Thursday, May 31, 2007

Dear Luc

Thank you for letting me talk
with your mum and dad tonight.
You were so patient.

Sorry that I couldn't play
the frog game with you.

I do hope you enjoy your big brother class
at the hospital.

See you later, alligator!

Oh, yes
You really remind me
of the "little bean" that you were
when you were born!

On egos, ideal births, and leaving your stuff at the door

We all have shakey egos. So, it's always lovely to hear, "You're a life saver!" But, for me, along with the squishy good feeling I get from that comment, I also have a quiet little cry. The credit shouldn't go to me. The ultimate strength comes from within each woman in labour.

So, I'm really happiest when I talk with a client, months after her baby's birth, and she stops mid-sentence and says, "Did I ever tell you how wonderful that foot massage was? It helped me to be in my body, to focus on the work I was doing. It made me feel powerful."

For me, being a doula is all about reminding the woman that it's all HER power - internally and externally. As well as owning the power of her labour, she also has rights and responsibilities, which she's fully capable of exercising.

I've had my births, I've worked through my own stuff. And like my daughter says, "You check your stuff at the door." For me, being a doula isn't about "giving" a woman the birth I think she needs. It's about helping her to access her own truth, drawing on her own life experiences. She has nine months to do the work of establishing her own boundaries, re-evaluating relationships, and preparing for the emotional work of birth. Because, contrary to popular belief, this is not a physical game, it's a mental and emotional game. And the demons are ones that you've met before...

One former client thought I could guarantee her a quick, painless labour, and achieve an "ideal birth." Sorry, I can't do that...

I can translate what's happening, tease out the meaning in the medical jargon, de-mystify the logic of the body, anticipate possible scenarios. I can help facilitate the transition INTO labour and THROUGH labour. But I can't alter a woman's own life experience, her beliefs and expectations, or the variable reality of this particular birth day.

It would be presumptuous (and egotistical) to think that I could make any guarantees, or have as a goal to help each woman achieve an "ideal birth." Who is to say what is the "ideal birth" for each woman? I really believe that each of us has the labour that fits us. I don't think that belief is a cop-out or just me being fatalistic. I need to support each woman through her own experience of birth, without ego or judgement. If I can't support her choices (which would place her or her baby at extreme risk), then I must be honest about my own limits, and respectfully decline care.

As a doula, I carry with me the experience of hundreds of births. Each birth teaches me something more about women's lives, our bodies, our strengths, our weaknesses. Each birth teaches me even more about relationships, communication, and random interaction.

My job is to sift through all the gifts I've been given from each birth, to help each woman find her own way through her own birth experience. My job is to fade into the background as she discovers her own power. My job is also to provide her partner with the tools that he or she needs on that day, so that they can work together with the baby through the process.

As part of my care, I do a final "dress rehearsal" visit to each family's home. We try out positions, see what pieces of furniture might work well to lean on, if there's a "circuit" in the house to pace, how wonderful the cold tiles feel on the feet. Yesterday, I knew things were serious when the phone call came, "She's doing tippy toes! Oh, and she only made it half way up the stairs before the next contraction came! We'll meet you at the hospital." Rather than questioning their decision, I knew that, having given them the tools to recognize strong active labour, they were right on track.

When we met at the hospital, one nurse said, "I knew they must be with you. They knew what to do, and she wasn't worried about making noise. Did you tell her to make so much noise that we'd bypass admitting? (I grinned) Well, it worked! She's in Room 1."

It's so wonderful to do all the prep work with clients - to give them the tools that they need to labour in their own way. This morning, I encouraged the dad to rock his wife's hips, while she lay on her side, oxygen mask on, breathing calmly and deeply, waiting for the baby's heartrate to rise. He was able to feel the direct impact of his hands on the baby's heartrate. The rocking stimulated the baby, and kept the baby safe.

When we were all tired, we welcomed the body-building nurse, as he held the woman in his arms, chanting as she pushed, "Yeyeyeyeye... goodygoodygoodygoody... ohhh... ohhh... that's good!" The dad and I grinned at each other. We were working as a team, to honour the woman's wishes.

As wind-surfers, this couple understand the need for working with the wind, whichever way it blows. That understanding helped them to cope with the challenging labour that they faced. They were able to achieve the birth that was right for them and their daughter.

After birth, this baby, who had spent most of the labour star-gazing (aka "posterior"), laid on her back on her mum's tummy, tilting her head back to view the nurse, smiling quietly, then turning her gaze to her mum.

Then mother and daughter practised sticking their tongues out at each other, while dad giggled.

It was that family's "ideal birth." They had witnessed the body's power, the power of labour, and the power of great communication and understanding. It will take them a long way in their journey as a family.

