A doula is a trained professional labor coach. Characteristics like patient, kind,
compassionate run the top of list when looking for a good candidate. I meet that criteria, my personality is well
suited for tense situations, able to live through the unknown moments with
others. But I’m human and I have moments
where my client is getting on my last nerve, the doctor is obnoxiously
demonstrating he holds the power, when I just want to punch the father of the
baby in the face.
The first time I really struggled to like the client was in my early years of hospital doula work. This mama was a
young woman, 19 years old. I stepped in
to cover for the primary doula who had already been in attendance for 18
hours. The day prior, the mama arrived at the
hospital barely in labor. Her bag of
waters broke at home and she checked in at the hospital within the hour. No contractions. No labor. Her doula, a newbie, was eager to attend a
birth and so arrived early as well. They
spent hours in the room visiting, watching TV, waiting for the contractions to
start. As evening set in her
contractions started on their own. The contractions
grew in strength and crept closer together through the night hours, keeping
her from a restful sleep.
Upon arrival I discovered
my young new mama client to be in a foul mood.
In the beginning I felt genuine compassion. I introduced
myself with a bright smile and reached out to touch her shoulder. She tensed under my hand and felt cold to my touch. I noticed her eyes were freshly lined with
black eyeliner, her long smooth hair in place, dressed in cute tight yoga
pants and even tighter tank top. Her
basketball belly looked as though it would pull her 100 lb self forward and
onto the floor. No ugly hospital gown for her. The primary doula clued me in that this young mother was alone, father
of the baby an older married man would not be showing up to support her during
her birth. Again I was full of
compassion, what a lonely place to be during an intensely vulnerable experience.
Soon the doctor ordered Pitocin be
administered to bring on stronger contractions and active labor. It took three nurses about an hour to start her
IV. With every anticipated needle stick
there was drama, wailing, delicate rivers of eyeliner streaking her
cheek. And so I doulaed her through
it. I used all my tricks to calm her:
holding her, encouraging words, distraction, relaxation, visualization- she
quickly drained all the compassion from my heart. “Good Lord,” I thought “if she can’t stand to
get an IV how is she going to deal with the coming labor?” Finally the queen bee nurse came in and took
charge. A motherly figure, all business
and expert at both starting IV’s in tricky veins and handling a whimpering patient, finally successful with the IV start. As the nurse left the room, she turned to
look over her shoulder at me. She gave
me a knowing glance and with a sigh, “Good luck in here, you’re gonna need it.” Fortunately the client spoke only Spanish and
didn’t understand the nurse’s words.
The contractions swelled from loosely spaced mounds on the
computer display to sharp peaked mountains every several minutes. She was drowning, struggling to keep her head above water that was the pain. Her lack of effort irritatied me. But I continued to give her my
all. Forced compassion, in soothing
tones discussed how to get her through this experience. She decided to get an epidural and as soon as she consented, she quit trying to cope. Mama flailed for the
next 20 minutes it took to get the anesthesiologist, signed consents and prep
ready.
With painful patience I held her as she had her final
freak out. Epidural meant more evil
needles, she hadn't thought that far ahead. After the IV experience I
realized her fear of needles was real, no matter how illogical I thought it to
be. So with more wailing, an anesthesiologist’s harsh words and fresh kind nurse’s able hands we helped this
mother receive the pain relief she needed to move through her labor.
Once the nurse tucked her into bed, no longer feeling the
crashing waves of contractions, mama closed her eyes and fell asleep. Relieved, I left the room for a meal and some
fresh air. The surge of irritation and
struggle to maintain compassion for this mama worried me. Of course I had moments in other labors where
it took efforts to step aside my own feelings to provide good care. Somehow this was different. I just didnot like her. I hated to admit it to myself. I surely didn't
want her to know or sense how I felt. I spent extra effort compensating for my dislike.
For days following this birth I was haunted by how difficult
it was to like her. I felt shame. This new mama so lonely, isolated, and young. I understood why she acted so much
like a child. An unintended pregnancy leading
to a life of increased obligation does not a joyful birth make. Her life is so
much more complex and difficult than mine. Did she sense my irritation, my effort to be kind and caring? I'll never truly know.
This is a dilemma all care providers face from time to time. As birth professionals it is our responsibility to process a our reactions. Self-reflection, honesty about our own prejudices and prickles lead to better self awareness and stronger ability to care for others. I know I am not a perfect human, or a perfect doula; but I don't want my imperfection to get in the way of giving competent care.
I
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