The Birth Stories Begin...

Often my work as a doula could make a Hollywood movie seem tame in comparison. Throughout the years that I have been privileged enough to do this work, I have encountered situations that would make your hair stand on end, gasp for breath in shock or just make you fall down and laugh hysterically. Seriously, no one could think up the stuff I have been challenged with! Some of the stories I’m about to share truly showcase my love for this work and will leave you in stitches in the meantime.

I am always honored to attend repeat clients. It truly is the best compliment a doula could get, being hired again and again by the same couple as their family grows. It is also an honor when a specific group of people place their trust in me as well. The Mennonite communities are some of my favorite people—they lead a simple life and truly accept and surrender to the process of childbirth. As an outsider it often comes as a surprise to me that I am hired, but being the only option that bridges midwifery care with the medical model is what leads most of them to me—that and a heavy referral base. Think Amish, but they have electricity and vehicles!

Since maternity care is so few and far between I do quite a lot of traveling as a doula, sometimes upwards of 3 hours one way to attend a family as there aren’t any doulas or midwives available to them and their delivering hospital can be as much as 2 hours away.  In July 2013, I was discharged again to the small village of Rolling Hills about a 35 minute drive from the town of Brooks in Alberta, my home province. This would be my first time with a “five-peat”…my fifth time attending this same couple. People are often confused as to why a woman bearing her third, fourth, fifth or more children would even need the services of a doula, but keep reading.

I arrived at their home around 5 o’clock in the evening, to her puttering around, folding laundry, getting the other children settled down for supper and silently stopping for the odd contraction. Most of the Mennonite women I have attended do not show outward emotion, even in pain; they just surrender to the process completely, trusting God will guide them through. It is a very peaceful environment but if you’re not keeping a close eye out, things can radically change in mere minutes. I knew this woman labored quickly once she got into the active stage of labor, and by quickly I mean very, very fast. We were in hospital for only 33 minutes last time before her daughter was born. I spend most of my time in silent observation with this couple, as they have the art of childbearing down to a small science. I started to time the contractions in my head, only going by a ‘tell’ she had that I had picked up in her first birth; her right eyebrow would raise slightly during a contraction, but she rarely stopped moving and did not change her breathing pattern much at all. Anyone else would have missed these signs, even her husband to this day wonders how I know when it’s time to go to the hospital with her! He’s always like, “What eyebrow thing?”

Around 8 o’clock in the evening I knew it was time to begin the drive into Brooks, the only sign I had that things were moving along was that raising of her eyebrow and it was happening every 3 minutes. Thankfully her sister-in-law was helping out that evening, putting the other children to bed as we silently stole out of the house. This mother climbed into their van in the passenger seat, as I climbed into my car and followed. I always tell dad’s that if something disturbing happens, to quickly pull over and I will offer assistance. I have never had a dad actually pull a vehicle over; usually they floor the gas and drive like demons, leaving me eating smoke and dust! Not more than 15 minutes into our drive, while I’m blasting “Born This Way” by Lady Gaga, this dad suddenly slams on the brakes and swerves for the ditch. First thought—a very bad word! I pull in behind them and I can see through the back hatch window the mom climbing the seats of the van to get into the back hatch part and I can hear her yelling that, “It’s coming,” from two feet away. Keep in mind, this woman never before made so much as a peep birthing her other children! I race up to the van as the automatic hatch opens as dad is scrambling to get out of the driver’s seat. I bolted to the back of the van, the hydraulic lift humming as the door went up. Sound goes from a muffled panicked yell to decibel eardrum splinting level. What happened next could not have been better timed.  All I see for a split second is a gigantic bulge of membranes presenting, probably as wide as a bread plate, as she’s squirming on her bottom hiking up her skirt. She looks at me with a very stunned look as I look at her with probably the very same look. Then BANG!  Yes, that load of amniotic fluid hit me squarely from neck to knees coming at fire hydrant speed. Thank goodness my mouth was closed! My boobs were now swimming in the fluid in my bra, I’m soaked through to my skin, and there’s meconium in the fluid.  It’s all over me so how could I miss it! Quickly I run back to my car, turn it off, lock it and leave it on the side of the road. All of this took maybe 3 minutes?  I jump into the hatch and tell dad to get us to the hospital, which we still are about 20 minutes away from. The hatch automatically closes as I kneel beside this mother, trying to mop up the river of fluid streaming out of her with her skirt. Dad floors it, literally goes from zero to 120 km/hr in a matter of moments, the engine of that van screaming under the duress of being pushed into overdrive.

