A Week In The Life of a Doula (Sort Of), Day 2
As I wrote in the initial post about the first day of my doula week (postpartum visits! So important!), I’ve compressed some of these activities into a single week to give an idea of the full scope of doula work and I've also modified situations/people to maintain client privacy. These are all things I've done on the job, though, and every moment has been wonderful.
Today is birth day! For many, this is the only day that they think of in regards to a doula, but our work goes so much deeper and farther than that. Just like it takes a while for a pregnancy to progress, it takes time for the doula and family to build a relationship strong enough for the mother to feel safe with a doula in her intimate space during birth. I cherish the privilege of this trust with each of my clients. And, let’s be real here: Birth is awesome!! I love the other dozen things I do in my doula work, but that moment when I know a client is getting ready to meet their baby finally… oh, yeah, that’s really special, y’all.
And how do these moments go?
Well. My phone chirrups at 2 a.m. No, that’s not right. It makes a crazy, loud, clanging sound. I change all of my clients’ ring tones to unique, hard-to-miss ones as they approach their due date so that I can truly be available to them 24/7. So what really happens is this: My phone makes an outrageously loud sound at 2 a.m. & I wake up to see a text from a client about possible contractions. We text back and forth for a while, talking about signs to look out for and things to help her rest, then agree to check in later since it still seems to be suuuuuper early labor.
I smile as I set the phone down, thinking about how the last time I was up at 2 a.m. with a client, it was when I left the hospital after watching their gorgeous birth. Somehow even something as mundane as hospital parking lots seems magical when you’ve watched a precious, small human slip into this bright, surprising world. Some births I’ve been at the hospital in the afternoon. An induction had me showing up at 8 a.m. Babies are predictable in only one way, I’ve found: their ability to bring joy (and some exhaustion ;)).
But back to this 2 a.m. text. I make sure to snuggle down and focus on rest, knowing it might be in short supply later on. And I’m right. Additional texts come through just a couple of hours later and I make a plan with my client for when I should be at their house, then call on one of my multiple on-standby-care, wonderful providers for my own children. And I finish packing my bag.
I say finish, because I keep many of the essentials already pre-loaded. Like my cell phone ring tone adjustment, I also take the time to stock my bag with essentials ahead of time: my comfy birth shoes are nearby, an extra phone charger is there ready to use, & I put a few healthy snacks (for mom & me!). And on birth morning, I refill my water bottle, and head out the door.
Showing up at a clients’ house for them to labor at home is one of my favorite things about this job. It’s time where they focus on finding their own labor groove in their own space, and I can help them be more comfortable in these precious moments. It can be stressful to get to the hospital too early in your labor and then feel like you’re staring down the clock while waiting for things to progress. At home, you are more comfortable and can relax a bit more between contractions. I love giving physical support measures to laboring women while their partners take care of other necessary things (loading the hospital bags, calling work, contacting childcare providers for their children). I feel like labor tends to progress a bit better when a client can labor at home too.
Eventually, we leave for the hospital ~ they head out in their car and I go in mine. Once we show up, it’s go time! I continue to provide physical support (those hip compresses! & helping mom stay hydrated!) while her wonderful medical staff addresses the medical safety priorities (because, no, I’m not a nurse or midwife). After the immediate check-in, they leave to take care of other hospital residents. Since I’m working for my client and her family and am there for 100% support of them, they aren’t left alone in these moments. Her partner and I continue to provide support, sometimes with her husband giving support needed, other times resting and re-setting while I take over. This way, she is never without care. We switch positions around as needed; discuss the idea of a birthing pool (those births can be so special! but they are not for everyone).
As things progress, medical staff return for checks, and then eventually it’s transition and pushing time. A woman goes through a major crisis of confidence as she hits transition, and someone connected with her and calm can do so much to help instill strength as this stage happens. I love Rhea Dempsey’s words of wisdom about helping women here! A woman needs to know that she is not alone, to be reminded of her strength, and to be assured of her progress, to remember she is birthing a human, and that the baby will be there soon.
Pushing is another hard stage. Sometimes we have to move around a bit and try different positions. Sometimes a midwife suggests the position change and I back her up; sometimes an OB and nurses are working on leg support and back support and I’m there for that too. Sometimes it’s a matter of pulling a woman’s hair back into a fresh pony tail, refreshing her cool compress, and making sure she gets a sip of ice water. These things sound so simple, but when you’re in the throes of labor and feel like every cell in your body is determined to make you miserable, the “little” comforts suddenly become huge.
And then there’s a baby! I step back a bit to allow for medical providers to check on safety, to hastily take some pictures of these first moments of greeting (if the family hasn’t hired a birth photographer. I do know a few ;)). There is really nothing to compare with the profound & unharnessed joy of a mother meeting her baby for the first time. Everyone breathes a deep, exquisite sigh of joy and relief.
I stay around to make sure mom has some healthy snacks, to help baby with breastfeeding (which means a lot of helping mom is positioned comfortably and well), and to help with any loose ends. I’ve stayed longer when an unexpected NICU transfer happened so one parent could be with the baby and the other still had a familiar face and trusted support. I’ve left sooner when the family had a strong supportive collection of relatives show up shortly after birth. Because a doula-client relationship is actually a relationship, we have been able to develop a sense for what is needed and we have open honest communication about that.
After leaving their room, I find a quiet place to jot down a few notes about the birth. These will help when discussing the birth with them at our postpartum visit, as it is so healthy to sit down and unpack emotions from the day that brought their child (or children… into the world. Joy & pain so intermingled (that’s the definition of raising children, y’all) can be a lot to take in, and I always look forward to after visits.
I head home, make sure I eat food somewhere in there, and then plan for a day of deliberate rest… just like I prescribe for the mom. ;)