Recently I was asked a question by an expectant mother who called to inquire into birth doula services. “What is your track record”, she asked, “for realizing unmedicated vaginal birth outcomes, versus medicated births, as well as cesareans?”
This question, I must admit, caused a very strong emotional response, and I have been musing on it since yesterday. It made me think firstly that it was interesting that she asked this question very openly and forthrightly, a few do. Most leave this as an unspoken, yet ever present question, hanging in the air. Even when unspoken though, it is an expectation of many women who use the services of a birth support doula, carrying it with them into their births, and believing the doula will somehow do the work, take away the pain, and be the one who is responsible for creating the birth they dream of.
If I take this question apart a bit, and restate it, what it asks me is, what are YOUR personal achievements, accomplishments, and measurable performance outcomes in having created, caused, or conjured all “natural”, non-medicated, vaginal, rather than medicated or cesarean births for your former clients? In other words, how much power and magical skill to affect and influence the future do YOU personally possess, which will ensure my ability to achieve an unmedicated birth, if I contract for birth support services with you?
For a moment I tried to imagine what the person would look like, who could give an answer that lauded her own achievements, crowning herself the all-powerful, wizardly, oracle, and queen doula. The picture that came to mind was of someone with very little life or birth knowledge or experience, as well one who is possessed of a very small body, topped by a grandiose, and zealously springy head, rather like a bobbing dashboard toy, being much too immense to fit through any labor room door.
In order to answer that question in a manner which enumerated a long line of unmedicated, vaginal birth outcomes a birth doula was personally responsible for having authored, fashioned or forged, she would have to first clothe herself in a very impressive cloak of ego, while rays of golden light emanated from her unparalleled, supreme being. This would also create the need for a chorus of scoffing, incredulous, naysayers, standing just to the left and somewhat in the shadows of where she reigned transcendentally Divine, center stage, and grinningly proclaiming, “ She sho thinks a heap o herself, uh huh!”
If encountering this ego driven prospective doula, assuming the expectant mother is not temporarily blinded by the fearsome flames of power shooting skyward, and heating and enlivening the very air about her, ( think the floating head of the Great and Powerful Wizard of Oz), the mother would do best to turn and run with great haste from the theatre, else see herself taking a back seat to this doulas unquestioning magnificence, if she is sadly wooed and manipulated into hiring her. Such formidably perilous and exalted creatures I pray, exist in small number, as most birth doulas tend to lead from the heart, rather than from the ego.
Returning to our original question then, I have no choice but to turn it right round, responding that the medicated or unmedicated outcome of a birth, just like the decision to use or not use medications, is not up to the doula at all. It is the mother who makes this decision, as any doula worth her salt understands, due to the fact that pain is a very subjective and many- faceted experience. Doulas inform, educate, walk beside, support, comfort, serve, love, and accompany on this journey and transition into the life of a mother, but we do not make decisions for our clients, or create exacting conditions and outcomes.
The adventures and challenges along the path toward motherhood are an important rite of passage that all women must undergo on their own. It is a refining process much like a chunk of coal endures, as it experiences intense heat and pressure, becoming in turn a magnificent diamond. It is the human equivalent of an alchemical transformation which begins with a bit of ordinary metal that, through the purifying, perfecting fires, becomes changed into silver or gold. Pregnancy and birth are a sort of womanly hero’s journey which must needs direct us into the deepest, most demanding, stygian depths, where we will discover a treasure we never before knew existed, and enable us to carry this treasure back with us, returning victoriously to the surface once more. This is not a quest which anyone else can embark upon in our place, or fulfill for us. Nor should anyone, out of self- serving need to satiate their own desire for power and praise, attempt to steal this journey away.
I cannot predict whether you will realize an unmedicated birth outcome anymore than I can gaze into a crystal ball, giving you an exacting date and time when your labor will begin. The one who determines the ability to realize the birth you envision and desire, is you, my dear expectant friend. You are the only one who must set the goals and intentions necessary to carry out the deep soul work asked of you, on this road to motherhood and caring fully for the life of another. You are the only one who can process, prepare for, and navigate the challenges and unknowns of pregnancy, birth, and entrance into motherhood. You too are the one who must work to educate, embolden, and arm yourself with the tools, and then practice and hone them into an art. You are the one who must say Yes! To the fears, allowing them to be just as they are, yet not clinging to, or giving them power to hold sway. It is you, yourself, who must learn to let fall away the chains of anxiety and doubt that would bind you and steal away your glorious birth, and instead use your artful tools to embrace the miracle, revel in every joy, and paint the most magnificent work as a master painter, fully embodying his vision with complete joyful abandon and surrender. Once the canvas is complete and your birth story, with its myriad colors and textures, stains and spans its expanse, frame edge to frame edge, you are the one who will stand before it, utterly spent from the gloriously demanding effort, yet in complete awe of the masterpiece you have shaped and brought into existence.
So, what is my track record of having achieved unmedicated vaginal births versus medicated births or cesareans? Zero, naught, nil, zip, zilch, and diddly squat! I don’t have a track record at all. I merely have the honor of standing beside the artist and helping to remind them of the tools, the brushes, pigments, palette, and canvas upon which they themselves will create and achieve. It is you dear Mother Becoming, who must take up these artistic accoutrement and wield them like Monet, who painted gloriously sublime water lilies that to this day sweep away the beholder with their floating lovelieness, even though he painted them through the blindness of cataract clouded eyes. It is you who must paint through the blindness and unknowns of your coming birth journey, to realize, embody, and embrace the exquisitely sacred and wondrously metamorphic work of art and achievement at its end.