I thought it would be a good idea to spend a little bit of time fleshing out some of my thoughts and opinions on doula care for those of you hoping to get to know me better. Then we’ll discuss how doula care fits with a miscarriage or stillbirth.
First, let’s balance what a doula is not (and some of this is already spelled out on the website) with what a doula is… A doula is not a nurse or a midwife or any other medical provider. I have no medical training, so I will not be providing any medical care or evaluations (no blood pressure checks, etc..) or giving out any medical advice. Also, (and you will find varying views on this among doulas) I believe a doula is not an advocate or go-between between you and your medical providers. I encourage you to communicate your needs and desires directly to your physician or midwife. I love this quote found online (courtesy of www.BirthAdvantage.com), “Doulas DO NOT advocate. Doulas teach and empower you to advocate for yourself. They will help you prepare for your birth and encourage you to ask the right questions during your birth. Nothing is more empowering than making important and informed choices for yourself and your family.”
A doula does not take the place of your spouse or partner. As a doula I am committed to helping the two of you work together as a team in your labor and birth. Your partner knows you better than I ever will. And your partner’s intimate knowledge of you – your strengths and weaknesses, your likes and dislikes, your past – makes them the ideal person to coach you through a marathon labor. My knowledge of labor and birth can give the two of you suggestions for labor positions and relaxation techniques that you can do together. Furthermore, a doula can provide support for your partner as well as you, making sure they also stay hydrated and relieving them for bathroom breaks or a meal, so that you are continuously supported and they are not in pain from a full bladder! A doula also should not take the place of the family and friends who make up your natural circle of support. A doula can support you and support your mom or sister or bestie as they support you.
So how do I describe doula care? Well, it involves a lot of listening – listening to mom’s words, and trying to listen for what is unsaid as well. Watching for cues in her movement and posture that clue me in to what she may be needing. Doulas are a sounding board for mom to share her fears and then help to diffuse those fears. We can speak to those fears with answers or help you find the right questions to ask of your caregiver so that they can address those fears. Doulas build comfort. Think for a moment about how we perceive comfort…through our senses, right? A doula works to establish and maintain comfort for the momma doing hard work. A warm blanket when she’s chilled, a cool cloth and fan when she’s sweaty. A quiet, peaceful environment. A massage for her aching lower back. These are just a few examples of how a doula builds comfort. A doula also bolsters confidence… “You are doing it!” “You are so strong!” “You are doing a great job.” A final key factor in doula care is sharing suggestions. A doula can offer suggestions for positioning, movement and comfort measures to relieve pain or to bring baby into a more optimal position for birth.
To sum up, I would say that the roles of a doula are to: Listen, Diffuse Fear, Build Comfort, Bolster Confidence, and Share Suggestions. The doula’s role is one of nurture and care. I believe this tender support is so beneficial for a mom in the midst of labor and birth. A mom doing the hard work of bringing a baby into the world should feel supported, nurtured and cared for. Labor and birth is a very raw, open, vulnerable time and we do well when we see the value in making sure mom feels safe, comfortable and cared for in this time.
Now, what if that mom’s world has just come crashing down with the heart-breaking news that her baby inside her has died? Shouldn’t we seek to pour even more tender love and care into her when the road she has to walk involves the searing pain of grief and the vulnerability of birthing? How much more does this momma need someone to listen to her, hear her fears, and answer her questions with honesty and gentleness! How much more does this momma need someone who can build comfort around her for her and her family as she is numb with grief! One of the more indirect ways that a bereavement doula can build comfort is to anticipate and diffuse potentially traumatic scenarios. A bereavement doula can not (and should not) try to take away the family’s grief for their child, but a bereavement doula can do their best to prepare the family for meeting baby and work to keep their environment safe and supportive. Furthermore, we work to build special memories with baby – photos, footprints, assisting in bathing and dressing baby, etc…
I think that doulas are often thought of as a natural birthing coach, and when people have that understanding, the concept of a birth and bereavement doula seems disjointed and awkward. But if you view a doula as someone who nutures a mom during a very vulnerable window of her life you can see the value in doula care for a momma experiencing a miscarriage or stillbirth. The focus is not on the birthing method or birth scenario, but on the listening, dffusing fear, building comfort, bolstering confidence, and sharing suggestions, in order that mom will feel cared for and supported in her time of need.
