Tuesday, September 23, 2008

Birth Doula

Last Friday night, in the middle of a friend's birthday party, I was summoned to attend my first birth as a birth doula. After a night of labor and about an hour on an epidural, my client delivered a baby girl on Saturday morning at 6AM at a quiet, shiny hospital on the Upper East Side. About an hour and a half after the birth, I stumbled out of the hospital into a cab, confused and sleepy.

In the days since the birth, my husband and the one or two friends who knew about it have asked me with some excitement, "So, how did it go?!" And mostly, I don't really know how it went. Nothing bad happened. My client delivered vaginally with the absolute minimum of complications. (I won't say "no complications," because unless your practitioner is as gentle as Gandhi and you are as unbending as the Hitler Youth, giving birth in a hospital entails complications, because it is the hospital's job to create complications. I say this with no bitterness. It's just true.) My client was in labor. I stayed with her until she gave birth. Then I left. Is that what a doula does?

During my doula training, the trainer - a rather famous doula in the New York area - said again and again, "Less is more, doulas! Less is more!" We even watched videos of (also very famous) doulas at work, and our trainer pointed out all of the things that she wouldn't have done. "That's too much! Too much! What is she doing? Why is she waving her hand in mom's face? Why is she standing there in that circle of love? [Meaning getting in the way of the mom-dad connection.] Less is more, doulas! Less is more!" At the time, it made perfect sense, and I was also feeling flattered to be addressed as "doula," and I wrote it down diligently: "less...is...more." I pictured myself sitting serenely next to my laboring client, my wise, angelic presence permeating the room.

As much as I thought I understood "less is more," though, I found myself rather shocked at how very little I did over the course of my client's labor. In early labor, I put a hot towel on her back. ("Oooh, that feels good," she said, but then the towel fell off her back and we forgot about it.) In the triage room, I rubbed her feet. ("That really helps," she said, but moments later I said something, and she said, disappointedly, "Now you broke the focus.") In the labor and delivery room, I put a tissue with peppermint oil on her pillow. ("That smells good," she said.) Really, honestly, these are the three distinct actions I remember myself taking. Other than that, I was mostly doing nothing.

Thinking back to my training ("Less is more, doulas! Less is more!") and also talking to E, the director of the doula service that I am working with, I am relatively sure that I did a relatively good job, and that all those times I was doing nothing, it was because there was nothing to be done. I know in my brain that just being there - "Occupying that emotional space," as E put it - is the most important function that a doula can serve. But it is REALLY counter to my nature to just lie around like lox when there is a person in the room who appears to need help. I'm not saying that I'm super-compassionate or anything, but I do have a highly-developed guilt mechanism that locks in really well with an abysmal inferiority complex, making me feel like I should always be DOING something to help people, because if I don't, they'll be mad at me, and I'm not worth anything anyway. I also have a touch of ADD (I'm being perfectly serious here), which means that just sitting in a serene manner is not really part of my psychological landscape. So it looks as though, for me, Doing Nothing With Conviction is going to be the hardest part of being a doula, rather than, say, Back Massage. Because if you can't Do Nothing With Conviction, you will end up dithering, and a dithering doula is, like, the pits, whereas a doula who is not so hot at Back Massage is totally live-with-able.

Oddly, while I felt dithery and anxious ("Ohmygod I'm not doing anything!! Ohmygod what should I do?! Ohmygod she's having another contraction!! Shitfuck!!") beyond all belief through a great deal of my client's labor, I appear to have not come off that way. The nurse, filling out the feedback form I need for certification, wrote, "She's a very calming presence," and E reports that my client said I was a big help throughout. The aforementioned inferiority complex keeps singsonging at me, "They're just saying that to be nice...they're just saying that to be nice..." In a more grownup part of my brain, though, I am just barely allowing myself to think that it might be true - I might have been a positive, calming presence for my client, and, all dithers aside, I might even have a special talent for being that way. I can't be sure that this is true, but I am working on thinking that it is, because I know that as much as I want to help my clients, I will only be able to do so inasmuch as I believe that I can.