Meanwhile mom is panting; I can see a little circle of hair—beautiful dark wisps poking out between the folds of her vagina. I calmly tell dad to go faster! I think at one point he hit 160 km/hr. Now anyone who lives in Southern Alberta knows the main arterial highways…they’re busy and loaded with truckers. This little highway we were on connected to the TransCanada and usually you have to come to a complete stop before proceeding; or get run over by a semi. I could see the highway getting closer and closer through the back side window and dad wasn’t even slowing down. Traffic was light, but there was traffic!  Mom is grunting now with her contractions, which thankfully spaced out since her water broke, but she desperately wanted to push and her body wasn’t taking “not yet” for an answer. I focused on her face, kneeling on my knees, her face in my hands having her breathe in pattern with me, “Choo, choo, choo,” just like an old-fashioned steam engine. If she breathed, she could not actively bear down with her contractions and all I could do was hope and pray her body wouldn’t decide to hit the eject button! Next thing I know we’re both rolling across the back of the van, my head connected squarely to the side window frame, a goose ache and a major migraine followed. Dad did not stop but took the corner onto the highway at a blistering speed. To this day I’m still amazed we hadn't rolled or got into a collision!  He politely yelled back his apologies at her whimper of distress and from the sound of my head cracking against the window. I knew we had about 5 more minutes to get through, but baby’s head was now presenting to about the size of a tennis ball and my eyes are watering from my own pain. I focused her into more breathing while I silently did more praying!  I’m cold from being coated in amniotic fluid, my head is splitting and this birth is imminent. How in the world did I get in this situation?

We pull up to the hospital and drive up to the ambulance entrance, about as close as one can get with a vehicle to the hospital in Brooks. Dad opens the hatch as he jumps out. Mom’s yelling now that she’s really got to push, so Dad scoops her up in his arms and runs for the entrance. I follow, leaving the vehicle running and the doors open. If you can visualize it, think of a clown car that just vomited its occupants haphazardly! Like ants abandoning the ant hill! I’m racing to grab a wheelchair, which dad deposits mom into and she’s leaking fluid all over the floor. She’s now yelling, “Doulas are the best!” Medical personnel and other people spill out of the ER, doctor and nurses follow us as we make a mad dash for the LDR wing, mom yelling about doulas all the way. This trailing entourage does not assist with anything but rather just witnesses the gong show.  Nurse at the LDR desk greets us, takes one look at my drowned rat status and chuckles that, “You took one for the team.” I bark out, “Fifth baby, water broke, pushing, head crowing,” as mom is wheeled into a labor room. Dad and I barely get her on the bed before a beautiful baby boy slid out of her like a giant bar of soap, hollering at the world at his arrival. The bed caught him as everyone else was completely unprepared!  Baby was born a mere 2 minutes and 22 seconds after hitting the hospital.  This was my quickest hospital entrance to baby birth yet. But at least we made the hospital and I have yet to add car birth to my resume.

Afterwards I was given a pair of clean scrubs to change into by hospital staff, even though it’s against their policy, an eye wash just to be sure I didn’t have meconium in my eyes (I didn’t) and eventually was driven back to my car by dad, albeit at a much slower pace, a few hours later so I could make the hour drive home. It was somewhere just outside of home that my heart finally settled in my chest, the adrenaline leaving my body like a deflated balloon. Births like these may seem like a doula is doing nothing, but believe me, she’s doing plan A, preparing for plan B and cooking up plan C!

What Do You See?

What do you see, doula, what do see;
What do you see when you look at me?
Am I a mother who's knowledgeable and wise;
Strong and capable at birth in your eyes?
I shower, I lunge and I rock on the ball;
My husband and I go for walks down the hall.
I trust my instincts to squat and to stand;
You show your support by squeezing my hand.

The lights are dimmed, the music turned on;
The concept of time has come and gone.
I release my fear when the surge rides high;
I blow out my breath on a mighty sigh.

