Tuesday, February 23, 2010

Repeat Clients

There is nothing I love better in my practice than repeat clients. Whether a woman had a challenging or easy birth, it is such an honour to be asked to share in her subsequent birth experiences. There is something I find so delicious about being considered "the family doula". I love it when it extends to the circles within which the clients live and work as well, so this small city of mine begins to feel like extended family with all the interconnectedness.

I am the doula for students and professors in certain departments in some of the universities in Montreal, to a circle of dancers, to a group of family physicians, to the postpartum nurses at one of the hospitals I work at, to moms of established playgroups, etc. It is amazing to see how the work grows, and to be asked to keep coming back. While I get many many requests for doula work, some of which I personally simply cannot take on due to volume or other engagements, I ALWAYS try to take on my repeat clients if they ask me, even if I am quite booked for a particular month. I have changed vacation dates, made exceptions, reduced prices, whatever it takes to do my best to meet those needs. I feel that if I am given the exceptional honour of being asked to attend the birth of a former client, I'm going to accept whenever I can. It is so sweet to be proudly shown and given the previous child to snuggle while the mother talks about this present pregnancy as we drink tea, and to be able to discuss little things about her last labour. There is something, I think, profoundly comforting about having someone at your birth who knows you...who knows some of your unique birthing behaviours.

The story of the first birth I went to which I told you about a couple of blogs ago, is a perfect example. I attended my friend's next birth (her third) several years later. Knowing her beautiful, interesting behaviours helped me get the midwife in the room on time. Had I not known, I would have ended up doing a repeat catch. For this labour, she chose a midwife at a birthing centre. She had chosen to treat for Group B Strep, so as soon as she felt some labour-ish sensations, she went there to ensure she had antibiotic coverage 4 hours before birth. I went over there, and she was barely contracting at all. We had fun, walking around the beautiful old building. I took pictures of her big belly, and of her and the baby's dad. The contractions she had didn't make her crack a sweat.

After a little while, she started having a few more noticeable contractions, which made her lean over and breathe a little harder. Nothing to write home about. Then she leaned against her husband and had a really big one. Then she started walking around in a way that struck me with great clarity; this cute duck-ish walk she did, while emitting a few little whimpers, was what had happened just before she started crowning at her last birth. I RAN down the hall to where the midwives were hanging out. I said, "The baby's coming!" They looked at me like I was crazy, because they hadn't seen or heard any convincing, serious active labour when they had been in the room about 25 minutes before....otherwise, given her history, they would have stuck around. As far as they knew, she was just beginning to have some noticeable contractions. But midwives tend to believe wild allegations of precipitous labour, regardless of what the cervix has been doing a few minutes before, so one of them came tearing back up the hall with me. My friend looked at her, yelled "It's coming!", did her "yank-down-her-panties-and-throw-herself-onto-her-back-with-a baby-head-between-her-legs" thing, this time onto the bed, and proceeded to birth her 10 pound baby in a few easy pushes. I don't think the midwife even had time for gloves. But thank God she was there, because she did her midwife magic and that baby was born over an intact perineum (not so when I clumsily caught her previous baby years before).

It is so beautiful to watch a woman you have helped before undertake this journey again, trusting you to help her manage her fears and life situations. I have a lady who calls me every couple years from a religious Jewish community, saying, "Hi, I need you again!". She called me recently again...this will be the fifth time. She really depends on my presence. She says I calm her, and buffer the energies of the hospital. I don't take that responsibility lightly. It's not a casual duty. This is a woman's birth experience, after all...her own way of expressing this unique, feminine, biological function and all the emotions and circumstances surrounding it. To be invited into that inner sanctum requires commitment that is made months in advance. I would be very sad if I ever missed one of her births. She has had so many challenging circumstances in her life, and I am the anchor who holds all her information and wishes so she doesn't have to explain herself to every person who walks into the room while trying to go inside herself and labour. I don't need to do anything for this woman, who is a very powerful and experienced birth giver, but make sure she has a calm space within which to do her thing, and hand her the homeopathic remedy she likes to take throughout labour (amazing stuff...it's from Israel and written in Hebrew, but man, it makes birth speedy and efficient for the ladies I've seen use it). I need to call the doctor in when she starts smacking the bed with her hand, because I know this is how she expresses her need to push NOW. She and her husband are very fair skinned, and the babies they make are very very pale when born, but it's never been a problem at all, so I pass that info on to Pediatrics when they express more than just a little concern. It's very simple work, but so enriching!

My hope for all you new doulas is to eventually know the joys of a practice that is largely made up of repeat clients. It is very nurturing...for them, and for you.

Lesley

www.motherwit.ca