What does a doula DO-la?

I mentioned that I was feeling sore after a birth to my father-in-law and he looked confused.

"How are you sore?! Aren't you a liaison at the birth? What are you doing that requires your arms?"

Many people really don't understand what a doula does at a birth, even people who know me! A lot of what a doula offers is intangible: expertise, a calm presence, witnessing you, and making sure that you are heard. Even though some of my work is ineffable, generally, the support that doulas offer falls into three categories: emotional, physical, and educational.

Emotional

Doulas provide emotional support by getting to know you, your family, and your personal wants and needs. By the time I walk into your birth room, I've snuggled your pets and admired your nursery. I know your values and what makes you laugh. I know if needles make you woozy and how long your partner can go before feeling hangry. I love asking juicy questions that are designed to make you deeply reflect on the birth process and the transition to parenting.

• I might just sit near you and breathe in time with you

• I might notice tension in your body and ask about it

• I make no assumptions about how you are feeling

• I might make eye contact with a partner and smile to reassure them that what is happening is normal, and that they will meet their baby soon

• I hold your hand while you get stitched up

home birth, hip squeeze

Physical

If you have heard of a doula, you've likely heard of the hip squeeze: a move that opens room in the pelvis and provides some relief. We offer lots of different physical touch, from counterpressure to light massage. As an educator, I have hip-squeezed more pregnant people than I can count. Now, I have a felt-sense of people's bones and muscles: what is tight, where to touch, how to find that exact right spot. I've been told I have good hands.

• Massage

• Position changes to help baby rotate efficiently through your pelvis

• How and when to use a TENS machine

• Heat packs and cold compresses at just the right moment

• Essential oils, and more

Is my backpack filled with every possible tool to help you feel safe and comfortable? Yes. Are my most used tools my hands and my brains? Also, yes. But it's good to have puke bags handy just in case.

Educational

Birth is infinite and even after years of learning, there's always more to learn. Just when I start to think I have something figured out, a birth comes along and hands me my ass. Then I go home and study some more. I'm a birth nerd, plain and simple. I study all things birth so that you don't have to!

Sometimes, the education happens in prenatals and sometimes it happens at your birth. In the birth room, when something unexpected happens, I like to ask if we have time to talk about a possible intervention before it happens. It hits the "pause" button and gives you a moment to breathe, take it all in, and form your questions.

More examples of educational work:

• I share evidence based resources, including curated books, podcasts, articles

• I check in after appointments to see if clients would like something contextualized or explained in a different way

• I teach Birthing From Within childbirth ed classes and Comfort & Coping

BIRTH IS A SOMATIC EXPERIENCE

I can't really talk about birth without talking about nervous systems. Giving birth is a full body experience. Evolutionarily, it makes sense that humans cannot and will not labor if they do not feel safe, settled, and supported. Thousands of years ago, you needed to hold your baby in until there were no predators around. Now, people often give birth in hospitals and your body does not know the difference between a tiger and that pesky resident who isn't listening to you (even if your brain does).

As a doula, I work hard to make sure that my own nervous system is regulated as fuck. I take my own somatic work incredibly seriously. I have pre- and post-birth rituals. I go to solo therapy and couples therapy. I practice yoga. I see an acupuncturist at least once a month (and more after a difficult birth). What does that mean? When I walk into your birth, you do not need to worry about me. I am coming in settled. Fed and rested. I can be a calming presence to you, to your partner, AND to the medical team. I am known for taking deep, audible breaths during births as a small way to regulate myself and those around me.

Our nervous systems will inevitably sync up and that gives me the chance to help you down-regulate.

Other ways I would describe my work:

• I'm the vibes guy

• I'm the walking google

• Hard things don't scare me

• I say "this is normal" A LOT

• I might ask you to do hard things to help you (like sit on the toilet)

• I hold down the sacred space and think a lot about energy

• I'm a pelvic anatomy nerd and I talk people into the positions that help baby come down and rotate

• I get so excited when people talk about their butt holes

Are doulas medical advocates?

You would likely get a different answer from every doula you asked. Some training organizations explicitly teach their doulas to never interact with medical staff, that they are not allowed to advocate for their client. Others teach the exact opposite: that you must go in blazing hot and ready to burn the entire system to the ground.

I generally find myself somewhere in the middle of those two extremes. While I do believe that the medical system is broken, I do not blame the individuals who are a part of it. I believe that doulas can help to slow down the room and bring a sense of humanity back in. I make it a point to chat with your nurse because I know you'll get better care if everyone feels relaxed and comfortable in your room. Even the really grumpy ones come around to me eventually.

Every once in a while, I witness a provider ignore my client. In those moments, I do amplify their concerns. I do sometimes witness unavoidable trauma. When the big scary moments happen, I hold hands and breathe. Later, I help clients process and find resources.

FAQs

Do you catch babies?

Nope. I am not a medical professional. Unlike providers, I am often with people from the beginning of labor until the end. Although a sturdy 8 year old can catch a baby, it is not my role. And I definitely don't take vitals or give medications.

Could my mom be my doula?

Would you support my unassisted birth? (aka "free birth")

Recently, I was tucked into the corner of a birth room making myself small while the new family got to know their baby. During the most intense moment of labor, the partner had panicked and needed a moment away. Right after the baby emerged, the they sobbed into my arms in relief. Now, they were holding their child with a look of pure wonder and love. The partner looked at me and said, "I still have no idea what you do!"

Sometimes clients can't articulate what I've done even after a birth, and they just tell me that they couldn't have done it without me. As long as you feel safe, seen, and satisfied with your birth, idgaf if you can define "doula."

Gotta stay silly after overnight labor support