Monday, November 14, 2011

Nope, I won't bring you to a birth

Doulas and midwives probably get this a lot, and I get my share: "I am so fascinated by birth. I'm interested in becoming a midwife [or doula], but I'm not sure yet whether or not it's right for me. Can you help me find a way to attend a birth?" Sometimes people are asking specifically, "Can I come to a birth with you?"

My answer is always the same, "If you'd like to go to a birth, you should definitely do a doula training!" Doula training is a relatively low-cost and low-time investment, gives you a taste of learning about pregnancy/birth, and offers valuable knowledge about labor support if you plan to go into midwifery. Where I live, there is a local volunteer doula program that makes it easy for novice doulas to find their first clients. I tell people who ask that I am happy to be their "mentor" doula in the program (since the first birth they attend as a volunteer is always with a doula who has experience with the program), or to ask one of my doula clients if a doula trainee can come along to the birth.

I am surprised by how frequently people say "Oh yeah doula training, I thought about that, but..." The "but" usually has to do with lack of time or trouble scheduling or wanting to go to a birth sooner than the few months it will take to do the training and get set up with the volunteer program. They just don't have time, because they want to decide about midwifery real soon and go to a birth real quick.

I hear this enough and it starts to wear on me a little bit. I try to impress on the people who want to go to a birth, but skip the doula training, to think logically about the situation. There are a lot of people who want to be at a birth. Think about a hospital birth (since most births are hospital births). There's the mother's own family/friends/support people; there's the medical staff who need to be there (OB/midwife, nurse(s)); then there are other people who need to observe including medical and nursing students. For a midwife or doula to try to bring someone who's just curious to see a birth is usually not practical (and will probably exceed the hospital's visitor limits, which are often capped ridiculously low.)

Furthermore - and this is what I try to put gently to the people who ask me - to ask to attend a birth just because YOU want to see one, particularly just to ask to attend a birth of someone who is a stranger, is also unrealistic in terms of respecting the birthing woman's space. There are a few birthing women who have a welcoming "all-in" philosophy of birth - they don't mind having their whole extended family, neighbors, and FedEx guy watch them vocalize and pull off their clothes and push out a baby. Fantastic! It's their birth and they should have whoever they want there.

But most women want and DESERVE to hold a smaller space for their birth. They ask selected people to be there for a reason - because that person will have a lifelong connection with the baby, or because they rely on that personal for emotional security, or because that person offers them a great back massage and hip squeeze. Like I said, for a few women your curiosity in midwifery is reason enough to invite you to be present. I think that's totally fine. But for most, they're going to need something more.

I think the questioners do understand this on some level. That is why they don't generally call up pregnant women they happen to know and ask "Can I come to your birth?" They ask me to ask for them. And this is my bottom line: I won't ask. There's something that question that rankles in a way I had to separate out: beyond just trying to elbow into a private experience, it's specifically imposing on me as a doula. The questioner is asking me to use my experience as a doula and the trust I've built with a family for their own purposes, but is not going to invest their own time and energy to make that possible. To do a doula training gives you something to offer the birthing woman and a reason to be present; and it also gives me something important: honestly, I want to see, before I put myself out there, that you are serious about this interest in midwifery/doula-ing. Midwifery school and midwifery as a career are a huge commitment. It's not so much to ask to put in a couple months of prep as a doula to see if that's what you really want. If you won't, then I question whether this is just a passing idea.

Sticking to this policy, I've seen it pay off. The people who were serious and have continued to pursue midwifery, or doula-ing, became doulas without hesitation; the people who hemmed and hawed have discarded or put off the idea of birth work as a career.

Reading back over this post, I realize it sounds pretty negative to the idea of "just anyone" showing up for a birth. I want to re-emphasize that I am not opposed to a woman inviting whoever she wants to her birth - including someone she doesn't know very well, who has a passing interest in midwifery. And if someone out there has had the experience of asking and being happily invited to a birth in that scenario, more power to you - you're pretty lucky! But think hard before imagining that just getting to see a birth will help you decide about midwifery. After all, you can watch a million births on YouTube (I know, it's not the same, but still.) It's possible that what will really help you decide whether you want to be a midwife is not the 12 or 18 hours you watch one woman labor and birth; it is the experience and preparation that get you to that point.


Katie the Baby Lady said...


Emily said...

I really like this post because I've just had this happen to me - a classmate of mine who had heard me talk about birth work told me she'd read some things and thinks she might want to be a doula or a midwife, and asked me if she could come to a birth with me so she can be sure. I told her to read my blog, and the blogs of many others (actually, I bombarded her with links) to see what being a doula is really like, and to look into a doula training.

