One of the sad things about today's care of the pregnant/birthing/postpartum woman is a lack of respect for her intuition. Many women are considered hysterical or completely blown off for discussing their intuitions. What exactly is intuition? It's about looking inside and gathering information about things and situations not by reason, but by feeling. It is not about being psychic. When we refer to intuition, people sometimes think we're refering to looking into the future, which, unless you truly are gifted with psychic ability, is not generally possible. I think intuition just means gathering information about things which are conveyed in ways more subtle than can be perceived by the five senses. I don't believe, as doulas, we can predict how birth will ultimately play out in the future (try to pin Birth down, and she changes on you...she hates us puny humans trying to "know" her too well), but you can, in the here and now, be able to intuit something about a woman, perhaps an emotional or energetic frequency, that can give you a good or not so good feeling about how that may play out in the field of childbirth. And you can be wrong, which is okay, because nothing is fool proof.. not ultrasounds, amnios, or blood tests (oh my!).
As a doula you would never say, "I have a great feeling everything is going to be fine, so don't bother checking that unusual symptom out with your midwife or doctor." Most women wouldn't eschew some form of prenatal care if given the choice, based upon intuition alone of their and their baby's wellness. Some do, and more power to them, but most don't. But just because we usually don't use only intuition to gather information, doesn't mean it should be discounted as an extremely valuable tool to determine things about a woman's experience.
I trust women. A woman in her childbearing year tends to have incredible insight into the workings of her body and her baby. She should be given plenty of space to talk about these feelings freely without fear of being judged as "silly". When you're growing a baby inside you, you are linked to another being more intimately than any other way. It is no surprise that a woman can have very strong feelings about what's going on with her baby. I kinda believe that a baby transmits his feelings to his mom in some cases. I don't think he says, "Mother, I am planning on becoming photographer someday," or "Ma, I will be born with a large birthmark." In fact, many women before the days of ultrasound were unaware they were carrying twins until the day of their birth. I just mean I have seen wild flashes of insight which, in spite of medical disbelief or logic, have been proven right. There are just times a woman tells you something when you know in your own gut what she is saying is incontrovertible...you know it by a strong feeling of resonance with the truth of her words.
Here are a few examples. A really crazy amazing wild woman friend of mine named Michelle, was my doula for the birth of my first child. She had given birth to her own first three children at home in the mountains of Tennessee, one of them unassisted, I believe. When she became pregnant with her fourth child, she had been doing some doula work in hospitals. She told me she thought she'd birth this baby in a hospital. I asked her, "What do you mean? You've had great home births. What makes you want to go to the hospital?" She told me she wasn't sure, just that she had felt really comfortable in a certain hospital she had worked at, and felt drawn to give birth there. She arrived at the hospital in labour, and was very quickly rushed to the OR for an emergency C-section because of severe fetal distress due a real and serious umbilical cord problem. Her son was fine. And her next three children were born at home in the Dominican Republic.
I had a client once who was SO enthusiastic about water birth. She booked herself a space at the Birthing Centre where her midwife said there was a room for water birth. She even wrote an assignment for a training she was doing on the joys and benefits of water birth. So in labour, there she was in the water. 2 interesting things happened, that were probably unrelated (but who knows?), but I'll mention them both. One thing, was that about five minutes before the baby was actually born, she got this look on her face of seriousness. She looked at me and announced, not with a fearful tone, but just in a very matter of fact way that she didn't want to be in the water any more. She is a joyful lady with a lovely sense of humour, so this sudden change to serious was unexpected. I was surprised, but just got her out of the tub as she wished. She hopped on the bed and birthed her lovely child. That baby had the teeniest tiniest little cord you ever did see! There was no way we could even put the baby on her because the cord was so short. The midwife said, "Wow, that's interesting. Had you given birth in the tub, we wouldn't have been able to lift the baby out of the water." Not that this would have been dangerous necessarily, just that it might have been pretty awkward to get the mom and babe out of the tub.
The other thing was that in the tub while the baby was making its descent into her birth canal, she was sitting in a really strange way. I can't even describe it, except that it looked like she was trying to open up one side of her pelvis as widely as possible. It looked super uncomfortable, but that's how she wanted to be. I did some bodywork with her a few days after the birth of her baby and found one leg to be quite shorter than the other and her pelvis very contracted on the side she had been intuitively opening up in labour. She told me she had been in a bad car accident during her childhood, and had sustained injury to her pelvis, but it was not something she had consciously thought of during labour. But her body "knew", and so most likely did her baby, sending her messages the mysterious ways babies do.
