I recently attended a birth where intervention was necessary. In short, it was an induction leading to cesarean. I can’t give too many details for the sake of client confidentiality, but suffice it to say, it was a difficult labor and birth. And it was the first time in my five years as a doula that I recommended cesarean. It was a little foreign to me, to tell the truth. Isn’t my job to prevent those kinds of things? That’s what all the “Reasons to use a doula” lists on the internet say. So shouldn’t I be pushing the parents to keep trying for that natural birth?
No. That’s not my job.
My job is to support and to help the parents make the decisions that are best–safest–for their family. And if that means suggesting an epidural, or recommending cesarean, then that’s what I will do.
I feel that in my short time as a doula, I’ve become a little more balanced. I’ve been to a few home births, a couple of birth center births, and a few hospital births. All but one of the hospital births I’ve attended have been inductions. One was a high-risk pregnancy with low amniotic fluid and the baby was at a great risk of infection; two were after ruptured membranes and no active labor. Some doctors have been more in favor of natural than others. Some nurses have been friendlier than others. But regardless of the situation–no matter what interventions the mother opts for, or what choices she makes in her labor, my job is to support.
And really, when you think about it, sometimes those inductions need more support than the natural labors. Trying to get into labor–the stress, the pressure, the time constraint–I’ve been there. I’ve had that experience myself. And then the added pain of Pitocin? Yes, that mama is in great need of support.
Some doulas become snobbish in which births they will or won’t attend. Some will only attend home births. Some will only attend hospital births. I’m comfortable in either setting, and I’ve found that I’m also comfortable helping mom to make the decisions that are best for her and her baby. I won’t speak for her–that’s not my job–but I will help her to weigh the options and discuss the risk and benefit for each possibility.
But again, I think I’ve become more balanced. No longer do I hold to the ideal that a natural birth is the only “good” birth. Nor do I assume that every mom who had an intervention is facing depression and guilt over her choices. Sometimes those choices are the best choices. And if I can give mama and papa enough support to accept their decisions, to be happy and comfortable with their decisions, even if–or especially when–those decisions weren’t on the birth plan, and were not what they had dreamed of in their childbirth class, then I have done my job.
There have been births where I have felt almost useless. After a few hours, they didn’t need me. But after the fact, they tell me, “We couldn’t have done it without you. Thank you for being there.” Maybe they don’t need me for the whole birth. Maybe they just needed me as “training wheels”. Maybe it only being the two of them at the birth was exactly what they needed. But knowing that I was there when they needed me, and that I gave them the support that they needed in those moments, and that I fulfilled whatever need they had of me for that birth… knowing that, I can feel that the birth was just as it needed to be, and that I played the role that was just right for that specific birth. Whether I rubbed her feet, or helped her breathe through contractions, or told her, “It’s okay to get the epidural,” I know that whatever I did was just what they needed. And that is my job.
That is what a doula does. Listen. Educate. Support.