The pressure overwhelms, the urge is strong;
You smile at me and say, "It won't be long!"
Suddenly there is a hive of activity;
Bright lights, loud voices - the commontion scares me.

My husband holds my hand, you whisper in my ear;
"Listen to your body, there's nothing to fear.
"I breathe my baby down, slowly blowing out;
The burning is so outrageous that I have to shout!

I feel my baby crowning, my journey almost complete;
I see a head, shoulders, legs and finally - tiny feet!
A wet warm baby is placed gently on my chest;
After all, I had read that skin-to-skin was best.

I stroke that velvet skin and cry silent tears of joy;
My baby...My baby...My beautiful baby boy!
I turn to you with my heart on my sleeve;
"You did the work," you said, "all I did was believe."

I wrote this poem in 2010...so what do I see? Strong, capable, smart women - loving, gentle, encouraging families. This job resonates within my soul...I truly love what I do.

The Birth Story

This is probably the most challenging aspect of being a doula.  Some doulas write them, others don’t.  I always have but finding the delicate balance of writing my observations without taking over the story can be incredibly difficult.  I witness the actions, the environment and the timing but I’m not the one experiencing the story first hand. 

Truth be told, writing is not my forte and I struggle immensely sometimes to find the right words, the right flow and the right pace.  Birth has a lot of stops and starts, often extremely slow in the beginning and then winding up to a crazy finish.  How to document all that, especially if a birth is particularly long, grueling or negative?

I have tried to find the positive in all births, moments where moms are particularly strong—either in their determination or when faced with difficult decisions; the comedy—like when I slammed the back rest of the car seat into a mother’s face giving her a bloody nose in the midst of 2 minute apart contractions; but sometimes I have to relive the trauma and find the light of the situation.  I can only write what I see—and often times I wonder if I wrote what the mother felt.

Those stories are slices of time in a couple’s life—a time when most families are working together and working at their best.  I see parents united through some pretty intense moments, overwhelming choices and bear witness to their hopes and dreams.  Ultimately though, I am only an observer and some of those stories take me an awful long time to write.  I’m long-winded, you see—what normally can be told in a few words, takes me a paragraph.  I stop and start…I agonize…I finagle...I laugh…I weep, and I try desperately not to write my own emotions into it.  It’s not about me, it’s about the amazing journey two people took to bring forth new life into the world, but damn it’s so very hard to get right!  I worry that my client’s saw their births completely different than I did; perspective and perception of situations are a delicate line to walk.  I worry I got it wrong.  I worry…period.  I am documenting an intricate part of this couple’s, this woman’s, life—the birth of a child.

There are stories that take me days to write; I literally have to walk through the minefields of time, action and emotion and there are others that I can pound out in mere minutes.  I’ve often been asked if I have a “formula” when I write them—sorry, not Danielle Steele or Nora Roberts here!  Each story has the same first and last paragraphs…all the pages in between come from my heart.

I have danced with the idea of not writing them at all, but many of my previous clients tell me they cherish those stories.  I’ve actually been hired just for the stories and not because of my skill as a doula—I’m not sure what I really think about that to be honest.  I offer so much more than the story; or at least I like to tell myself that.

If I wrote yours, I hope I got it right…

Chapter Seven: Knocked Up, Knocked Down

Loss.  That one word ripples throughout the birth world at a rate most will not believe, and yet many cannot perceive.  I know most of you will go, “Nope.  Not going here.  Next!”    The creation of human life is one of the most complex and shockingly beautiful things women’s bodies are designed to do.  The micro-anatomy that goes into this complex task is so astonishingly complicated that it truly is a miracle any of us walk around at all.  And yet, most of us do.  Most...but not all.

When a baby dies, a mother dies or a uterus is lost in a life-saving attempt—all becomes fragmented.  Shattered.  For all those mothers, fathers, families, nurses, doctors, midwives and yes, doulas—we all must pick up the pieces.  Those jagged remnants of reality become a new paradigm for all those involved.  I have watched marriages fail under the stress and strain.  I have seen fabulous practitioners move on to other areas of practice or leave the field entirely.  I have heard of other doulas, myself included, deal with secondary post-traumatic stress.  No one is ever prepared for this—no one.

