Have you ever thought about being a doula?

A friend asked me this, via text message, this morning. I was going to write her a big, long email back about my experience in doula-dom, but realized what good blog fodder it is! So here I am.

Yep, I thought about about being a doula. In fact, a little over six years ago, I set out to be a doula. Seeking a better birth experience with Joey than I had with Kevin, I hired a doula, and it was a very positive experience, and it kind of became the impetus for me to try to satisfy my fixation on pregnancy and birth by endeavoring to become a doula myself. What could be more fulfilling, I wondered, than being in a line of work that allowed me to support women during pregnancy and birth, and to witness the miracle of birth over and over?

I completed all of the study requirements set forth by DONA at the time, and underwent their weekend-long training workshop. The only other requirement to gain certification was to attend three births as a primary support person (and obtain written evaluations from the mothers, attending physicians, and nurses at those births).

In a nutshell, I was never able to follow through on the whole thing because I didn't have round-the-clock childcare available (which is necessary when you're going to be summoned by women in labor at all hours needing support) . . . plus, I kept having more babies myself ;)

I did attend two of the three required births, however. Well, actually, one and a half. And both of those experiences, along with my own hospital birth experiences, left me with the definite conclusion that I'm just not cut out to be a doula. I get too fired up about this stuff, too emotionally involved.

The first "client" I had (I use that term loosely since I offered my services for free, as most aspiring doulas do for those required certification births) was a young woman having her second baby. She was a single mom; her boyfriend had dumped her shortly after she got pregnant the second time. Her name was Melissa. I still remember the day she went into labor. I had met with her a few times during her pregnancy in order to establish a rapport with her. On the day she went into labor, we went to the park and walked around the lake together. Her contractions were sporadic but increasingly uncomfortable. She thought she might be leaking amniotic fluid but she wasn't sure. Towards evening we decided that she should call her doctor. She was told to go straight to the hospital. She called me from the hospital and told me she had been admitted. I can't remember how far she was dilated, but they determined that she was definitely in labor and that she was in fact leaking amniotic fluid, and since they didn't know how long she had been leaking, they were treating it as PROM (prolonged rupture of membranes) and so they hooked her up to an IV of antibiotics for the duration of her labor (don't even get me started on that). By the time I got to the hospital, her mom was there with her and she was confined to the hospital bed and writhing in pain. She wasn't progressing as quickly as they wanted, so they kept threatening Pitocin to augment her labor. She kept declining, and we tried some natural measures to get her contractions into a more active pattern. She labored for hours, mostly confined to the bed (because of the IV and fetal monitor they insisted on), which probably slowed her labor down. Anyway, finally she requested an epidural, which was given to her when she was 8 cm dilated. After laboring pretty much all day, the girl was exhausted and she finally fell asleep. It was the middle of the night by now, and her mom and I both dozed off too. At one point, a nurse came into the darkened room and checked Melissa's cervix. She whispered, "You're complete now. We can get things set up now and you can push, or you can sleep for a while longer, it's up to you." Melissa opted to rest a while longer. A little while later, the doctor came storming into the room. This wasn't even Melissa's regular OB, it was just the OB who happened to be on call, and he had come in briefly to meet Melissa once shortly after she was admitted, and that was the extent of his involvement with her to this point. He roughly checked her and told her point blank, "You need a c-section. The nurse tells me that you've been complete for a while, and yet the baby hasn't been born yet. It's too big for you to deliver vaginally." I was stunned, absolutely stunned. So was Melissa. WTF?! I knew this doctor was full of shit, I just knew it with every cell of my body. He was telling her that her baby was too big before she had even tried to push him out. We reminded him that she had given birth to her first baby vaginally with no problem. He said, "Second babies are always bigger than first babies. This baby is too big." I was terrified that Melissa was just going to go along with it, but it wasn't my place to make her decisions for her. I was only there to support her and help her reach informed decisions. Fortunately, she asked the doctor for a few minutes of privacy to think it over. He was a complete asshole. He actually said to her, "If you choose not to do what I am recommending, I will not be responsible for whatever happens to your baby." I swear to god, he said that.

As soon as he left the room, I went into a tirade. I told her that CPD (cephalopelvic disproportion - or in lay terms, a baby whose head and body are too large to fit through a mother's pelvis and/or a mother whose pelvis is too small to accommodate her baby) is impossible to accurately diagnose when a mother hasn't even attempted to push her baby out, that it's horribly over-diagnosed, that the doctor is full of shit insisting that second babies are "always" bigger (my second baby was exactly the same weight and an inch shorter than my first), and that she had every right to insist on an opportunity to try to push her baby out.

Melissa told the nurse that she wanted to try to push. So the nurse went and got the doctor and they broke down the bed and got everything ready. The doctor wouldn't even look Melissa in the eye. He had her lie back and put her feet in the stirrups and . . . sliced a nice big episiotomy with a pair of surgical scissors. I will never forget that as long as I live. I swear to god it was an assault. It was like he was punishing her for having a mind of her own and deciding to reject his recommendation of a c-section. I'm pretty sure I started crying then.

Melissa pushed her baby boy out in less than ten minutes (I'm getting the chills just typing this . . . all the images are coming back to me). And he weighed several ounces less than his big brother had weighed at birth.

I have no doubt that Melissa having a doula present saved her from a completely unnecessary c-section, and it was a great feeling to know that I was able to play a part in making such a life-altering difference to someone. It was also absolutely indescribable to witness the birth of a baby from that perspective - from the perspective of a witness and not the person giving birth (although it goes without saying that there is nothing more miraculous than being the one giving birth). It was an honor and utterly humbling.

But. The whole experience sent me into a sort of tail spin. I cried for days over that, over how that doctor treated her, how he lied to her and assaulted her. I went into a sort of depression over the whole thing. See, I couldn't distance myself. And it hurt. A lot.

The second opportunity I had went like this: it was a mom having her first baby and she was about a week past her due date and both she and her doctor were ready to have this baby out. There were no problems - the baby was doing fine in utero still, the mother was doing fine, but she was sick of being pregnant and the arbitrary 40-week mark had come and gone and her doctor was more than ready to put an end to the pregnancy. I actually inherited this client at the last minute from the doula I had used with Joey - she had a family emergency come up and knew I was trying to get my certification births done, so she called me and asked if I could take this client for her. So I didn't have an established rapport with this mom and her husband. I met them at the hospital and sat there twiddling my thumbs for about 12 hours while they induced her with cervadil and then Pitocin. Despite those measures, she still wasn't progressing, and they finally decided to stop the induction and let her sleep for the night and then try again in the morning. I went home at that point, telling them to call me the next morning and I would come back. They didn't call me back until after the baby was born, though, and she had ended up with a c-section. Totally not surprised. But very disappointed and disillusioned.

And again I went into that whole crying jag thing over it.

I hate the maternity system here in the US. I hate how women and babies are treated, and I hate that women just accept it for the most part. I hate that women fear birth. I hate that doctors lie to women. My own birth experience with the twins was horrible, and just completely confirmed my distaste for the hospital birthing industry. And that's what it is - an industry. I would love to see the US adopt a midwifery model of maternity care (as supported by WHO), but it's never going to happen. Obstetrics is big business. Huge. And women are all too willing to hand over responsibility for their birthing experiences to doctors who supposedly know what's best for them. Doctors who have discovered better ways to bring their babies into the world than Mother Nature has provided. Because women are defective, you know. Didn't you know that?

See how I get all revved up about this stuff? This is why I can't be a doula. It all just hurts too much.