This video, BirthMarkings, made me get all weepy. I think it’s a preview for a documentary about women’s postpartum bodies. While I’ve found Shape of a Mother (NSFW) useful sometimes, it seems to lean towards the young and white. This video, BirthMarkings, includes mothers of all ages and a variety of sizes, shapes and ethnicities talking about the changes in their bodies after having children. It’s made by a woman named Margaret Lazarus, and originally posted on the International Museum of Women website, where she talks about the inspiration behind the documentary.
When I was pregnant, I read about the benefits of babywearing, but I hadn’t really thought them through. Today I was reading a post on Offbeat Mama that talks about some issues specifically dealing with being out in public with a premature baby. One point made was that “babywearing can really help” for keeping a preemie close and protected when you’re out and about.
It made me think of a trick I use with my son. When we’re going someplace with a bunch of strangers, I wear him. Even now that he’s big(ger, at 11 months), I strap him into the Ergo. I discovered this when I first took him to my former place of employment to meet everyone: some people wanted to touch him more than I was comfortable with. One woman even put his foot in her mouth. In her mouth! Someone he’d only just met! I learned that if he was in the Moby wrap, people didn’t do that kind of thing to him.
As he’s gotten older and gained stranger awareness, we think he’s an introverted person. Taking him to a big party results in a completely wiped out, overwhelmed baby. Recently, we were visiting my family in Texas, and took him to the high school where my mom’s involved with the theater booster club. All the women there wanted to meet him and snuggle him, but he doesn’t enjoy being passed around from person to person. So I strapped him into the Ergo. It fixed everything — no one asks to hold a baby who’s being worn, it turns out, but they can still see his face and smile at him. And he feels safe, close up to Mama or Papa.
At this month’s Birth Support Network meeting, we had a visit from the leaders of the local ICAN chapter. ICAN, the International Cesarean Awareness Network, is mainly a support and advocacy group for women who have had Cesarean sections. One of the speakers was the author of Well-Rounded Mama, which I had no idea was written by a local. It was great to hear her provide citations for her statistics and teach the group as a whole about how to use PubMed and find studies on various subjects. That was a small part of the conversation, but a really useful one.
The main part of the meeting was taken up with a discussion about Cesareans and how doulas can best support women through C-sections, regardless of the circumstances surrounding them. It was an emotional evening for me. I left with a resolve to do more research about Cesarean sections and how to support women through them.
There is a great post up about having doulas at homebirths on the Citizens for Midwifery blog. The author asked various people — doulas, mothers, midwives — to give their opinions on the subject, and she got a bunch of fantastic responses. They ranged widely, from a midwife’s skepticism: “I don’t know what I would be doing during the birth if there was a doula there, too,” to many wholehearted supportive statements of having a doula at a homebirth.
I’ve been thinking about this a lot recently — my next client is planning a homebirth, with the midwives who helped me have my son. It’s a very different experience, planning to be a doula at a homebirth. In this case, I know and trust the care providers. My client knows and trusts everyone who will be attending her birth. This is very different from a hospital birth, where you may simply have the OB or midwife on call, and certainly you don’t know the nurses popping in and out (although you do get to know them over the course of your labor — I’ve known women to develop good rapports with the on-duty nurses during their labor).
In order to learn more about what my role in this upcoming labor might be, I went to talk to the midwives about how they interact with doulas at homebirths. The one I spoke with said, “Doulas often get bored. There isn’t as much for them to do.” This idea was mentioned in the Citizens for Midwifery post as well — with good midwives, a doula often doesn’t need to do as much active, hands-on work for the laboring woman.
So what does a doula do at a homebirth? It turns out, there is a lot TO do. I anticipate doing some or all of the following (after supporting the mother, which obviously comes first):
- Doula-ing the father, making sure that his physical and emotional needs are being met.
- Doula-ing the midwives. Making tea, making lunch, being an extra hand (or leg rest — in my labor, my best friend ended up holding my leg while I pushed for what I think might have been a really long time).
- Filling/emptying the tub.
- Taking pictures.
- Making food postpartum.
- Doing laundry, making the bed, general clean up.
- Helping Mama with a postpartum shower while Papa holds the baby.
- Sitting and holding the space.
- Simply being.
Those last two are actually the most important, believe it or not. Having another woman around who has done this before seems to make a big difference for many laboring moms, especially first-time mothers. (Citation needed for sure — I’d love to see a large study on this specifically, but until then, I’ll go with the ones that say doulas reduce Cesarean rates.)
There’s another big reason to have a doula at a homebirth: if you think you might transfer to a hospital. In many jurisdictions, the homebirth midwives cannot or will not accompany the laboring woman into the hospital room. This is not an issue for my client, nor was it an issue for me, but it will hold true in some cases, so it’s important to mention. Having a doula, in that circumstance, could make a huge difference.
I really don’t think there are many cases where having an extra pair of (wanted, welcomed, trusted) hands at a birth is a bad thing. As in a hospital setting, perhaps more than in a hospital setting, the doula involved will need to work with the caregivers, in addition to for the mother. As a doula, it is a professional challenge to learn to do that work at a homebirth, and mostly, it’s a tremendous honor to be invited to be present in that setting.