As a doula, I have personally witnessed the devastation of many, many miscarriages and the heartbreaking loss of four cherished and much wanted babies.  Those experiences alone, coupled with my own losses brought me to the brink of desolation, despair and depression.  Pregnancy and birth are supposed to be joyful; children are supposed to outlive their parents.  Why, after my own personal hell, am I subjected to the pain and grief of someone else’s?  Because it is my job—one of the hardest, most demanding roles in antepartum and labor support.  For some women it is not about the “birth” experience at all, it is about bringing a baby home.  For every woman I serve, I never promise that everything will be alright, as you just never know, but I continue in my hope and faith that all avenues will somehow meet and a happy outcome will be achieved.  It’s the only way I can do this job and stay sane.  I have walked that lonely terrifying road personally—I get it, I really do.  

What makes being a doula so cathartic for me is the request to serve those women and families again should they make the decision to try for another pregnancy.  I have been asked back by all those families, plus many others going through their first pregnancy after a loss.   Courageous does not accurately describe these women.  I am in constant awe of the resiliency of the human spirit, the will, the drive, the bravery and the dignity these women have shown.  I am honored that they see my presence not as a hex or a curse, but of value.  At any point, I could have been the scapegoat for the previous situation and had all their anger, resentment, hate and bitterness directed at me.  Believe me, it happens.

Unfortunately loss for me as a doula doesn’t just end with the little ones.  Thankfully I have only been in this situation once, but losing a mother was one of the hardest roads back I have ever traveled.  Yes, women can and do die in childbirth in this day and age.  The saddest part of this, aside from a husband  left with two little boys to raise alone, was this mother talked with me at length about having a vaginal birth after a cesarean.  We met and bonded over the course of several weeks.  She ended up choosing a repeat caesarean and declining my service for the birth, but requested me for postpartum help.  I read her obituary in the newspaper four days after our last conversation and her decision. I became unhinged.  The floodgate of questions and tears have never really stopped, not even eight years after the fact.  I still wonder if things would have been different if she tried for a vaginal birth.  I will never know.  It is a heavy burden to carry even though I know realistically nothing was my fault.  I wasn’t even there. 

Now most people associate loss with mothers or babies during childbirth, but there is another type of loss.  The loss of fertility.  I’m not talking about choosing to end reproduction by tubal ligation, rather I am talking about going in for a life-saving emergency surgery and waking up with a hysterectomy.  This, like the other losses, has a resounding bang of finality.  The shock and horror, the grief and heartbreak is just as profound.  I’ve held together a few women through this and while I am very good at hiding my emotions, each and every time I see a severe postpartum hemorrhage after childbirth, I cringe.  The saddest part is all of these women were first time mothers.  Never would they feel the bounce and kick of a baby, watch the waves of hiccups ripple over a swollen belly or gripe about morning sickness again.  That had been stolen from them.  They are grateful to be alive and knew the possibilities of the reality before going under anesthesia, but it still hurts.

These journeys I have taken with these families have left a deep and significant impact on me in my work.  If there is one thing I can share with other doulas who may have gone through these similar situations, or may face them in the future is: Don’t grieve in silence.  You don’t have to share the confidential particulars, but share the stories with others you trust.  It will impact you in ways you never thought about, learned about or know.  Each and every loss is unique.  I battled with “compassion fatigue” for years before I sought help.  I teach about my experiences now, as I find it another way to heal.  Plus, as most of these mothers will tell you—education about the scary side of birth needs to be told.  It is not always love, peace and harmony; sometimes it grabs you by the throat, chokes the air from your lungs and leaves you in a puddle of tears. 

Chapter One: I, Doula

My boss is a bitch.  I can be called to work at any hour of the day, any day of the week and on any day of the year.  I pray her rhythm is smooth and steady but know that it can be erratic and brutal.  I am breathless with anticipation, cold from battered emotions or exhausted from sheer effort trying to figure out her personality.  She makes me wait endlessly for some, tests how fast I can jump with others but more often than not, she decides I can do more than I thought I could in a 24 hour period.  She is a fickle creature and if you try to rush her, she may humor you, or she might turn as vicious as a trapped animal.  She may even quit.  She is physically, mentally, emotionally, spiritually and socially exhausting—always.  My heart is expanded every time we meet, but I wish sometimes the images seared into my brain would disappear.  I love her and I hate her.  She is Mother Nature—and she’s about to give birth.