Luckily, I haven't had to have the serious talk with her yet - the one you just laid out - you can't just show up to a woman's birth out of "curiosity"!

But I also don't like women who do the doula training, set up their doula business, advertise, etc, before they have even gone to their first doula birth. I don't think you should really invest in this as a lifetime or business commitment until you've lived the life a little bit. Its a big emotional, time, money, etc commitment!

I've met a few doulas and midwives in training who have changed their minds months or years into their coursework and birth work. It takes a lot of time and introspection to decide if you can fully give yourself to the doula life.

That's just my humble opinion! :)

Rebecca said...

@Emily: I'm glad to hear that other doulas have this same experience. I agree that there's a middle ground between wanting to show up at a birth out of curiosity, and committing your whole life to the cause without ever knowing what it's like. I think it's very reasonable to do a doula training, attend a few births, and then decide whether you want further in or not. I think some people just get so enchanted by the idea, they can't imagine NOT loving it...and then might get blindsided by the reality of doula work.

Susan said...

Great post, and a great philosophy. :) My problem has been that while I LOVE doula work and am enchanted by the idea of being a midwife, it was nursing school that turned me off. I started a 2nd degree nursing program last fall and just was so not a fan of general nursing (rehab, adult care, etc). I also was working full time while simultaneously attending a full time, intense program, so that contributed as well. I ended up dropping out of the program about 2/3rds of the way through the first semester. I've thought about going the direct-entry route, too, but I don't like the idea of not being able to practice wherever I want. I think it's just gonna take sucking it up, finding a way to finance working part time only, and trying it again sometime in the future. :-/

PhDoula said...

Nice post! I agree that bringing someone to a birth steps into very private territory and that using your influence as a person in a position of power goes against your doula creed (if you have one).

When I first started out as a doula, I wanted to know what being a doula was all about. Mainly because I didn't trust myself to be helpful around someone that's vulnerable (i.e., a laboring mom and/or a confused and overwhelmed dad). Doula training, in the grand scheme of things, is a good investment, but at the time it seemed like a great deal of money to risk. I wish there were a doula apprenticeship program in my area. I reached out to a couple doulas but nobody was willing or interested to take me on as a doula apprentice.

In terms of myself and handling my feelings of "am I good enough for this?" I now have come to realize that doulas don't just come with a sense of serenity and ability to tackle any situation; that it's a learned and practiced art; that every doula is scared sometimes, questions herself sometimes; and that being a doula comes necessarily with strong emotions. And that's fine. That's healthy, and it's a part of what we do. I just wish I'd known that sooner -- and I would have, in an apprenticeship, or, in other words, by attending another doula's birth. It's something you don't learn from training.

Rebecca said...

Very true! I also had to leap in without a mentor and learn a lot through experience, including the fine art of just being present. Because of that I am so happy to bring other doulas in training to a birth, as long as the family agrees and we can stay under the "support person" limit. I recognize that hesitancy of "what if I don't like it/I'm not good at it" but I am happy to talk prospective doulas through those concerns...just not willing to have an actual woman be their guinea pig without any commitment on their part.

Susan said...

PhDoula, I also agree that an apprenticeship would be a great thing! When I lived in Indianapolis, I had a couple clients who were doula trained or planning to be so who wanted to shadow me at future births, and I was pleased to be asked - it made me feel like, even as a brand-new doula myself, I was doing something right that they wanted to piggyback on my experience. Plus I know how honored I was to be asked to attend a birth as a new doula, and I would have loved to share that with other aspiring doulas (unfortunately I moved without being able to bring anyone to a birth with me). And I'm also with Rebecca, that I wouldn't want to bring a woman who wasn't committed to pursuing mom/baby work in some capacity. It's not respectful to the family or the doula to tag along just to gawk at a birth, without already having some idea and some commitment that you want to work with motherbaby diads. I know it took me a few years, during which time I did a LOT of reading, to make that leap, and I was terrified to attend my first birth by myself (I also didn't have a mentor), having never seen a birth in real life. That's why I wouldn't mind having an aspiring doula attend with me (with Mom's permission), but I would want to know that she had thought very seriously about the profession and whether she otherwise felt a good fit with it even without attending a birth.

Keelytm said...

This was really fascinating. I've thought about becoming a doula as well, but I would never ask someone to bring me with them to a stranger's birth. The only thing that is keeping me back is I don't know where they have a training program in my area. Is there a website that lists different training programs? How can I find out where I can get started?

Rebecca said...

Hi Kelly,

Check out this post for more becoming-a-doula info!