Notes from the underbelly

I’ve been spending lots of time with my client who is in the last few weeks of her pregnancy.  It’s been a lot of fun and at the same time I’m realizing several things that I need to work on as a doula.  Prenatal meetings are so much more important than I ever thought they would be!  And I bet I’m learning more from her than she is from me.


In our first meeting, I wanted to learn as much about her ideas for her pregnancy as possible.  I was nervous that I would forget to ask an important question.  And those of you who know me well will not be surprised at this – what does Kristina do when she is nervous?  She makes a list.  I made a four-page questionnaire.  Yeah, I’m still cringing over that one, too.  The poor girl who answered my questions patiently.  Next time, however, I need to trust my instincts more and let the conversation be a bit more free flowing, asking questions as they come up and letting the mom talk more and me just sit back and listen.  Questions like “What do you want from me at the birth?” and “What are your biggest fears?” seem to be good places to start.  I still need my questionnaire as a crutch, but I do think I can get it down to one page next time.


We’ve also been emailing back and forth a lot – and I think the written word is a place that both of us feel comfortable.  I’m finding that she is a lot more open with me through email, and I have a moment to really think about what it is I want to say.  That’s not to say that we haven’t had some great conversations over the phone and in person, too.  But I am still working on learning when to shut up already and let her talk to me.  There is a very fine line between offering balanced information then letting mom make her own decisions and offering information that clearly shows my own biases then trying to “fix” whatever is going on.   Walking that line will take some navigation and some experience.


The doctor’s office visit went fine, too, although it completely slipped my mind to introduce myself as the doula – duh.  I was so focused on being there emotionally for my patient that I forgot that one of the major reasons I was there was to establish myself as an important person for the birth.  It is also a strange position to be in – I’m not really supposed to ask questions for the patient so there is not much I can do.  Although I couldn’t help myself and asked what position the baby is in – and he is in a great position and ready to go.  She is also well on her way to dialating and we all expected that she’d be in labor by now but it hasn’t happened yet.  She is experiencing a lot of pre-labor contractions which can be so exhausting – mentally and physically.  She is handling it as well as anyone possibly could.


We had another meeting with her and her friend who will be her birth coach where I went over some coping skills and positions for labor, and taught her friend some techniques like massage and other ways she can be helpful at the birth.  It was a lot more fun than I expected and I’m really considering adding on becoming a certified childbirth educator in private practice to my business.


I’m working on creating a brochure and I have a graphic designer friend working on creating me a logo so it will be interesting to see what he comes up with.  I’d like to do a mass mailing with a letter, brochure, business card, and maybe a “what is a doula” brochure and the DONA position paper on the value of labor support to all the docs, midwives, hospitals, and community groups that deal with pregnant women.


I met with a nurse from labor & delivery at one of the local hospitals recently.  Although I must say I was handed off from nurse to nurse 3 or 4 times until they finally found someone who was willing to talk to me, the one who I ended up with was wonderful.  She was very supportive of doulas and does a lot of doula-ish things in her own practice as an obstetric nurse.  I was pretty nervous before the meeting because I wasn’t sure how to ask my questions about hospital protocol without sounding like I was trying to suggest that they needed to change (something I wouldn’t dream of trying to do), but she put me right at ease and I was able to ask the questions and get really positive and helpful answers.  She even showed me a few techniques for positioning in early and late labor to help with getting the baby favorably positioned (occuput anterior).


2 Responses to “Notes from the underbelly”

  1. 1 karen July 8, 2007 at 8:00 pm

    Oh, it’s all so tricky and can be so time consuming too. Email is a life-saver for this stuff. I schedule two prenatal visits for chatting, discussing preferences and practicing breathing, positions, visualizations. Hardly ever do we do what we planned, but they have grown accustomed to me and seen how willing I am to respect their wishes and this carries us through.
    Still catching up on sleep from my last birth, which naturally came on my moving day – yikes! It was an overnighter, but all went well and I was happy that her prodromal labor stuff finally turned into the real deal! Hope your client labor soon!

  2. 2 Dan July 9, 2007 at 11:22 am

    My favorite first question when I’m encountering patients is “What is your best hope for my involvement?” Sounds a little hippyish perhaps, but it rarely fails to get some useful information and gives me a starting point.

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