my low, loud moans with every contraction. It was hard, but felt manageable. I would look around at the sleepy faces now and then and crack a wry joke.
Eventually, I felt like I was SO close to giving birth and right before every contraction I would think, “Is this going to be the contraction where the bottom drops out, and the baby comes out in one big, terrible push?” But then the contraction would happen, I would feel slight pressure, but nothing like the real urge to push. After what seemed like at least an hour of this (time, who knows?), I looked up at one of my midwives and said, “What do you think is happening here? Do you think it’s an anterior lip?” And she told me that she could check to see if I wanted her to. I did.
She checked me while I was still in the tub and she said that there was an anterior lip, but it was soft and moved right out of the way when she touched it, so she didn’t think it was holding the baby back. She did say that there was a bulging bag of water and that this baby might be bigger than my previous babies and just need this water to break so that the head could come down more quickly. She said that she could break my water to help us get the rest of the way.
I thought it over, and I knew that once my water was broken the next contraction was going to be The One which gets the baby out. But I’d been waiting/dreading that moment for quite some time anyway and I didn’t want to wonder and wait anymore. I was ready. She broke my water with a little prick and on the very next contraction there was no mistaking the Fetal Ejection Reflex that kicked in.
It’s hard to describe what it feels like. What I can tell you is that I yelled my head off, saying things like, “I can’t breathe!” (I could definitely breathe) and “I can’t, I can’t” (I could) and “Oh God, Oh God.” I gripped my husband’s hands and held on for dear life as the baby rocketed out of me. This part of birthing is not pleasant for me and does not feel manageable. But I don’t think it’s pain that makes it unmanageable, I think it’s the speed. In these 3 minute pushing sessions, it’s like someone opened a trap door beneath me and I’m in free fall, clutching and screaming. Thank goodness for hand-holders and the relief when the baby is finally out.
6 minutes after my midwife broke my water, at 5:54 am, all 9 lbs 1 oz of my belly buddy was out, caught by her very own mother who had gotten into the tub with me for just that reason. Sadly, the first words that little one heard from me were profane as I yelled “HOLY S&*%T!” right after I caught my breath. It was a second before I could turn around and take in the beauty of my friend, her husband and her baby, united at last.
What this last birth taught me was that as much as I really wanted one of those controlled, blissful, calm pushing phases I will not get it (not that I’m ever having another one, because I am not). I tried really hard to mind-over-matter my way into a calm and collected pushing phase, but I was spectacularly unsuccessful. The birth reminded me how wonderful it feels to have my autonomy so respected and to have complete trust from my family and my providers.
Birth matters because we are so vulnerable during our birthing times. We need tenderness, respect, and choices that are not an illusion. When we have these things, we can come through birth feeling more powerful than before even if the birth looked nothing like we wished or expected it would.
My births taught me about compassion and love. And this world needs more of both.
If you’re the kind of person that thinks helping equals a lot of doing (hint: this is a pretty common belief among cisgender men) then you’re more likely to feel helpless during the process. But if you can adjust your perception to include “holding space” as something that you are “doing” you will not feel helpless even if your body is largely holding still.
If you don’t know much about the concept of “holding space”, this article will demonstrate how a midwife or doula can “hold space” simply by knitting in the corner. This article explains “holding space” in the context of a relationship, but it totally works for labor (and can be great to learn for the postpartum period, and really, for the rest of your relationship and your life).
If you had someone who held space for you during your labor, tell me your story! Let me know what that support looked like and how it felt for you?