Thursday, April 7, 2011

A Rose by Any Other Name...Birth Speak

I have been noticing in the doula world some stuggles over words. We have so much to do, so many balances to create, so many environments to improve. Some of these struggles are completely spot on and need addressing. Some verge on what seem to be an attempt to be more unique or less mainstream than the average bear. Words most definitely have the power to make us distinct. Language is very important, no doubt. If I'm standing up strongly for myself and creating a stink over injustice, I don't like to be called a bitch. Calling someone "sweetheart" in a way that's clearly condescening and sexist, instead of in a loving, nurturing way is awful.

There is tremendous power in words and we do need to be careful. But sometimes quibbles can be much ado about nothing. Yes, apparently I am waxing Shakespearean this evening. I don't love the quibble over the word "contraction". Yes, while the endorphin suffused state of birth in no way feels emotionally like a contraction but an expansion of consciousness, in reality the uterus most certainly contracts. Hard. Calling it a wave or an energy rush is not a bad thing, but really, it doesn't change the fact that a uterine contraction is occuring. Calling it another name might make it seem less "hard" (I consider it to be a word referring more to simple mechanics than to Medicine) and perhaps more spiritual, (and in our culture this desire for a shift of balance in birth perception is certainly helpful for many), but I am perfectly comfortable with "contraction". The uterine contraction causes a heck of a lot of sensation, and while I understand this phenomenon is perhaps not what some people want to focus on in their birth experience, really, that big sensation which goes hand in hand with the mechanical uterine contractions seems to take center stage in most labours regardless of what we plan or hope for.
I have noticed that many people don't like to use the "p" word with regards to labour...you know what I'm talking about.....pain. There have been several terms generated to shift perception surrounding the birthing sensations, but in my humble experience both personal and in birth attending, I tend to believe birth hurts, no matter how you try to pretty up the word. But the pain isn't a bad thing. That strong, strong sensation creates the flow of endorphins, and our experience of it raises oxytocin levels so the next contraction is even STRONGER. We birth hopped up on that beautiful " 'ormone of luve", which is guided and driven by...you guessed it, pain. Whether they plan to or not, the vast majority of women feel some level of pain in labour. Instead of quibbling about the word, perhaps shifting the focus from the pain as being some nasty by-product of the childbearing process that we "shouldn't" have to suffer through to being a noble, healthy challenge we are absolutely capable of moving through would be more helpful. Call it an interesting sensation, call it a wave, sure...that doesn't hurt. But the sensation still does. And that's okay.
I see more and more doulas not seeming to like the word "training" for the process by which doulas learn their skills. The definition of training is: "organized activity aimed at imparting information and/or instructions to improve the recipient's performance or to help him or her attain a required level of knowledge or skill." I believe in training. Where I veer from most doula training organizations is that while I believe in good training including apprenticeship with an experienced doula, I don't care much about certification one way or another. In the doula world that piece of paper, while it is great because it means you did what was asked according to someone's made up standards, it in NO way means you're "done" learning. It in no way defines the greatness of a doula. Frankly, it means little to me. I have doulas on my team who are certified and who are not. What attracts me to them is their integrity, reliableness, passion, compassion, and a sense of knowledge I get from them just by speaking to them casually about birth. We develop through constant learning and continuing experience. So while the piece of paper stating "qualifications"is not so important to me, the fact they took the time to invest and immerse themselves into the preparation or "training" of how to be a doula is. There is a basic level of skill being a doula needs. I don't want to say "required" because that's too rigid. While the learning is life long, there are basics to know. You might want to know what a cervix is, for example. You need to know how to listen actively. You need to understand the process of labour and how women experience it. You need to know some tools to help. It's not all hearts and flowers and broadcasting love. So doula courses DO train doulas. Whether we want to claim that word "train"or not as what we do to prepare doulas is up to us, but I am happy with the word. I do not consider it too mainstream. I don't think it necessarily leads to an assumption of a means to an "end" of learning and major standard of pratice focus over skills. I don't believe it's about a check list of qualifications so you can call yourself a doula. It's about basic skills, information, and personal growth so that all participants can find their unique path and expression of the work. I'm sticking to the term "training" with impunity because I think it's a good word for the process of learning basic doula skills.
I'm not so down with the term "delivery" for the receiving of babies. What I don't like about it is that it implies the attendant "delivers" the baby. While they may be actively helping in some cases (whether it's needed in that situation or not), I've always kind of felt that mothers deliver their babies into the world. But I won't argue with or correct someone who uses this term.
You know what word I really don't like? "Doula"! It rubs me in all kinds of wrong ways. It comes from the Ancient Greek word "slave", for crying out loud! And a bonded slave at that. While the ancient lady of the house was birthing and mothering, her maidservant hung out with her and carried out a very noble role, but maybe not necessarily with the love and passion we modern doulas bring to our work because we do it from a place of free will and choice. To tend to women in their childbearing year is an honour. But the ancient maidservant was probably bought into the family and would have been stoned to death if she didn't carry out her role, like it or not. I can't think of one great other word describing what I do, but I must say it has never fell comfortably out of my mouth. Dooooouuuullllaaaaaa. It sounds kinda flakey to me..even a little romantic. Plus, half the people you mention it to say, "say what?" But hey, it is very deeply entrenched in our modern language, so instead of quibbling about it, I just go with it. It doesn't really change my life so much. Whether I'm called a doula or a birth attendant or an accompagnante, I love the role I play. A doula, the essence of the work being summed up by this popular word, is what I choose to call myself, whether I dig the acutal term or not. It's what people know and respond to. Really, "a rose by any other name would smell as sweet."

Lesley