Tuesday, August 19, 2008
I have been putting off writing this post, but this stuff has been tumbling around in my head for almost a week now and I thought it might be good to get it all down and sorted out a bit. I don't know if I had mentioned it here before, but one of my life desires is to some day become an assistant midwife. I would like the road to that goal to take me through doula certification and some kind of lactation consultant training, if not certification. I really have a heart for pregnant women and their babies and I really do love everything about birth.
I had originally planned on starting my doula certification process this last year, but one thing led to another and I never ended up starting, officially. I have been slowly but surely gathering the books I need to read and have cracked a few of them already. I guess this just isn't my doula season yet though. :)
Although I have given birth to three children naturally, and hopefully a fourth one coming up here in the fall, I do not feel like I am the know all end all expert on natural childbirth. Far from it! I know what works for me. When my brother called me to tell me that the time had arrived for their baby to come, that is the perspective I left home for the hospital with. I packed a few things that I knew had been helpful during my birthing experiences and just planned on staying for a bit to help everyone get settled. I was there a couple of hours, her water had broken naturally, but she was only 34 weeks, 4 days pregnant. I guess the powers that be decided that this baby could wait no longer and decided to proceed with Pitocin. This is where my inexpertise in birth really kicks in. I have friends that have gone weeks with ruptured membrane and the baby has been just fine. I guess being exposed to the alternative side of childbirthing makes me more likely to "question everything" that the status quo takes as normal.
I stayed for a few hours, but had to get back to my boys, so I promised to come back later that evening after Eddie got home, to check on how things were going and see if I could be of any more help to them. I felt good leaving them with an admonition to "Drink a lot of water and tea and eat eat eat!" My brother called me a few times at home with updates and then I headed back in the evening, expecting to mostly be a spectator and stay in the room and be supportive as long as I was allowed to. In the hospital where they birthed, only three extra people were allowed to be there when pushing began. I figured that I would be the last person they would ask to stay.
When I arrived labor was already in full swing. I believe she was 5 cm dilated when I got there and starting to be in a good amount of pain. I had heard her mention previously that she wanted a completely natural birth, but in my personal experience, that is very hard to achieve in a hospital setting. I was hoping to help as much as I could. I had my rice heat pack to warm up, a birthing stool, a pitcher of Raspberry Leaf, chamomile, spearmint, and honey tea that I made up at home, plus various massagers and snacks like nuts, dried fruit, and whole grain muffins. There was a shower in the room too, so I thought we were set. The first draw back was that she was not allowed to use the shower because of being induced with Pitocin. The second drawback was that the nurses refused to warm up the rice heat pack because their microwaves were for food, not patient's heat packs. The thrid drawback was that the nurse continually kept asking if she could give the mother Fentenol in her IV because it would "help labor progress more quickly". She came and asked at least every 10 minutes, finally resorting to telling the mother that if she didn't take the Fentenol, her cervix was going to swell up and she was going to have to have the epidural she was trying to avoid and possibly end up in a c-section. For crying out loud!
The only thing I could do was rely on God. I prayed that He would give me direction and wisdom in how to deal with the situation. My biggest desire was that I wouldn't be pushing my own natural childbirth agenda on the mother and taking over her birth experience. I just wanted her to be informed, but also to feel like I was on her side no matter what she chose. I really have no idea what being a doula is all about yet, since I haven't been trained at all, but I know how I would want to be treated during my own birthing experience, so I tried to use that as my guideline. I felt like I needed to establish a team attitude with the nurse on duty, but she was not making it easy. I could tell she didn't trust me, and I really didn't trust her, but I was determined to work with her as much as she would let me. I was hoping to convey that attitude to my brother and his family as well, because I didn't want it to ba an us against them situation. That would end poorly for all involved. Can I say again how terribly inadequate I felt for this task. I know this is long and rambly, but I need to process all this so I can sleep tonight! Sorry that you have to be along for the journey.
I mostly just tried not to contradict the nurse right to her face. I waited until she left the room, and then I offered information to help them make the best decision for themselves. They had originally agreed to take the medicine, but by the time the nurse got back with it, they had changed their minds because they were better informed. I just tried to offer encouragement and information as needed. The thing about the nurse that I did like, was that eventually I was able to win her over. I thanked her for at least letting the mom get out of bed and cope with her labor however she could (it is unusual that women who are hooked to an IV are allowed to walk around, in this hospital) She said that as long as the baby looked good, she would continue to let the mom walk around. Because of the trust I developed with the nurse, I was later able to talk her into leaving the room for 5 minutes so I could give the mom some homeopathic remedies which are not allowed in that hospital. I asked in a vague way, and because of the trust, she let me do it. That was totally God. I mostly just coached the mother to breathe, drink, breath, drink, breathe. God totally gave me the confidence to take charge and get her attention and be the safe beacon in the midst of her labor to focus on. It was pretty cool.
Okay, to wrap things up, it came time to push, she made it the entire labor with no drugs or epidural, and even though she was scared about having an episiotomy, she came through everything with flying colors. I found that since I am not really a doula, I didn't know what to do about the follow up stuff that doulas usually do (at least in my experience with them). When Karlos was born, our doula stayed with us for a bit after he was born, then came and brought us dinner when we got home from the hospital. She made herself available morning or night if I had breastfeeding questions, she showed Eddie how to make icepacks for my sore bum and she just took good care of us. She was so helpful, both Eddie and I feel like we would not have made it through the experience as successfully as we did without her. We even named Elliott after her. She is now one of the head nurses in the maternity ward of the hospital where my nephew was born. I didn't get to see her, but sometimes I think about why she chose being a doula or nurse instead of being a midwife. She had three of her five children at home with a midwife, why did she chose the hospital as her place of operation?
I think I may know now. As hard as it has been for me to attend or hear about births where pain relief is used (because I wish all mothers and babies could have the natural beautiful births that I have had, not because I think everyone should be a masichist like me) I have realized that there are those few who have no other options, whether in reality or because of that lovely status quo again, and they need doulas like the one I had for Karlos' birth to remind them that they have the power within themselves to birth that child in whatever way they determine is best for themselves and their baby, no matter what the hospital tells them or pressures them to do. Does that make sense? I guess I feel like God just really gave me the opportunity to be able to use my experiences to help another mom realise her potetial. I think that is mostly what it is all about.
I'll probably have to go back over this later and do some heavy handed editing, but I think I got enough out tonight to be able to relax and go to sleep, Thanks for sticking with me. :)