I recently held a private doula training in person for one particular doula trainee. It was, of course, different from teaching a group of women, and much like private childbirth class sessions, I tailor-made it for her.
In birthing classes I am always aware of how different each woman (and couple) is – their hopes, visions, wishes, fears and needs. In this doula training I was struck by how different birth doulas are, and how different their needs can be.
I have found, in training over 100 doulas in Los Angeles over the past 25 years, that some doulas need to learn not to OVER-doula. I myself had the “tough love” style of doula-ing (before I retired and now focus mainly on teaching and childbirth preparation classes), and attributed my clients’ 75% natural birth rate with that. That style was based on my own birth experience with my midwife Joyce and my doula Joanie. They sat quietly in the darkness while I labored in the room and in the dark bathroom. I dilated quickly during those 3 1/2 hours (after 3 hours at home) and felt the fetal ejection reflex when it was time to push. No one doubted that I knew what I was doing and they were simply interpreting my need to be alone and in the “zone.” I didn’t want to be touched nor spoken to. So in my own doula work, I held back, with the “Less is More” attitude. This is very difficult, until the birth when it all makes sense.
I watched while other doulas pulled out their full bag of tricks, constantly applying the “easy” things – massage, rubbing, encouraging (which I also did), techniques, and their clients seemed to often end up with epidurals. I wondered if this was because at some point that type of doula-ing didn’t “work” anymore in the labor. The woman may have experienced a lack of independence, a strength that comes from the ultimate solitariness of labor. At the same time I am quite sure that this is what some women need, and the doula should provide it.
Other trainees need to learn the technical aspect of birth in Los Angeles – physiology, stages of labor, variations, techniques (back, hips, neck) medical interventions (much of which is learned in Part One of the doula training, the birth class with couples, but needs review). They might be very new, hesitant about their skills or competence, and looking for practical ways to feel like a professional (although they will get a dose of “less is more” as well).
Some need to rid themselves of their “agenda” (natural birth, contradict the medical mindset) and accept that they are simply one of the ingredients of this woman’s choices. It is not their birth, nor do they have the power to change the medical system or be the be-all end-all of her outcome. This is also hard. Others need to move on the spectrum from idealizing birth (woman is a goddess, all outcomes will be beautiful and joyful) to seeing some births that have trauma or disappointment and an awareness of what some call obstetrical violence. The doula trainees hear stories from new naïve doulas about their eye-opening long hard labor jobs and what they felt (impatience, exhaustion, helplessness, dismay). I even have a film of a very serious shoulder dystocia for the one who thinks nothing can ever “go wrong.” On the other hand, the majority of films are of normal, healthy births (including in real time) with wide variations and beautiful outcomes. One of the lessons learned is how vastly different the doula’s role was in each of these births. We teach the pregnant moms that birth is unpredictable; it is vital that doulas absorb this too.
These are the advantages of a small doula training in Los Angeles and Supported Birth is proud to offer them.
