This is Coach Lisa here. If you're just here for my perspective on a birth story - scroll down partway down the page and there's a prompt where you can start reading from.
You may or may not know that I'm currently studying my Birth and Postpartum Certification through Doula Canada. Part of the requirements for certification include working as a Doula for 3 Birth and 3 Postpartum Clients. I wanted to do this as a way of providing extensive and holistic care for people through pregnancy and beyond. I was craving more knowledge on the physiological aspects of birth and delivery so I could extend my scope of practice and better serve my clients when helping them get back to exercise and movement.
A few weeks ago - I had my first experience as a Birth Doula. This was also my very first time being present at any birth believe it or not.
I shared a short story on my Instagram a while ago and it turns out many people wanted to know WHAT a doula even does, others just wanted ALL the details. And so - with my clients permission - in my own words and based only on my experience, I'm going to share a little more.
Firstly, let's answer what a Birth Doula is. Put simply - a Doula is a support person. As I had come to learn from my coursework, for birth specifically, my role would be to help create a birth plan for the client and help advocate based on that plan. I would be a translator between the health care team who had their toolbox of treatment and my client - making sure that everything gets understood, acknowledged and consented to. I would be there to provide knowledge, comfort (physical and emotional) and guidance through the process.
And so begins my journey into the delivery room with my first client. I began working with her when she was around 14 weeks pregnant. We knew each other personally and so she reached out for guidance with exercise, pelvic health, strength etc through pregnancy. This was all comfortably in my wheelhouse. As she was already super fit and active, she wasn't having any pregnancy complications and felt good, we kept her workouts consistently between 4-5 sessions per week ranging from 30mins-1hour each with additional pelvic floor, mobility and stretch work. We checked in virtually through the programming platform every week and once a month we'd meet in person to discuss any new symptoms (there were never many) and go through a workout so I could make sure her at home program was suitable for each stage of her pregnancy.
At around the 6 month mark in her pregnancy I had decided to do my Doula Course and during our 7 month 1-1 appointment I offered to come and work as a Postpartum Doula for her and her husband. My rationale here being that I felt pretty comfortable in the postpartum realm with my knowledge base at the time without needing to rely too much on my Doula certification material. I definitely did not feel ready to offer any type of service during delivery 😅 because to be frank - I hadn't even started my online modules. We did however also agree that her next 1-1 would be together with her husband and I could take them through some birth and labour comfort measures that they could use when she was in labour.
The time came for the next 1-1 appointment and really - I just asked questions about their birth expectations - were they feeling nervous, excited, apprehensive? Did they have ideas on how they would want the day to go? While we were chatting I had serious imposter syndrome. They were definitely more prepared and ready for this than I could even pretend a little bit of studying had prepared me for... At the end of the appointment, she mentioned something about regretting not working with a midwife and only having her husband and medical team with her and so before really even thinking clearly - I blurted that I could be there as a Doula for them if they wished. I think they sort of had the idea to ask me as well. And so it was decided.
I reflect on that appointment quite comically - in my coursework, there's an actual template to use (did not know that at the time 😂) but instead of a 'birth plan' what I felt like we had was a series of 'would you rathers' i.e 'I would rather use gas than other pain medication' or 'I would rather a C-Section than an episiotomy' etc. Also, a little selfishly, I thought that this would be a good way for me to get experience - both parents are medical professionals, had extensive birth knowledge, she had been so active through pregnancy, I could literally just be there as a support.
This is something I wrestled with a lot in the 2-4 weeks prior to her birth while I was CRAMMING in my study to cover the labour and delivery portion so I'd at least know physiologically what the hell was happening. But - in such an intimate and exciting part of someone's life, what sort of value was I supposed to add? How can you plan for that when you literally can't have any expectations for how things are going to go down. Reassurance sort of came when people said things to me like 'I wish I had you at my birth, you're so calm' or 'They're so lucky to have you there with them'. Side note - I've never once thought of myself as calm. Ever. But it seems to be a recurring theme in my life.
*START HERE FOR BIRTH STORY
When her water broke, she let me know she was going in to the hospital to get checked. I was pretty anxious that evening and reminding myself 'If I feel anxious about supporting her - how must she be feeling not knowing what the next 24+ hours holds except that she'll have a new baby in her arms'.
She let me know that if her contractions didn't start overnight, she'd have to be induced in the morning.
Here's a theme of what I was thinking in my head:
'But she doesn't want to be induced'
'According to my coursework - getting induced makes contractions stronger and closer together - that sounds pretty awful'
'Why are they only giving her 12 hours before induction' *frantically. goes through research to see how long she can actually wait before getting induced*
This was my text in reply to her: 'Noted! How are you feeling?'