I cannot tell you how many times I've been with women, lots of them first time moms, who are told they are 2cm dilated or so upon arrival at the hospital, but contracting as if in active, not early labour. Often, nurses want to send these women home, because the belief is that if you're only 2cm dilated with your first baby, you've still got many hours to go. But many of those moms announced there was no way they were going to go home because they were sure, because of how they felt, they were moving right along in labour. And it's crazy how often they are argued with, being told they're just not managing their pain very well, and that it's only going to get harder, and they might even "need" an epidural later if they're feeling labour that strongly at "only" 2cm. But I tell them, "you're contracting great! Your cervix is going to catch right on up to those contractions." And so it usually does, proving that for them, active labour can certainly be going on at 2cm, no matter who believes them.
I remember having a client who was having SERIOUS contractions. But they were far apart, like about 8 minutes or so. They were intense enough to make her want to get to the hospital. I arrived, and she was sitting on a bed on a monitor with a barf bowl under her chin, and that really stoned look women get between contractions when labour is powering on. I watched her contract, and though she wasn't making much noise, you could tell it was a really good one. The nurse looked at the monitor and laughed at her, telling her she shouldn't have come to the hospital yet, that contractions HAD to be closer together for them to even consider taking her in. I asked the nurse to check her, just in case, because I had a feeling this mom was in really active labour. The nurse didn't want to, but did. The mom was 7-8 cm, and gave birth quite soon afterwards. I don't put much stock in numbers of centimetres of dilation, but I'm glad for the mom's sake her cervix gave the nurse the numerical "evidence" she wanted to admit my client.
I just don't understand why a woman who says, "I think the baby is coming sooner than you think" is met with arguments against the claim of her own experience. My doula colleague who works primarily with a community that has lots of babies sometimes ends up actually catching the baby in the hospital because the medical staff don't always believe the woman will deliver as quickly as she says she will. If a mother of 8 says, "The baby is coming!", and her cervix gets checked (grrrr) and you hear it's 4cm, believe the mother, not the cm. Put on gloves if the doctors leave the room in disbelief. TRUST THE WOMAN!
A few weeks ago, a lady called me in the morning saying, "I sort of feel something happening, but I'm not sure...just lots of pressure..no pain or anything. I wanted to give you a heads up." I hung up thinking, because it was her second baby, that things might rev up quickly. Just the sound of her voice sort of gave me a feeling. Sure enough, on my way to a prenatal appointment, the woman called me up crying fearfully that contractions were coming really close together, were intense, she was alone in the house and couldn't reach her husband at work. I booted over there in about 10 minutes to find her on hands and knees making active labour noises. I managed to get in contact with her husband and mother-in-law to make arrangements with her other child, and then I wondered what the best option would be. I was wondering how long we had before this baby was going to make her arrival. Things looked and sounded convincing, and I knew if her waters broke, I'd be catching a baby. Ambulance? Cab? So I figured I'd ask the mom. In a small space between huge contractions, I put my hand on her back and said her name, and asked her to look at me (I normally wouldn't interrupt a woman's concentration like this, but I felt she would be able to give me information I needed). I asked her straight up, making deep eye contact. "Are we going to make it to the hospital?" She stopped breathing heavily, checked in for a second, and said, "yes, we are." So I called the cab. The baby was born about 45 minutes after we arrived, 5 minutes after her waters broke.
I have many many more stories like this to illustrate a woman's deep connection to her body and her baby, but you're all gonna have to wait for my book to come out next year :)
I'm really digging this exercise in blogging, and could go on for hours, wind bag that I am. But I'm going to be making my posts a little shorter in the future in order to make more progress on my book. It's going to be called: Choosing Wisely: A Doula's Guide to a Happy Birth Day.
So, just to reiterate before I retreat back into real life (hyper kids who have eaten too much Friday night sugar, a lady whose waters have been broken all day, and many new client requests to process):
Intuition is often undervalued in our medical system. We need to listen carefully to women, and pay attention to our own feelings as well. BUT, it doesn't mean intuition is all we should use. It is one tool out of many. A primary caregiver having excellent clinical skills and experience AS WELL as good instincts and a gentle, compassionate, honouring bedside manner is ideal.