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.