I like to believe I chose this career path; but in all honesty, I think it chose me.  I’ve always had a nurturing spirit—give me something to love and I will give it my whole heart.  Being a doula has been both a gift and a curse, but I wouldn’t trade this job for anything.  I cherish every woman and couple I have met on this journey, each baby I have seen take its first breath, and the heartache that can and will happen inevitably in this profession.  The constant state of ambiguity, contingency plans, and spontaneity may be overwhelming for some, but for me it is my life’s blood.  I thrive in this chaotic lifestyle as it challenges my brain, stretches my compassion, pushes my endurance, and simply because nothing compares to it.

I do question my rationale once in a while; especially if I am weaving on my feet after being up a few days in a row, recovering from a bladder infection because I didn’t void for hours on end or am having digestive problems because the only thing available to eat came out of a gas station or a vending machine.  I have powered through births with pneumonia, raging headaches, and muscles screaming from abuse.  I have drunk enough caffeine to overcome outrageous fatigue, so that I think some days I bleed brown instead of red.  I have perfected the art of sleeping standing up with my eyes open and sounding totally coherent on the telephone after waking in the dead of night.  I know every speed trap on a myriad of Alberta and Saskatchewan highways and back roads; I know when to go for broke and when to ease off the gas.  I have been bitten, spit on, punched, and had my hair pulled out—usually not with intent but in the heat of the moment.  I have been hugged, kissed, and praised; celebrating the trials and triumphs with new parents.  I have waded through puke, blood, amniotic fluid, mucous, fecal matter, and urine.  I get excited at body fluids during the process as it usually means change is happening—who does that?  I have tried to quit, but this calling is too strong.  I was made to be the silent observer, the gentle guide, or the voice of reason during birth.  Why, out of all the things in the world to do, am I good at this?

Seriously, who in their right mind signs up for this shit?  The hours suck, the money crappy, the disrespect rampant, and the job unknown.  If you don’t know what a doula is then please look it up—I’d be a millionaire if I was paid a dollar for every time I heard, “You’re a what?”  I have invested my time, my heart, and my existence to helping women and their partners welcome new life into the world.  And while it sounds all roses and rainbows, it is not, so please open your eyes.  There is a cost—be it emotional, physical, familial or financial.  I have been berated by medical professionals for simply existing; not for something I said or did outside my scope of practice, but rather to confirm an egotistical megalomaniac’s hierarchy of power.  I have contorted my body into positions that would rival a yoga master, a mechanic, and Houdini himself all in the effort to make a mother feel more comfortable.  I have missed huge events in my children’s lives which they remind me of constantly, and it makes my heart bleed with thoughts of failure as a parent. I barely break even most of the time from the effort and expenses I put into the venture, even though money is often the last thing I think about.  I have pushed the envelope of sound body and mind and paid dearly for it.  I have cracked, gone over the edge, burned out, and fought my way back too many times to count.  This profession may be valued by some or ridiculed by others so I am constantly dodging a minefield—good, bad or ugly—daily.

If I take this back to the very beginning, I can either blame or thank my mother.  After having a terrifying, unsatisfying, and demoralizing first birth experience, I found myself pregnant again almost five years later.  I remember thinking “Isn’t there a better way to do this?”  Now, never ask fate a question and be unprepared for the answer.  Mine came in the form of a newspaper article about the benefits of doulas that my mom found when I was seven months along.  “What the hell is a doula?” and then “Where do I find one!”  My mom’s greatest gift to me aside from giving me life was the gift of another woman’s support. 

I ended up with the most amazing birth experience because of one woman’s help and knowledge.  It was my missing piece of the puzzle.  I rode the glory of that birth for months!  Because of this life-changing experience, I wanted to be the bearer of wisdom, kindness, and support to others.  God, I was so sweet and terribly naïve back then.  That is not to say that I am cranky and mean now!  I was taught by some of the best in the birth field; however, I have since learned that not every birth experience was going to be as fabulous as my own, but my presence can make a difference on how that experience was perceived. 

