Wednesday, February 8, 2012

Don't be a "Do-la"

One of my teachers on my path of studying body/mind integration therapies had this great saying: "The more you do, the more you doo doo." Translation: the more you mess around with techniques "just because" instead of listening to the recipient of the work, making gentle suggestions with your hands, voice, tools, or energetic intention (IF warranted), the more you interfere with the body's impetus to self-healing. Obviously, there are times when big guns need to be called upon in our work as doulas, like hip presses and frequent positional changes, bodywork or remedies, even sometimes a little tough love. But as the intense birth energy works through the mother to open her up and bring forth her child, our job is ultimately to support, not meddle in what is normally an already pretty perfect process.

Many doulas these days introduce themselves to me or others with their catalogue of credentials, CEUs, certifications, and qualifications. The "with whoms" and "how many hours" and "advanced studies" all seem very important, and are listed in CV style on personal websites. Now there is NOTHING wrong with constant learning. I do it myself. But at some point, clients really don't care what you studied. Their eyes will glaze over after you've listed the third workshop or so. They are not concerned with a piece of paper (at least the hundreds of couples I've worked with aren't...rarely have I been even asked about my certifications, CEUs, advanced training, or association memberships). They want you to make them feel safe and can usually tell by meeting you if you "click" with them or not. Their feelings towards you will usually matter more than your impressive CV.

Many apprentices I work with and very new doulas I know, still years away from getting to tons of the great educational opportunities out there, are able to exude an energy of safety and calm that is palpable in the birthing room. Many a time I have seen doctors and nurses walk in and literally say, "It FEELS really good in here. I'm just going to sit down for a while." And they do, vibing out with the doulas for a spell. While the tools we learn from more experienced birth practitioners ARE immensely valuable, these are not necessarily the keys to becoming better doulas. More knowledgeable, and more skilled, yes. But not necessarily better. For you doulas out there who maybe see all of these opportunities online to attend amazing workshops and conferences but are unable to attend due to having young children or a lack of financial wherewithal, please don't despair. Being a doula is about a life time of learning. Until you are able to enrich your hands on skills through continuing education, if you are able to doula with presence,awareness, and most of all love, this is absolutely good enough. As far as I'm concerned, this is a grassroots, ancient, woman to woman role (not a "profession")which, if you are called from a deep place within to do, you will know very intuitively how to do it without a lot of bells and whistles. Women have been providing this support for each other from the beginning of time, so I figure the ancestral memories of how to do it are easily activated for those who feel that inexorable pull.

Often times, the more tools one has at one's disposal, the more one is apt to want to bust them out willy nilly if one's powers of discernment are still developing. I hear great explanations of the chosen tools/methods that are being applied to any given scenario, because it is exciting to speak of what we've learned...but perhaps not while the mom is busy trying to work her baby down and couldn't possibly be paying much attention.

My rule of thumb as a doula is to take the birthing mom's lead. It is easy to read someone's needs during labour. For example, some are chatty, and feel more grounded when you respond with a matched energy. You can see the labour progress and watch her fade away eventually into labour land. It is fun to have a conversation, then a conversation where concentration to keep talking through the contractions is necessary, then having the conversation between contractions, then having the train of thought forgotten entirely as the mother shifts into dream time. This is not talking randomly, it is actively using words appropriately as a method of relaxation. In fact, this woman left in what we think should be silence might actually feel more frightened or abandoned. Other women, however, would be in labour for days if you kept talking, so they would require near silence and perhaps a lot of touch communication. Some want you outside the room keeping unwanted visitors out of the space (cue lock and load sound), their need for your presence as great, just more with a focus on you containing their experience instead of mingling with it. Understanding how and when to apply the tools you have is far more important than having a ton of tools and not having appropriate discernment.

When a student or another doula I may be working with comes in with a massive amount of tools in her doula bag, claps her hands together and says, "Okay, let's get this baby out!" identifying where the squatting bars and birth balls are (before even really tuning in), I groan inwardly. It is an almost clinical approach, and I know we'll be in for a long haul much of the time. If, in being so excited about all the stuff you know that you start engaging the labouring mother's intellect and lecturing about why the double hip squeeze you're doing works, or say more than a sentence about why you're tucking a rebozo under her tummy and shaking her around, you may be impeding the labour process for that particular woman. Honestly, the mother doesn't give a whit about why if things are really active, she just wants sweet relief and is open to ideas you think may help her if she feels scared or flagging. That's what she hired you for, not to give her a crash course on labour support tools.

A doula should never be dependent upon her doula bag of tricks to help her during a birth. There are times you'll have to dash from somewhere that's not home without your stuff, and it shouldn't worry you at all. Your most important tools are your hands, your voice, your insight, your communication skills, and ultimately, your heart. The rest is just icing on the cake.

