the doula as the witness

being a doula and witness of birth can take us to many places within ourselves.

from absolute ore at the wonder of birth – ecstatic, full of love, joy& endorphins moving through our bodies: to the depths of despair – from feeling deeply satisfied to asking yourself

what have I just witnessed, where did it all go wrong, what could I have done to change the outcome.

I am speaking through the eyes of a Doula. and focusing primarily on birth within the hospital system.

42 years ago at the age of 22, I attended my first birth  whilst training as a pre-school mothercraft nurse. I was sooo excited to be invited to witness a baby being born – my first birth. what I walked into was far from what I expected. the mother had her legs in stirrups, the obstetrician was standing between her legs, a set of forceps in his hands and said in a threatening tone ‘If you don’t push this baby out soon I will be using these’

I was shocked, I froze, slowly moving back to the wall behind me for support, I remember knowing this was wrong and that was the moment I knew I wanted to be a birthworker.

I recently conducted a small survey involving doulas in and around Melbourne on the topic of being the witness.

25% had attended 100 plus births and 50% said from what they had witnessed they had considered stopping attending births with 16% taking a break because of the impact the negative experiences had on them. this number is high!

the questions asked were not about the birth outcome but how the woman, her partner, the baby were treated. there were beautiful positive experiences where the doulas described their feelings ie elated, blessed, proud, hopeful, deeply satisfied, on a high ( we all know that one!) one comment was ‘witnessing a positive birth lets you walk on sunshine as a privileged member of the village’

In the survey, 35% experienced the birth as negative – talking about a hostile environment, emotional abuse, violation of human rights. their responses to how they felt were: feeling traumatised, distressed, shaken, disempowered, angry, driven more to advocate for human rights, disgusted that a woman could bully another woman in her most vulnerable space.

as a doula you are the witness to who is in the birthing room and what is happening in the birthing room: mum, partner, other support people baby/babies, midwives, doctors etc and they in turn witness you. 20 years after my experience of my first birth as the witness at the age of 22 I returned to the same hospital as a doula along with her midwife supporting a woman who had transferred from home. 1st baby, lack of progress, exhausted mother, baby’s heart rate starting to dip. on arrival there was concern about baby’s wellbeing and a caesa was recommended. mum and her partner said no. I knew this mum well, she had a strong connection with her baby and her inner knowing and she was strong. I trusted her and supported her decision. the Drs and midwives were witness to someone going against their advice and witness to me supporting her. they called me out of the room and suggested I was influencing her decision – I said I was not, she was making her own decision. she went on to have a natural vaginal birth.  our role is not to make decisions for the mother/couple but to support and encourage her to find her truth, her voice, which is exactly what she did.  for the first and only time the hospital contacted me a couple of weeks later to come in for a meeting with Drs and midwives who attended the birth. as a witness to that birth I was elated, proud of the mum, and on a high. their experience as witnesses was the opposite, they were concerned, felt helpless, worried about the birth outcome. the head OB let me know he was so worried he didn’t sleep that night ‘I thought that baby was going to die’. this gave me an understanding of how different it can be for the midwives/drs/OBs as the witness to the doula. if we can find a way of working together with respect and understanding of our roles as birth professionals mothers/partners and babies will benefit.

being a doula is a big space to hold and you find your way of looking after yourself and protecting yourself on an emotional and spiritual level. you experience the most miraculous event, birth and sometimes birth along with death. from my personal experience it took me a few years to find my way of self-care as a birth worker and from my experience as a teacher of student doulas the sooner you do it the better, for you, for your family, for the women and families you are supporting.

how do we prevent burnout – it is not unusual to attend a birth and your story is triggered. your birth – when you birthed your way out from your mother's womb and the birth of your babies. these stories and experiences live in your body, maybe on a very subconscious level but they are still there. the old saying goes the work you do in the world is for others but primarily you are doing it for your own healing.

when you witness a birth it is the mother’s story it is not your story, we all talk about leaving our story at the door before we walk into the birthing room.  to do this it is important to process and resolve as much as we can within ourselves ie the negative birth we attended last week, last year etc. we don’t forget it but we don’t let it run the show.

we learn from every birth we attend sometimes we are happy about our role, proud of ourselves and other times we think what we will do better next time. acceptance that we did the best with what we had and knew at the time is what will support us as doulas. it is you supporting yourself, taking responsibility and knowing you are forever changing and learning.

asking the Doulas on the survey how best they supported themselves after a birth most said, writing in their journal, debriefing with other doulas and mentors, debriefing with their partner, women’s circles and self-care. I would like at add, breathwork, bodywork, somatic therapy and as we know there are many other healing modalities. ‘trauma is not in the event, it is in our nervous system’

self-care is paramount. we are natural givers and carers. learn to give care to yourself. I believe the sooner you do this the longer you will stay working as a doula. as tempting as it might be, don’t take on too many births, know your limits, add into your package cost of a massage, a taxi fare home, be very careful driving after a birth (there are many times I should not have been on the road) work with backup and support. very happy to see in recent times doulas around melbourne are creating their business as a group ie 3-4 doulas working together, backup and support for each other.

we are not doing ourselves or mothers/partners/families we are supporting any favours by getting exhausted. as we have seen witnessing birth can put us on a high for days or put us in bed for days. we are making a difference, it may seem slow at times but it is steady. we may feel not much is changing for the better, but it will, I encourage you to hang in there, support yourself, support each other as you support the mother and her family , we can make change for the positive and it is my dream that in the future that you as doulas, as the witness see and feel and be part of more and more positive birth experiences. we can and do make a difference. if each one of us makes a difference even at 1 birth and if we add up all the births we are attending or have attended we are making a difference. birth matters, mothers matter, babies matter and doulas matter.

- Sunderai felich, keynote speaker at doula conference 2018

Rain Inaya Ali