Monday, July 29, 2013

Being a Doula for a Doula

When the referrals for expecting moms comes in to Everyday Miracles (http://www.everyday-miracles.org/services-and-classes/our-doulas/) it tells us only the barest of information on the woman. We see her due date, whether this is a first baby, if she is eligible for a car seat and breast pump through her insurance, what hospital she has chosen, where she is receiving her prenatal care and often not much more than that. Occasionally there will be a note, for example that she is in a methadone program, or that she doesn’t speak English. Our secretary will call the mother and explain a bit about our doula program and confirm that she would like to participate. So when I received Jessica’s referral it didn’t say a whole lot. I called her and set up an appointment for the following week at Everyday Miracles where she could attend childbirth education classes, yoga classes, and other offerings.

When she came I gave her a tour of the place and visited with her. Jessica was excited about this baby and they had both already read a lot of information about natural birth and knew what they wanted. She gave me a copy of her birth plan which looked perfect. I wouldn’t add anything. Then she told me she was in training to be a doula. Oh, wow! This will be fun!

She had taken the DONA birth doula course already and sent for the certification package. (http://www.dona.org/develop/birth_cert.php) At this point you have 2 years to meet all the requirements and submit your paperwork. She has attended a few births already and was gathering the rest of the information she would need. I invited Jessica to meet at my apartment for her next appointment and offered to lend her any books that I had ordered when I was being certified. Thus began our friendship. Since I didn’t need to educate her about labor or breastfeeding we used the times when we got together to look at birth videos, my own included. I had gone to The Farm in Tennessee to have my twins in 1982 with Ina May Gaskin and the Farm midwives when I had exhausted all the options to have a natural birth in Minnesota or Wisconsin. The birth was filmed and made into a teaching video called “Twin Vertex Birth”© Ina May Gaskin 1982. (See our story at this blog under the April stories listing, called Twin Birth on The Farm.)

I had several other teaching videos that Jessica had not seen, so we saw those together and talked about everything about birth and doulas and midwives and hospitals. This reminded me of the days two and a half decades before when I was expecting our 5th baby and I was starting to take classes which would eventually lead to my midwifery license. My mentor back then was my own midwife, Roberta. We were living in a log cabin at the time, our back-to-the-earth-simple-living experiment which was anything but simple. With 5 children and no electricity or running water (except if you counted my husband running the 50 gallon jugs up from the well at the pump house once a day), three still in diapers, and a ¼ mile dirt driveway which was impassible in the winter except by sled and also impossible the rest of the year after each rain which washed out the gullies further. But our 11 pound Hannah was born, though a whole hour before Roberta made it out to our rural route, parking on the road and hiking in the rest of the way. See “Wet Nurses and Other Alternatives to Bonding (and Free-Range Children)” at this blog also under the April listings.

It must have been past 5 a.m. several weeks later when Jim called to let me know they were in labor with regular contractions. I asked if I could speak to Jessica which would give me even more of a clue if this was early labor or the real thing by how well she could talk to me during a contraction. I encouraged her to labor at home a while longer if she was comfortable there. I called back around 6 a.m. not having heard again and spoke to Jim because Jessica could no longer speak through the contraction. I asked if they were thinking of heading to the hospital yet and he said they were still thinking about it. I offered to come to their house but they were doing OK so far on their own. When I called back again a little later I asked if they wanted to have this baby at home or in the hospital and that got them out the door in no time.

I was very excited for Jessica and had been looking forward to this birth. She was so down to earth, so well prepared, so healthy. Not all of the refugee and low income women we also serve are. I quickly dressed, checked my doula bag and called a taxi. I was at the hospital within 15 minutes. I asked at the desk if Jessica had shown up yet, and they assured me that they had not come in yet. A half an hour later, I checked at the desk again and they said she had still not arrived. Then they asked what her last name was, and they couldn’t find her in their system. I called Jim back and quickly realized I was at the wrong hospital! I had never done this before. I hadn’t opened her chart; I just assumed I knew which hospital it was. Apologizing profusely I hung up and called the cab company back. I couldn’t believe it. Was I getting senile? After this birth I put a pad of paper and a pen next to my alarm clock and I ask EVERY SINGLE TIME what hospital are we meeting at, even if I think I am sure I know, and write it down ... each time.

I arrived at the right hospital 25 minutes later, wearing my happy birthday tiara. At least we could laugh about it. She was still in the triage area of labor and delivery. There were no free rooms yet in the regular section. It was early, but there was really no room to move around at all and we couldn’t walk around the halls because there were families of all of the emergency room patients milling around. After monitoring the baby for a while the nurse said she would let us know when something opens up on the floor.

