So what does doula support really look like at a birth?

Michelle and David attended my Birthready 2 day workshop and also booked me as their doula.  They gave heartfelt feedback about their experience with me (prenatally and during labour), which may help you better understand how doula support can help you too. Read on for their testimonial and feedback.

“Choosing Erika as our doula was the single best decision that my husband and I made in relation to birthing our baby. Erika is enormously caring, well-informed and experienced. From the start, she put us at ease with her open and friendly manner, her straightforward communication style and her warm sense of humour. We knew we could trust her to support us, but we couldn’t have imagined how indispensable her help would be…..”

Erika provided an astounding degree of emotional and physical support throughout a long and complicated labour. She supported me emotionally by continually offering her undivided attention, positive energy and encouragement. At my most vulnerable moments, her very presence helped me to feel safe and respected. I remember distinctly feeling that she was giving me not just her professional support, but her love and acceptance. I truly felt that she heard and understood my needs. When medical complications made it necessary for me to induced and monitored, Erika immediately reframed the situation in a positive way, which helped me to make the best of it. When I was really struggling to go on, she reassured me that what I was experiencing was normal.

Also, Erika was tireless in providing physical support throughout the many hours of my labour. For instance, by applying targeted pressure to my hips, she massively reduced the level of pain I experienced with each contraction. She also helped by massaging me, holding me and recommending different positions for me to try. Erika’s energy never flagged and her strength was a real source of comfort.

During most of my labour, I used only TENS machine and gas for pain relief, but due to complications I eventually had an epidural and a caesarian. I would certainly have required pain relief medication much earlier if not for my husband’s support – and he would not have known how to support me so effectively if it were not for Erika’s guidance. Erika was calm and respectful in dealing with hospital staff, confident in questioning and clarifying their recommendations, and able to seek the perspective of an independent midwife on my behalf when this became useful. Erika’s focus on evidence-based decision-making and informed choice was very helpful. Erika is a genuinely inspiring person and we are very grateful to have had her with us during labour.” – Michelle and David

Reflections about your journey to parenthood

1. What are you proud of with regards to your birth preparation and birth experience?

In the lead-up to the birth, I’m proud that I stayed calm and positive, that I did a suitable amount of research and reading about labour, and that I made the most of what I learned at the active birthing workshop. I’m proud that I took care of myself and was careful to choose postures that would optimise the position of the baby. I’m proud that I was diligent in doing pelvic floor exercises and perineal massage, and that I took my supplements throughout pregnancy without missing a single day. I’m proud that I practiced affirmations (which I previously thought were silly!) and that I even did a little bit of mindfulness meditation (which I’d never done before).
During labour, I’m proud that I was able to quickly come to terms with all the required interventions and let go of the idea of a ‘dream’ labour. I’m especially proud that I was somehow able to cope with the contractions for so many hours with just a TENS machine, gas and the (indispensable) help of my birth team for pain relief. I’m proud that I used a variety of upright positions and continued to be active for at least some of the time. I’m proud that I didn’t hesitate to ask questions, ask for the help I needed, and advocate for myself throughout.

2. During this process what new skills/aspects about yourself have you learnt?

I learned that I am able to withstand levels of pain that I previously could not have imagined! Aside from that, the whole process confirmed a lot of what I know about myself (e.g. I’m very conscientious about a lot of things, but pretty lazy when it comes to physical exercise; and I’m quite cerebral and find it difficult to “get into my body” and get in touch with my instincts.

3. Is there anything you would like to do differently next time you are pregnant / give birth / parent?

There are a couple of things: (1) I would like to find the motivation within myself to do more exercise and meditation during pregnancy, and (2) immediately after the birth I would like to allow the baby time to try to initiate breastfeeding unassisted as I think this would make subsequent breastfeeding a whole lot easier.

4. What were the benefits in having doula support? For example:

In preparing for birth
– Offering reassurance and reframing the pain of labour in positive ways;
– Helping us understand the natural birthing process, the mechanics of birth, and the sense of it being a marathon;
– Informing us about active birthing and common interventions;
– Sharing different perspectives and a library of resources;
– Just being available to share the wisdom gleaned from extensive experience of being with laboring women; and
– Taking the time to get to know us and develop a personal connection, putting us at ease so we could have a high level of trust, comfort and familiarity during the birth.

At the birth
Giving continual attention, care and emotional support
– offering encouragement and positive feedback about how I was doing;
– helping me feel safe and respected when I was most vulnerable, by the way you were present in such an intimate and private space;
– giving me love (that’s really truly how it felt!) when I was having a hard time;
– helping me feel listened to and heard (when I said “I’m not going to be able to cope with this degree of pain for much longer”);
– helping me understand what I was going through (e.g. saying “The doctor has given you news that your cervical dilation hasn’t progressed, and because of the disappointment you’re experiencing the pain more intensely”);
– normalising my experience and not judging me for how I was responding (e.g. early on when I was feeling really sad and just wanting it all to be over, I asked whether this was normal and you said “Women experience the process in a whole variety of different ways”);
– reminding me of my birth preparations (e.g. saying “Now, think about whichever affirmation really resonated for you” – this really helped me at a particular moment); and
– facilitating better emotional support from other members of the birth team.

Being an ever-present ‘pillar of strength’ in the room
– exuding unrelenting positive energy, inner strength and patience throughout an extremely long day;
– ‘going with the flow’ when interventions were necessary (and saying encouraging things like “That’s OK, we can still have a great active birth even with induction and monitoring”);
– just being there in a reassuring way when I experienced a terrifying moment of panic; and
– supporting informed choices (see below).

Offering tireless physical support
– giving me massage and pressure (e.g. the hip squeeze that did wonders to alleviate the pain of contractions);
– letting me ‘hang’ my bodyweight on you and holding me during some contractions;
– recommending different positions to try; and
– encouraging me to eat and drink (though I didn’t want to eat at all!)

In knowing my options and making informed choices
– Providing an independent perspective with knowledge based on extensive experience;
– Having a respectful relationship with hospital staff and also having the confidence to question their advice;
– Contacting an independent midwife for a second opinion about the need to induce labour under the specific circumstances (i.e. meconium in the amniotic fluid when my waters broke);
– When an unplanned caesarian was recommended, making an argument for continuing to labour with an epidural for a period of time before deciding on a caesarian;
– Being ready to advocate for my best interests if they were to conflict with hospital policy.

For my partner
– ‘Breaking the ice’: leading the way with calm confidence and setting an example for my partner to follow from the early hours of labour onwards;
– Guiding my partner in when to step in, and having confidence that he already knew how best to support me psychologically and emotionally;
– Sharing the physical work of caring for me, which would have been very onerous for my partner alone (even with the support of the hospital midwives).

Regarding preparation for life with my baby
At your birthing workshop:
– helping us think through how our days might be structured in the early weeks of parenthood;
– offering an introduction to breastfeeding;
– advising on how to settle a distressed baby.

5. Is there anything I would like my doula to offer, or do differently, that may improve her support for me, or others? (refer to the list above)No, you were absolutely perfect! David and I are deeply grateful for everything you’ve done.