Not sure when I'd actually have to be there - I decided she'd call me during the night or I'd get up to arrive in time for her induction in the morning. When I woke up around 5am I figured she'd be getting ready to go to the hospital to be induced. All the thoughts above were still racing in my mind - and as a Doula I'm suppose to be aware of any biases I might have but also make sure to deliver the appropriate amount of information so I wanted to double check and text my client, 'Are you ok with induction or would you rather wait longer?
Turns out she did want to wait longer but ultimately wanted to go in to see what the update would be from the medical team, knowing that she could also ask for more time.
I arrived at 7am to the maternity ward as she was discussing induction and options with her doctor. I asked her what she had decided and she was going to proceed with the induction. I tried my best to reassure her (and myself at this point) that we could work through contractions and pain with planned comfort techniques and gas.
We got into her birthing suite and the DOER in me wanted to get busy. But there wasn't much to get busy with to be fair - the nurses were administering medication and monitoring baby. Her husband got the speaker out to play some music and organized their stuff. I sort of just sat around (CUE IMPOSTER SYNDROME) chatting and hanging out. She wanted to be mobile - so she was standing, eating, chatting and self moderated - she knew she had to use the washroom and move and do all the things.
I don't really feel like it's my story to tell the play-by-play of her labour but I tried to lean on my own instincts to help ME get through. I fell into a coaching role. I'm good at that. I know how to Coach. And so I started timing her movement and rest periods, asking her when she felt she had energy for more and when she needed to rest, reminding her that when something doesn't feel right that it's OK to say something and to try something else.
Ultimately when she got the epidural I felt like a bootcamp instructor, rallying everyone to get some movement happening every 15 mins or so. I felt like I was being both helpful and annoying. What a line to toe... There were many times I wondered if they also were wondering what I was actually doing there. 😂
Despite or because of (we'll never know) my efforts to keep DO-ing something, she was finally fully ready to push. The nurse really was the one guiding her positions so I started coaching her with each breath and each contraction - at one point her husband laughed at me and said something along the lines of 'you sound just like you're training someone in the gym'. She seemed to respond well to my consistent counting down from 5/6 or 7 seconds and so I found myself massaging her head and shoulders or facilitating her breathwork for pushing.
Up until this point - everyone had told me how calm I am in stressful situations. When they put that baby girl on Mom's chest I had to bite my cheeks SO HARD not to well up with happy tears and emotions. I still feel that same rush of emotion when I write this and think about it. I was yelling at myself 'STAY CALM, STAY CALM, STAY CALM'.
When I was driving home I felt like it was everything and nothing like I expected it to be.
The next day I received a very sweet text from my client reiterating 'You were calm, collected and knew exactly what I needed'. Reading this she will definitely realise that's NOT what was going on in my head 😂 but I look forward to honing in and feeling clarity with my Doula skills and services with experience.
I had a postpartum visit with my client one week after she gave birth and this is where the entire coaching process has shifted for me. My entire practice and way of working has changed for this client. Because I was there with her, and could see and understand what she went through on the day, I felt comfortable prescribing exercise for her just 3 days after birth. This is not what you're thinking - they were things that could be done lying in bed. But I had the confidence to know that this would be a welcome message in her inbox versus something that would add stress to her day.
One additional question I had on Instagram is what does a Postpartum Doula do? We provide support in the early postpartum period. I have a list that a client can check boxes on based on what they need help or assistance with.
This could include (but are not limited to):
Help creating familial boundaries with visitations
Help creating routine and structure/ divide of responsibilities for the parents
Someone to hold your babe while you shower
Someone to provide care to your pet for a short while
Discussing your birth and working through your experience
Providing help with feeding/ sleeping
Providing resources for lactation/ mental health and more
My client is handling being a new Mom like a rockstar and she also had her Mom there with her helping around the house so I took her doggo out for a nice long walk in the sunshine and we sat and chatted about her birth experience and recovery plan and figured out how to wrap baby to her body. I think sometimes just knowing you have someone on your side is enough. I definitely got my hit of dopamine putting babe to sleep.
It's been so rewarding for me being able to play a PROPER role in recovery. You see - before I started this course, I would train clients until 40-41 weeks of pre
gnancy and then send them away with a 0-6 week exercise guideline I created but essentially wishing them well and saying 'come back whenever/ if you feel ready'. This puts me smack bang in the middle with all other health care providers that say arbitrary dumb shit like, 'you're cleared for sex and exercise now' at your 6 week check up.
With this client I have permission and confidence to check in frequently without feeling like 'I'm bothering the new family', I hope that this gives me a springboard to take this care and coaching into the relationships with ALL my pregnant and postpartum clients. Not only the ones that I may Doula for in the future.
Her plan looks different than what it did during pregnancy. But she's recovering SO WELL - physically and mentally. And I 100% believe that a little movement everyday is a huge part of that.
So - that's the story from my perspective. Feel free to reach out if you have any questions.
Coach (and Doula) Lisa