A Doula “Bears Witness”
Dr. Nancy over at Your Birth Coach made an interesting observation about a doula’s role within this paradigm. She empathized that a dilemma that lies in the dichotomy of a doula is that a doula is there “partly to bear witness to birth.”
Bearing Witness always means that I have the absolute honor of being present at the moment a new life takes its first breath. It is such a spiritual moment and so intensely personal and intimate. I remember after the very first birth I attended, leaving quite promptly following the birth. I felt like my presence was so invasive in this intimate experience of greeting their first baby. I gave hugs, left quickly, and ran stop signs on my way home, delirious from a long overnight, my mind stimulated with after-images of guttural moans and gurgly first sounds. I’ve learned a lot since that birth.
I’m regularly reminded of the intense power a laboring woman holds inside herself; and disturbingly, I often discover how that power dynamic can shift in an instant.
The White Horse Mentality
Watching a woman transform through her labor is spectacular. As the intensity of her labor increases, I get to bear witness to her surging power and confidence. I get to watch her OWN her labor.
But so often, mom gets to feeling a little pushy, and in comes the battalion. Her care provider appears, dons his uniform for this momentous event, and proceeds to rescue the laboring woman from herself.
Finding herself breathless at the top of an enormous wall that she’s just heroically scaled,the laboring woman is suddenly and enthusiastically “cheered on” the way an NBA coach might shout at his team members on the court. The shift from quiet, murmuring support to court-side chanting can be stark and alarming. As she’s told what to do and how to do it every step of the way, the message is clear – she can not be trusted with her own urges, her own intuition. Her confidence crumbles, as push by push, she relinquishes her ownership in the process over to her care provider.
Check out this clip from “A Baby Story,” complete with counting and chants of “Good Girl!”
It’s interesting to note, too, that it’s not the mother who ultimately gives a final push to complete the birth; rather the doctor maneuvers the baby the rest of the way out, reinforcing the idea that this, in fact, is not the woman’s birth to own after all.
In this clip, we also never get to see that baby handed to mom . As mom looks anxiously over her abdomen, craving that first intimate touch, her doctor dutifully hoards those precious moments for himself. Detached and aloof, he suctions the baby boy (a fact he announced abruptly during the birth, stealing yet another of the profound little joys of self discovery from the parents) AT THE END OF THE BED, offering a play-by-play as some sort of consolation.
Doula as Advocate
In the midst of this, a doula must remain an advocate for the mother. But how? A doula walks a fine line when it comes to advocacy. Certainly she works for the mother, but it is also important for her to maintain positive relationships with hospital staff so that her advocacy is well-received.
A doula can not change the culture in which a woman chooses to give birth.
This means that I can advocate for a mom as far as she has paved the road for me to do so. This includes careful consideration of where she will give birth, as well as ongoing honest communication with her care provider to ensure that they are on the same page.
Advocacy becomes futile where the atmosphere is toxic and primed only for Woman as Patient. This climate requires more than advocacy, it requires a revolutionary revolt. While I may feel called to play an active role in the revolt, the time of a woman’s labor is the wrong time to pull out my bongos and start chanting “THIS IS WHAT BIRTH REVOLUTION LOOKS LIKE!”
And you know how I feel about “changing birth one woman at a time.” (If not, you can read my feelings on it here.) While revolution is often sparked by an individual’s active resistance, change almost never occurs out of separate, isolated acts of resistance. The individual resistance needs to fester inside the marrow of Womankind.
If we take a moment to look back to the establishment of institutionalized birth it becomes clear how we’ve arrived at this place of inherent need to rescue a laboring woman.
Check out my follow-up post, where I explore Dr. Joseph DeLee’s rhetoric of saving women from “the evils natural to labor.”
In the meantime, what are your thoughts on a doula’s roles of “bearing witness” and advocacy?