When the going gets tough…

Phew! What a week! Hold on, it’s only Wednesday? Damn.

We had a couple of long, difficult births this week. It has me thinking about a lot of things…the strength of women, the importance of health care providers, the differences that partners bring to the table based on their past experiences, etc. It also has me re-thinking one of my favorite interview questions that we sometimes get asked: Tell us about a really difficult birth that you attended. Why was it difficult and how did you handle it?

I love that question. For anyone who’s ever met me, you know that as an introvert, I don’t do well with small talk. I like to get right into the big talk. I’m like, hey nice to meet you, what are your political views and where do you think we go when we die?

*Insert awkward blank staring*

Some people are cool with it and can roll right along. Others not so much. I can totally dial it back. ANYWAY….

This is part of what I love about being a doula. We get to skip the small talk and jump right into an intense experience together. So let’s talk about difficult births.

My answer to this question is that I once (well, many times, but this is a specific circumstance that I can think of) supported a very long, very grueling labor. Mom was a total warrior. She was strong, sure-minded, calm, and resilient. Her partner was a bit more on the anxious side but totally and completely showed up for her the entire time. I utterly adored these people. The reason it was difficult was that we had done everything “right.” Mom had been to a chiropractor and an acupuncturist leading up to labor. She exercised and meditated and did yoga. We talked through preferences, and they were excellent advocates for themselves. She took all my suggestions on body positioning to help turn baby into a more optimal position for labor, even if it was hard. She had a supportive partner and family. Her medical staff was extremely helpful and respectful. And yet. We did everything “right” and yet, after 30 hours of very intense labor, nothing was going the way we wanted it to. They had to make decisions they didn’t envision making. They chose to compromise some of their preferences. In the end, they did have a healthy baby who was born vaginally. So all’s well that ends well, right? Not exactly. This one took some processing and some grieving on the part of the parents (and yes, the doula too).

My teammates will often answer that the most difficult labors they’ve supported have been failed inductions. This is because inductions can be a multiple day experience whereby nurses and doctors/midwives are attempting to medically “force” (cajole?) someone’s body into labor when it wouldn’t otherwise be ready to labor. There are some very good reasons to induce. There are also some bogus reasons. (Here are some of the most common reasons and some good evidence to bump it up against, in case you’re interested):

gestational diabetes

low fluid

big baby

passed due date

But a failed induction means that a mama has been put through a lot of invasive interventions, to no avail. Her body has not been convinced to labor and this ends in a c-section. Which is not the worst thing in the world! Unless our client desperately wanted to avoid surgery. Then it is a difficult thing. As the doulas, we have had to find new and different ways of supporting those mamas as they navigated a path they did not envision for themselves.

Sometimes mamas panic. Sometimes partners are not as strong as they had hoped to be. Sometimes a nurse pisses off her patient. Sometimes a homebirth gets transferred to the hospital. Sometimes actual exhaustion settles in and takes over.

People love to say, “As long as the baby is healthy that’s all that matters.” People say it with good intentions but they’re wrong. While having a healthy baby may be the MOST important thing, it’s not the ONLY important thing. And claiming that it is can really belittle a person’s labor experience (mom OR partner) and invalidate their feelings. Read more about this here.

As doulas, the most difficult births we see are ones where moms and partners don’t get what they want. Whatever that is. Whether it’s a vaginal birth, a non-medicated birth, body autonomy, home birth, anything. We are dedicated to doing whatever we can to help our clients achieve their goals but there are some situations in which those “plans” become unsafe or simply not the best choice for them given the circumstance. Even if you don’t get anything you want as far as a birth plan goes…if you come out the other side and are able to say that you still felt empowered, respected, heard, supported…you may be able to process through the unwanted elements but still consider it a positive experience. Conversely, even if everything goes your way and you achieve every single bullet point on your birth plan but you did not feel empowered, respected, heard, or supported…you still may feel trauma from that experience. It’s valid. It matters. Your labor experience(s) will stay with you on a visceral level. If you ask any 90-year-old woman to tell you about her birth experience, I bet she could tell you the story including many details, particularly about how she felt.

We love the work we do. It’s much more than just a job. It is good, meaningful, soul work. It is not always easy. In fact it is rarely easy. But that’s what we sign up for. We know what we’re getting ourselves into and we still choose to be relentless in our dedication to helping our clients achieve their goals. And on the particularly difficult days, we have each other, good wine, and chocolate. Even on a Wednesday.