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!

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. 

Whew!

Well, can you believe it's March already? I certainly can't and the weather isn't co-operating either! It's only the 7th and I have attended 4 babies since the first. Last week was very difficult for me as well, more so because one of my April mommies lost her baby. Stillbirths are brutual, my heart breaks for my clients whom were so looking forward to bringing this baby home. I still haven't really processed what I need to, the activity of the other births have kept me somewhat sane and for that I'm glad...

On a lighter note...Monica is now officially certified through DONA International. I couldn't be prouder of her! She is definitely on her way! Chantelle also completed her birth doula training, although was very disappointed that 2 of the births she was scheduled to attend with me as a mentor delivered on the weekend she was away - on the SAME day, within hours of each other. I'll have to find more for her, which shouldn't be too much of a problem.

I've got two more birth to go for March, then hopefully I'll get a bit of a break as I only have 2 scheduled for April now. I need to paint my basement anyways! Busy, busy, busy!

Well, I should be off to bed, even though most people are waking up! Attended a very speedy delivery tonight and I couldn't be prouder of my mom and dad. They were AWESOME!