...and I happily slipped away.

- Jacquie Munro, Vancouver Doula

Saturday, May 05, 2007

Birthing from Above

From the desk of Jacquie's daughter

Growing up surrounded by my mum's work in childbirth, I had a slightly different introduction to the subject of reproduction than most children. Instead of reading "Where Did I Come From?" I looked through a plethora of illustrated Sheila Kitzinger and midwifery texts. I thought it was fascinating that the egg that was fertilized to make me was in my mum's ovaries when she was born, and was thus formed inside my grandmother! Wild. When she taught prenatal classes, I would come along and play with the infant-sized dolls in her teaching materials, using the plastic pelvis as a cradle. Then, as she began to do more labour support, I would act as her secretary and run into the kitchen to intercept calls before anyone else, often to hear a flustered dad drop the phone, with his wife moaning in the background -- "Mum, it's for you."

It was only a matter of time before I felt the need to leave my role as an earnest spectator and take part in my mum's work. On New Year's Eve, 2006 -- just a few months ago -- I shadowed mum at my first birth as an apprentice doula. It brought to life everything that I had merely heard about for twenty-three years. This sealed the deal. I was sucked in and needed to learn everything I possibly could about childbirth. Or, more precisely, I needed to fill in the gaps of all the knowledge my mum had slyly been teaching me over the years. Little did I know that in giving me those midwifery texts, taking me to classes, and leaving me to chat with clients, she had been training me to one day work with her. Cheeky monkey.

So, with the advent of 2007, I began the final semester of my Master's degree in Literature at UBC and decided that I would complete my university career with a directed reading in the language of childbirth guides -- to both fill in the blanks and end my degree with a fun project. I received such a fantastic education from my mum growing up. She had given me all the right materials to read, but I wondered, what were other women reading? My guess was that most women don't pick up "Ina May Gaskin's Guide to Childbirth" during their summer breaks or watch "Homebirths in Holland" on Friday nights. I turned to popular pregnancy guides, the sort of books that you find on the shelves at Chapters or are lent by a friend. I pulled together a list of about 20 bestsellers, narrowed my focus to the hot topic of caesarean birth, and began reading with some questions in mind:

What sort of language do these books employ? What themes, messages, social beliefs, and institutions do the discourses in these books support? Are women reading from the perspective I was raised, that childbirth can be sacred, empowering, and, above all, normal? With caesarean rates reaching over 30% in parts of Canada, what are popular pregnancy guides saying about surgical births?

I won't give away my entire paper (please email my mum if you want a pdf copy,) but one conclusion I did reach after reading these popular books was that, on the whole, authors don't view birth as normal. They describe caesarean births as a medical solution to "pathological" pregnancy.

My first reaction was to get completely wound up and militant: "We've got to do something about this, mum! Our culture no longer cares about the natural processes of the body. We've turned into a fast food society that wants its babies to be 'delivered' from above. Yet all over the world women have babies at home with midwives, without medical interventions, and their births are statistically safer!"

Then I realized that there was a simple way to counter the line of thinking present in pregnancy guides. Use language as a tool to reclaim birth from degrading discourses. That's why I like the term "caesarean birth," as opposed to caesarean section, c-section, c-sec, or C, or capitalizing Caesarean. By changing the language we use, we change our mindset.

I've known my whole life that birth in hospitals or through surgery has the potential to be sacred and empowering. Mum helps make that possible with the language she uses -- clients reading this know what I mean. She translates medical terminology into something a woman and her body can understand. Using positive phrases and non-judging words, she attempts to take the fear out of birth and make it normal, relatable, possible.

Why can't pregnancy guides do this? Because in our North American culture, birth isn't normal, relatable, possible. And that's a load of bunk. Don't read them, just use them as doorstops (except those by Kitzinger, Gaskin, Gurmukh, and the Dr. Sears family -- they're a'ight). Just read books during pregnancy that shut off your thinking brain and allow you to listen to the rhythms and instincts of your body. Children's books and trashy romances work well.

Oh, and hire my mum.

And just wait until our book comes out!

- Sarah Munro

Tuesday, May 01, 2007

Harper's Arrival

Today I drove a couple to the hospital.
I ran out of their building, jumped into my car, did a U-turn,
saw her kneeling on the stairs as if in deep prayer
her husband's body draped over her in protection.

Watch the bumps
30 minutes of head in the pillow
head on his lap
loving words
low moaning
legs braced for the curves in the road.

Water - I need water.
You're doing it.
You're amazing.

He calls out our progress
We're at Boundary
We've passed Knight Street
We're almost at Cambie
We're on Oak.

Press the button to obtain a ticket.

We park
One contraction
Two contractions
Back out of the car

Fully dilated