Monday, February 15, 2010

My 1st actual doula client

It's Saturday. I wake up, and it is Saturday. Like most, I mope around in my robe, drink some coffee, and procrastinate getting dressed to avoid facing the world. By 12:15, I have successfully put on jeans, yet, still with robe. My phone rings... NAMEOFCLIENT CALLING. Fight or Flight kicks in. Flight-I have a best friends daughter's 1st birthday party to attend in just a few hours. It's probably just to touch base. Let it go to voicemail. I am not prepared. Fight-This is what I have been waiting for. My destiny and duty. "Hello?" "I think my water just broke." Oh, shit. Lazy Saturday Mom hat hits the wall and lands on the floor, and out comes doula hat. I go through some questions to determine her state of emotions and state of labor. No real contractions, just positive her membranes ruptured. I reassure her, she will be okay despite the lack of contractions, and remind her of my first stage of labor with Nora. "Call your OB's office, and then call me back to let me know what they recommend." Panic. I run out and mutter some words, four letter and otherwise, to Jeff. I pace and wander around some more... Finally, I focus. I pack my binder, booklet, lotions and massagers in a backpack. I hopped in the car to run to New Leaf. I need snacks, water, enough frozen dinners to last my husband a day, and I was sure I needed another lotion or oil to add to my bag. My usual anal grocery separation at the checkout, had to be revised to bag doula stuff separately from freezer stuff. I head to the mall for my procrastinating last half of a birthday present.

Fifteen minutes late and pulling into the party zone, my phone rings. Again, FOF, but Fight wins without any contemplation. Nameofclient is in the hospital, 1 centimeter dilated. I tell her to call me if she is checked and further dilated, or if the "P" word is brought up. Two hours later, obsessing over and double-checking my phone that I carried in my hand, I get a phone call with the "P" word. Her dilation is just at 2 and her water broke 5 hours ago. She okay’s the pitocin, and now I race. I change my clothes, grab my bag, and head to TMH. At 5:45p, there is no change in her progression, and NOC is as calm as can be, despite the pitocin running through her veins. The three of us (third party her husband) sit and chat. Cell phones are ringing, mine included, to see how everyone is doing. Within a few hours, the contractions are intense. Her mother shows up, which has me worried. I didn't want to replace the mother having a daughter, role.

The time of day is hazy from hear on out. As soon as she needed me, it was automatic and natural. Words came out of my mouth without thought, and counter pressure and massaging just happened. The mother was beautiful. She asked to labor in the tub, and despite the monitors and IV, she was allowed an hour. I filled the tub, while her husband and mother had a moment to walk and labor through the halls.

Husband and NOC spent some time together in the bath. I could hear a few intense contractions, and soon the nurse ordered her back to the IV. We stood, sat on the birthing ball, leaned on the bed, laid on all fours on the ball and bed... We are contracting, massaging, communicating, and soothing together. It doesn't feel like doula and client. It feels connected and intertwined. There is honesty. We shared something you don't get from relationships you have had with people for years, or interact with in everyday life. She stood, and I embraced her, let her sink her weight into my arms, as mine intertwined with hers, holding her weight, allowing her to sink, and her head would rest on my shoulder. There was nothing more beautiful.

We had been laboring together for nearly 8 hours. No more tub was allowed. It was after 4am. Only 4 centimeters along. She asked for Nubain. We labored in bed for a while, since she had to return there to have her progression checked.

NOC's mom was copying my acupressure and massage techniques, engaging herself in her daughter's labor. The husband came up frequently to kiss and caress her, saying words of love and encouragement, softly in her ear.

By 6am I was on my own. Mom was passed out in the rocking chair, Dad on the reclining bed chair. We rocked and swayed, I held her, she told me where to apply pressure if my placement was off during a contraction, and communicated more or less pressure, if necessary. I was in complete awe of this woman, taking each contraction with confidence and breath. I ran my fingers through her hair in between, and told her how wonderfully she was doing. I was so proud of her, and so proud of myself. We were doing this together.

Time went on...and on and on. The nurses kept increasing her pitocin in an attempt to increase and strengthen her contractions.

The birthing ball started to cause discomfort, so we moved to an in room toilet, just perfect for her to sit upon, contract, lean on me, and for me to access her back and sides to counter press.