While accumulating a lot of knowledge and tools is a great and worthy endeavour , as you never know what could potentially help a birth that is experiencing a situation where a piece of knowledge or obscure skill could become invaluable, that list of creds isn't what makes the doula. It isn't what you DO a lot of the time, it is who you are. What you are DO-ing may be the simplest thing ever on a physical level, such as holding a hand or wiping away post vomit tears. But the energy you exude and the quality of space you hold is paramount. If you are distracted, inappropriately chatty, digging around for this and that in your bag "just because", flipping though your doula manuals to review procedures, shifting around and bustling, you are probably doing too much. If you sit, stand, or hold with awareness, with presence, "listening" to the environment and working with the feel (energy) of the room actively but quietly, this may some of your most effective doula-ing. And this will be confirmed to you. I recently had a lady having her third baby. She had had epidurals for her first two and wanted to have a natural birth this time. I sat in a chair by her bed. Yup, that's what I did. The whole labour. That is what felt right. I sat and beheld, quietly synching my breathing with hers, relaxing my shoulders when I saw her raising hers, loosening my jaw when I saw hers clench. She told me afterwards she couldn't have done it without me, and I reassured her that I did absolutely nothing, that she did all the work and was blessed to have had a nearly pain free birth. She said, "But you weren't just sitting there. I could feel waves of absolute calm and trust coming from you. I felt your connection to me unwavering, and it made me unafraid." Remember, labouring ladies are deeply attuned. A touch that has no heart in it will often be noticed and not appreciated. Zoning out because "there's nothing to do" makes some feel abandoned. Keep checking in.

In the doula training I provide, we certainly go over a whole bunch of nifty tools gleaned from almost two decades on the job, but those are only stepping stones. I prefer to focus on the quality of presence a doula holds for her clients. How do you listen? How do you tune in? How do you hold the space? How do you channel calm into a stressful environment? What may you need to work on within yourself to have more access to insight and intuition? What can you broadcast energetically to bring a positive change to a situation? This is doula-ing in the deepest sense of the word "holistic".

There is a BEAUTIFUL scene in the British series "Call the Midwife" which illustrates the essence of what I'm talking about. A clumsy new midwife named "Chummy" who has barely passed her qualifying exams experiences her first professional clinic day. An obstetrician has been called to this clinic (run by nuns) in London's East End (circa 1950's) to assess a case of a woman whose pelvis has been deformed by rickets. She has lost four previous babies at term due to severely obstructed labours. Now with the National Health Services, she gets the opportunity to have a Cesarean this time, and the only shot at having a live baby. The doctor is explaining the woman's rickety pelvis to Chummy, going over all this technical stuff, looking at his x-rays, not tuned in at all to the fact that this mother is looking terrified and grieving. He is very excited about the opportunity this poverty stricken woman gets to birth by Cesarean at a hospital and is kind of carried away with the details. He's a lovely man, he is just doing his clinical job and is not at the moment "tuned in". Chummy very clearly is, and has her eyes on the lady the entire time. You can just feel the solid, grounded compassion she starts exuding as she keeps eye contact. The mother bursts into tears over her lost babies, apologizing for her emotional state. The doctor looks uncomfortable and sheepish about the tears. Chummy takes her hand and gets close, and weaves a web of calm and safety around her, honouring her experience and her emotions. She explains how wonderfully safe this mother is in this excellent doctor's hands, that this is a new baby and new experience, and that everything is going to be okay. For all her lumbering ways and technical shortcomings, there is authority in her emotional presence. The doctor takes her aside and tells her that she is a WONDERFUL nurse midwife, because she has provided one of the most valuable things to her patient, which is a sense of safety and trust.

In my humble opinion, THAT type of doula skill is the most important to develop...excellent touch, verbal, and energetic communication and environment monitoring. And you don't even have to write it on your CV!

Doctors, nurses, and midwives are often reminding themselves to "sit on their hands" to allow the birth process to unfold optimally without unnecessary intervention. Doulas must be careful of this too. Remember, we are not "Do-las", which entails bustling around all efficiently, spouting our street creds, getting the job done with an agenda, and owning "successes", but "Doulas", who inform, nurture, honour,and support in the unique way each situation calls for...with presence, insight, grace, and love.

14 comments:

  1. Thanks for sharing Lesley. Beautifully written!
    Something I often tell my clients who tend to do,do, do or eat unconsciously is that real insight about their bodies comes when they are just being, accepting of the silence, or their fears and emotions- rather than trying to numb themselves by doing, eating or distracting themselves from the present moment. It can be so empowering to just be present. We often don't value that enough.

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  2. your insight helps me so much... man, i wish i had come up to Edmonton to do your training...

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    Replies
    1. ...hang in there, I may be coming to Calgary in a few months :)

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  3. Thank you so much for this post. My first birth as a doula (not first attended, but first "official" birth) is fast approaching, and I keep finding myself going over the contents of my birth bag, worried that I will forget something vital and important. This was just the reminder that I needed... that the most important thing for me to bring to a birth is my heart. <3

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  4. AMEN!!!

    I think that taking this approach can also help the mom to feel more empowered in her birth experience--that it was no one else's birth but her own. When it comes to doula-ing, I think there is little worse than a doula who tries to make the birth HER own...

    But more than this, what you have written here is so thoughtfully beautiful. For it is so true that our hands, our voices, our calm, our presence, and our ability to take the mother's lead is REALLY what makes doula support so valuable. They are the only absolutely necessary tools that we bring to a birth.

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  5. Thank you for this! It was a great reminder/refresher.

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