Friday, July 13, 2012

Why Doulas are Great Childbirth Educators

I am so looking forward to teaching the MotherWit Birth Essentials Intensive, Part 2 tomorrow. I LOVE teaching childbirth ed. I think teaching from the perspective of a doula is very useful to clients, as we are in the field, seeing lots of of different types of births and clients from their prenatal visits, to the labour and birth, to the postpartum debrief. We are for the consumer, not biased towards making them embrace one approach to birth over another. I remember when I was taking my own prenatal class over 20 years ago, very pregnant with my first baby. I had decided upon a home birth. I got no end of public guilt tripping and fear mongering from the nurse who was teaching the class, a nurse who seemed very out of touch with anything "real" about birth at all, aligned simply with what she knew from her medical perspective. My husband and I ditched after 2 days and read Spiritual Midwifery instead. As doulas, we are used to supporting everyone, and have worked hard to hone our skills in diplomacy and support. We spend endless hours with our clients in our prenatal visits, getting to know them and explaining the birth process to them in ways they can understand. It is easy to accept our students wherever they're at, without judgement, trusting they have the wisdom to deal with however their births unfold. Our tone is usually personal and friendly, as we have a lot of experience engaging and drawing out all different kinds of people. As doulas, we strive to keep the environment of a class warm and nurturing. Tea and cookies will almost always be found in our classroom. As a doula trainer, I make it a point to make hospital based prenatal classes a part of my students' curriculum. There is valuable information to learn from a different perspective from the way I've taught my doula students myself, but also, I think it is crucial to learn first hand what their future clients' heads are going to be filled with, for better or worse. We have been witness to some pretty intense statements made in a well meaning way, but without awareness that these statements are quintessentially disempowering to the pregnant people being taught. For example, a doula will probably never say, "You think you won't want an epidural now, but just you wait 'til the pain kicks in," as an intro to a 2 hour lecture on anesthesia (without about 2 minutes focus on breathing). We also don't tell our clients not to hire doulas (obviously) because fathers can do everything that a doula does (sure, sleep deprived, inexperienced, frightened and emotional...that's an awful lot of pressure to put on a dad and projects unrealistic expectations on him, setting the stage for him to feel potentially like a traumatized failure if things don't go as they had planned). Also, we will never say that natural birth is the only way to go. We honour choice. We will not show birth videos from the 70's with shirtless fathers in satin running shorts and elevator music in the background with a mother having a very unrealistic silent birth. We get real about what birth sounds like. Neither do we make the focus of figuring out labour progress by staring at a clock, as we've never known a clock to announce to anyone where they're at in labour. We prefer mothers and their partners to check in and observe feelings, behaviours, physical and emotional indicators. One thing we like to emphasize to our students is their innate sheer ability to birth in most cases, regardless of what personal choices are, and that hospital statistics don't reflect women's abilities, only a culture. Sometimes that little whisper of motherwit in a woman's ear, that reminder that she comes from a long line of maternal ancestors who clearly birthed quite well in most cases to get her line established, is all she needs to hear to awaken her deep, ancestral, body knowledge. The ability to inspire is the educator's most powerful tool. As educators and supporters of hospital birth, doulas emphasize that doctors are amazing at ensuring things are okay and intervening when they're not. We want confident women who can put some trust in their environment. But we also ensure they know that while their doctors are experts in dealing with pathologies, they are not usually experts in supporting labour or knowing what is needed to get through a normal birth unmedicated if this is, indeed, what a woman wants. It is unrealistic to expect their doctors or even nurses to play that role to help them deal with their labours. In fact, many doctors have never hung out with a woman throughout her whole labour, watching it play out with the woman's own personal nuances. And sadly, most nurses just don't have the time. Medical staff are there for safety purposes, and to receive the babies women deliver. We're about finding ways to prepare our students to get through the parts the doctors don't necessarily see or register, like "THE WALL", the ebbs and flows, and the sensuality of labour, giving them as many resources as possible in case they have nobody else there to support them. That requires a different, non clinical focus, and our class is about helping moms and their partners navigate their way through this primal dance, no matter how it plays out, without worry. Doctors are there to worry about the clinical stuff, leaving parents emotionally free to do their labour dance thing. A doula-led prenatal class tries to keep a focus that is truly on outlining the information as best we can, supporting choice, providing lots of ideas on coping, diffusing fear surrounding the hospital environment and potential interventions (you need to be relaxed in your place of birth), preparing for feeding and caring for a newborn (or two) and inspiring excitement. I can't speak for all doula/childbirth educators out there, but more of our students end up giving birth normally than in other classes which cater mainly to a hospital birthing clientele. I suspect most doula/educators have similar experiences. This excites us to no end. And no, we don't get all the hippies either :) We simply promote a more inclusive paradigm. This makes people feel safe. Not pushovers, as we emphasize patient's rights in a big way. But hopefully more serene.