The stories of these journeys are priceless—accomplishment, empowerment, strength, disappointment, rage and heartache.  It is often said that when a person’s inhibitions are lowered they reveal who they really are.  I see that time and time again, medications help it along sometimes too.  Pain is the great leveler—it has no equal.  Some memories of my current and past couples have me breaking out in uncontrollable laughter, or spilling a waterfall of tears.  These emotions are raw, true, and a beautiful dictation of the human spirit. 

When I decided to connect the dots of my life, to weave these moments of time together, I knew this is not just my history; it is the history of over a thousand children’s welcome to the world.  These tidbits are needed in today’s birth world—a world where fear, disconnection and medicalization overrules dignity, trust and respect.  Some simply are just too hilarious not to share while others need to be shared to gain insight and wisdom.  And because…I spent years trying to create a legacy only to realize I needed to leave one. 

Doula Tools?

Often I am asked what I bring to a birth—what is in my doula bag.  Many new doulas are curious and looking for tips or ideas of what to pack with them that is easily transportable for comfort measures and such when they attend labouring mothers.  Suffice to say, I carry nothing tangible—no essential oils, no massage tools, no lotions, no rice socks, no birth ball—what kind of doula am I?

What I bring to births pretty much is God-given…my voice, my ears, my eyes, my heart, my brain, my hands and a very strong back.  I do carry a camera, my wallet and a change of clothes; but otherwise I have no backpack of supplies, no rolling suitcase of magic tricks—no special items of any kind.  I think that all doulas new to this field eventually give up or limit what is brought to births the longer they actually do this job.  I think I carried a bag of labour support items for the first 5 births I did, then I just found I never really used any of it!

If one reads and understands the literature of what a birth doula actually is and what she is supposed to be in the first place, they’ll realize we were never intended to have all these lotions and potions.  The 21 controlled and randomized studies done on doulas in the last 25 years focus solely on the doula's presence, not what the doula is doing.  Doulas inherently protect a labouring mother’s space; doulas BE not DO.  Many times newer doulas think they need to be helping a mother labour by assisting in ways of massage techniques, using essential oils, understanding herbal remedies, moving her into positions to promote labour progress and such.  (Most of this stuff is outside a doula's scope of practice, but it depends on her certifying organization.) While sometimes a doula will offer guidance in different types of comfort techniques or help promote movement, if it becomes necessary, a doula does not need tools to do so…she needs instinct, love and kindness.  Birth is not a production—it is a bodily function, and it needs time and patience to occur. 

Most items, if indeed necessary, used during a birth can be found either in the home or the hospital—my clientele chuckle that I am the MacGyver of all things related to labour.  Many of my clientele already have things in their homes to use (which solves the whole cross-contamination issue) and most hospitals carry what I can use; if I need something.  Honestly, homes pretty much have anything and everything and hospitals have towels for gripping, ice and water dispensers, heated blankets, hot showers, water bottles, perhaps a birth ball gathering dust in a far corner, a TENS machine hidden away on a shelf and many other items that if you think outside the box, you find you can use it! 

But really, what all my mothers and partners want from me is a calming presence, a hand to hold, sincere praise and encouragement and knowing that I believe in them and the work they are doing to bring forth new life.  They want me to hold their private space, they want me to be the tranquility in the storm, and they want me to slow the pace down if things start to veer off their intended course so they can make informed choices.  They want my instincts as a birth observer—nothing more, nothing less.

So to answer the question I am so often asked—I take myself to a birth—the essence of me and I give that to each and every labouring mother.  No tools, no tricks, no magic…

Family or Career?

I cried when I received this…I nearly broke in two when I ended up withdrawing my offer of admission.  Why can people not understand that my family comes before my career? Initially everyone was on board of having their wife and mother move to Ontario (a mere 2500 km away) for FOUR years—including a 20 month practicum, but my youngest son’s reality is simply this…at 13 he still wants and needs his mom.  I chose him over midwifery school…for now.  Although Southern Alberta is screaming for midwives...licensed, registered midwives, and we have NONE…I’m sorry.  What kind of mother or midwife would I be if I sacrificed the very things that lead me on this journey in the first place?  One day…some way…some how…I will get there.  Just not now.  And for all you "non-believers" that I actually achieved an acceptance…see below…