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Doula catharsis

April 14, 2009

My past week as a doula has been a week of heartache and triumph.  I attended two beautiful births with two incredibly strong, knowledgeable and inspiring mothers.

Although I couldn’t have known it ahead of time–although no one could have known it ahead of time–the birth I attended last Thursday turned out to be the first cesarean section I attended as a doula.  It was my third birth, and I suppose that just goes to show that the statistics have really panned out for me.  (Currently, the cesarean rate in the United States stands somewhere between 31-34%.)  One out of three.  One out of three…  (Yet I still ask myself, “Isn’t the cesarean rate supposed to be lower for doula-attended births…?”)

After laboring beautifully–completely unmedicated, mobile and upright through most of her labor, pushing for nearly four hours in a variety of positions, and greeting the majority of her labor with humor (yes–humor!) and grace–my courageous and inspiring client ended up with a cesarean for a posterior baby who would simply not descend (or rotate, for that matter).  While I’ve obsessively re-examined her labor to figure out just what I could have done differently as a doula, I don’t know whether I’m relieved or heartbroken to realize that I’m not sure that I could have done anything differently–especially since there were no signs that the baby was posterior until the last hour of pushing.

But that doesn’t change the aching and sinking feeling I felt when, after greeting the mother in recovery, she looked up at me with tears welling in her eyes and whispered, “Kristen, I tried.”  I cried with her and reminded her of just how strong and amazing and inspirational she was and of just how much she not only tried but did.

And I cried all the way home.

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I needed something “different” for my next client’s birth.  As I told my husband, “I need a triumphant birth!”  (How selfish of me to “need” something from my clients’ births, I know…)

I became understandably concerned when my next client informed me that one of the obstetricians in her group (a very high-ranking obstetrician in the US, for that matter) was pressuring her to have a cesarean because her baby was “measuring large.”  Yes, at an estimated 9 lbs. 13 oz., her baby was measuring  “large for gestational age.”  But this does not mean that she needed a cesarean, especially since a) she had already birthed a 9 lb. baby and b) she was planning on being upright, mobile, and unmedicated during her labor and delivery.  (Henci Goer has a great section on birthing “large” babies in her wonderful, educational book, The Thinking Woman’s Guide to a Better Birth.)

I am proud to say that my knowledgeable, incredibly strong-willed client refused the cesarean and declared that she wanted to “let nature take it’s course.”

I am even more proud to say that at 10:32 this morning, my knowledgeable, incredibly strong client birthed her 11 lb. 10 oz. baby after pushing for only seventeen minutes.  She avoided an unnecessary cesarean, she proved her obstetrician wrong, and she demonstrated her unwavering faith in her body in the process.  A triumphant birth indeed.

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So while the triumphant birth of this (yes, I’ll admit it) big baby in no way “cancels out” the heartache I feel over my other client’s cesarean section, it at least shows me that, as a doula, I can–and should–expect these emotional peaks and valleys all throughout my career.  I will assist mothers who have necessary cesareans, and, unfortunately, I will probably assist mothers whose cesareans could have been prevented.  I will assist mothers who “fight the power” and refuse to be unnecessarily sectioned, and I will assist mothers who might even opt for an elective cesarean.  I will assist mothers who birth big and small, healthy and unhealthy, and hospital-born and home-born babies.  I will assist mothers who feel empowered by their birth experiences, and I will assist mothers who grieve what they lost during their birth experience.

But if I can reflect at least at least one-tenth of the strength, courage, and inspiration that all of my mothers show to me, then I should feel as least partly triumphant about my own work as a doula.  One mother, and one baby at a time.

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One Comment leave one →
  1. nursingbirth permalink
    April 22, 2009 2:50 pm

    Thanks for sharing those stories. Know that you are not alone in wishing there was something you could have “done”, I feel the same way a lot of times, but what may one day be comforting for the patient that ended up with a cesarean is that she truly did everything she could have to reduce her risk for a cesarean: went into labor on her own, refused scheduled C/S, was upright, mobile, and prepared for an unmedicated labor, pushed in a variety of positions, etc etc etc. And you are right, she didnt just try, she DID!

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