The L&D nurses shifted at 7a, and we withheld more Nubain. Eventually, a third dose was given, along with antibiotics because the baby had been without his amniotic sac, for quite some time. Contractions started to be painful. She went from breathing, massage, and bearing weight on me, the ball, or toilet, to moans. She was the most beautiful laboring mother I could have imagined. She asked for another chance at the bath early morning, but was declined because of the fetal and uterine monitoring, deemed necessary because of her pitocin drip. Other pain regulation measures were asked for, and declined. She lied down in the bed on her back, for another cervical check. By 11a, she had no energy to get up again. Epidural was her last option. I asked if we could go through 3 more contractions before a decision, yet the anesthesiologist was already in route. Papers and contracts were in the room. I handed the contract to her husband, and explained to her the possible risks, and encouraged her she could make it.... we had come so far! She asked many questions... how will this affect my baby? If I need a cesarean section, will this make it easier? Increase in pitocin? In the end, she accepted the epidural. She apologized to her husband and I. While I was left with feelings never felt before, I knew those were MY feelings. I assured her that she knew her body, herself, and her baby better than anyone in the room.

I was in the room for the epidural, yet requested to remain in front of her, with her mother. Her husband turned white while supporting her during this procedure, and had to sit this one out. The L&D nurse (happily) took over... she had experienced a c-sec before. I rubbed and talked Dad through it. Water and words.... what more could I give?

After what seemed like an hour, she was back to lying down in bed. I left to get something to eat. I needed a break. I cried the whole way to the cafeteria, knowing whatever I bought, would not be eaten. This PERFECT, natural, beautifully laboring mother, had an epidural. I was not upset or sad with her, I did not feel defeated.... I am not sure what I felt. It was 2p Sunday at this point.... Much more than raw emotion was in to play. I even suffered three cups of hospital coffee in a styrofoam cup sans raw sugar.

I rubbed her through a contraction, and then realized she couldn't feel my hands. Another walk.... for me to a phone. My cell phone had died, and I needed to talk to my strength and encourager, my husband. I cried. Walked to the public restroom, and tried to de-cry myself. 2:25p Sunday. 9 cm, 95% effacement, and -1 station. The two words I never thought I would hear in THIS birth, were said, and a reality. "I'll give you thirty more minutes to complete dilation, effacement, and ascent. Otherwise, we will have to proceed with a cesarean section.”

I was so proud of her, and me. I think the hardest part of this was that my perfect laborer wasn't able to be my perfect birther. I asked the midwife and L&D nurse if they would fill out my doula certification forms. I asked NOC's mother if she would have NOC fill it out whenever she was stable. I kissed NOC goodbye, told her, amongst a flow of tears about as intense as her contractions, how proud of her I was... how beautiful she was. I meant it with every cell in my body. I still can't get through this without crying.

She called. Cesarean went well, and a healthy 8+ pound baby boy. She said her uterus has a congenital disorder. The docs say she'll never be able to deliver vaginally. Her uterus blocks her cervix, it isn't bilaterally symmetrical.

I walked out of the room with no emotional control. Jeff was to pick me up just outside the building, but I had to walk. I sobbed. Sobbed all the way down the parking garage and towards the street. Sobbed into Jeff's arms, despite the cars behind us.

I wanted SO badly for my perfect laborer, my first client, my perfect client, to have what she wanted, and also, selfishly, for me to have what I wanted.

I am more than pleased with my performance and role as a doula. The forms I have filled are all 5's. The hospital staff specifically stated how wonderful I was with the mother, how concerned I was for the baby, and that most doulas treat the staff like shit, yet I was extremely respectful towards them and great with the mom-they were HAPPY to work with me. Happy I was there. It was an accomplishment for more than just me, but also the doulas in my area. I made a statement for us.

I am seeing little baby boy tomorrow. I am excited. My eyes still look like baseballs, but, I am so happy to have been involved in such an important part of someone’s, more than one someone's life.


MermaidLilli said...

Maureen, you described your emotions so well... as I understand the ups and downs of being with a client who ends up with the needed interventions at the hospital. After my thousands of clients, though, I have gotten tougher and even though I mourn for the woman's loss of that perfect birth, I process my own emotions better. So, it takes a few of those and finally you understand that it's ok... sometimes birth does not go as expected and that we are happy for what the hospital has to offer....all those interventions that we use only when needed.
You will learn not to own that outcome, whether it went the way you wanted or not, that it belongs to the client, and know that you did your job well. Much LOVE to you.

Maureen said...

Thank you So much for your words... I am sure my post did not convey the emotion and power that I and we felt... I felt I needed to write of it. Coming from someone I think so highly of, someone who I trust so much in the world of birth, someone who was there for my family and I, my first daughter... I thank you for your words. My story of Claire and the BC was tols throughout the lulls last night, and you were mentioned. I strongly believe, that without you and Layla, I wouldn't me the mother or person I am today. Thank you. Much love to you. I feel I owe you so much...

Anonymous said...

You, my lovely, are amazing.

Maureen said...

Thank you, V. <3