So we visited and breathed through the rushes which were steady but not unbearable. In Jessica’s own words, “We were finally moved to a labor and delivery room, though not in the midwife section, and they brought in a portable tub right away but had issues filling it, so ya’all were grabbing buckets of water from the sinks to fill it. I had to pee but just couldn’t and spent some time on the toilet whilst the tub was being filled… oh, and the popsicles, those were life-savers! Once filled I labored in the tub until I got too warm and stood in the tub and swayed and slow danced with Jim while you and my friend rubbed my back and fed me popsicles and water. Things were moving rather quickly. I came in at 6 and my waters broke – a water balloon between my legs!! and a couple of hours later I was 8 cm. Then things slowed down and I labored on all 4s in bed while ya’all reminded me to breathe and gave me my elixers -- H2O and popsicles. Once I felt the urge to push the midwife checked my cervix and I still had a lip on one side; later I learned that this is a sign of the malposition of baby’s head. I waited until I could push.”

Her midwife assured her that the baby sounded very good when she listened using a Doppler. Jessica explains, “Once pushing I didn’t feel like any progress was being made and asked if this was really possible.” It was hard to tell her she was doing everything right when she knew s/he wasn’t moving a whole lot.

“They made me change positions a few times, not delightful in high pushing mode, and finally ended on my back with my legs in the air and pulling on the sheet attached to the squatting bar. (Finally we could see a tiny circle of baby’s head.) Then the little guy came out after 2-plus hours of pushing. Bring on the waffles! This mama’s HUNGRY!”

She pushed for what seemed like forever and finally her baby boy was born, all 9 pounds and 6 ounces of him! And as he came out, out of the corner of my eye I saw a geyser of blood shoot straight up in the air. The midwife was at the bedside with Jim next to her. The nurse had not come back in yet. Somehow it registered in my mind that the cord must have broken at that moment, and in one move I spun around, grabbed a medium forceps clamp from behind us on the table and opening it up handed it to the midwife. We both saw the blood at the same time and both reacted immediately. She pinched the cord still at baby’s end with one hand and taking the forceps grabbed the placenta end of the cord as it disappeared back up into the birth canal. A bruise on the side of the baby’s head confirmed that he had been in an acyclic position, meaning his head was turned slightly sideways on the journey down to being born, which made it difficult to mold and difficult to descend properly. And now we knew his cord was short and just very grateful it didn’t break before he was out, which could have been catastrophic. It would have taken time to stretch so he could be born. It never ceases to amaze me how Nature accommodates such exceptions to the rules. The combination of all of these factors caused Jessica to sustain a 4th degree tear, which caused some complications later on though she was able to find help for it.

I saw Jessica and Taran (left) at our 10th year Birthday Party for Everyday Miracles last week. He is so amazingly strong, self-assured and inquisitive, a real ‘in arms’ baby. The difference is very obvious to me. (See at this blog the story under July listings called “The Ultimate Bonding Model.”) And now, having herself been on this bizarre, wonderful, outrageous, momentous journey of birth, I believe Jessica is truly a doula, able to put herself into another mother’s sandals or socks or bare feet at their birth. 

STAY TUNED... This and other stories will be appearing the book, Stone Age Babies in a Space Age World:§ Babies and Bonding in the 21st Century© or Call the Doula! a diary© both pending by Stephanie Sorensen

§This phrase was first coined by Dr. James McKenna, used here with permission and gratitude for his work. A world-renowned expert on infant sleep – in particular the practice of bed sharing, he is studying SIDS and co-sleeping at his mother-infant sleep lab at Notre Dame University. He is the author of “Sleeping With Baby: A Parent’s Guide to Co-sleeping,” 2007, Platypus Media, Washington, D.C.

“Around us, life bursts with miracles--a glass of water, a ray of sunshine, a leaf, a caterpillar, a flower, laughter, raindrops. If you live in awareness, it is easy to see miracles everywhere. Each human being is a multiplicity of miracles. Eyes that see thousands of colors, shapes, and forms; ears that hear a bee flying or a thunderclap; a brain that ponders a speck of dust as easily as the entire cosmos; a heart that beats in rhythm with the heartbeat of all beings. When we are tired and feel discouraged by life's daily struggles, we may not notice these miracles, but they are always there.” 

No comments:

Post a Comment