Doula Domino Kirke on why your birth providers are so important, and how to choose them wisely.
(Blog posted in its entirety from NYT Parenting.)
As far as I was concerned my midwife was going to have my baby for me. She was God’s gift to birthing. She had so much confidence, and trusted the birth process so intensely, that I fell instantly, wildly in love with her.
This was an age-old habit for me. Show me an older woman who knew her place in the world, who told me she knew better than me, and I was putty in her hands. To say I have mommy issues is an understatement. My mother is a shrewd businesswoman. She’s sexy, critical and the most intimidating person you’ll ever meet. I cowered around her until my teenage years, then developed blood-curdling rage towards her. Around the same time I was diagnosed with manic depression. I was the first daughter, the first pancake. I didn’t know who I was if she wasn’t looking me up and down, checking to see if I measured up.
At 25 I became pregnant and needed other people to sign off on just about everything I did. I didn’t trust an intuitive bone in my body. Pregnancy became an invisible cloak I hid inside with lofty ideas of who I would become once my baby arrived. I felt safe pregnant, in a container made just for the two of us, and our potential.
I met my midwife late into my pregnancy. I left my first midwife’s care after she advised against a home birth. She said my relationship wasn’t stable enough, and with my history of sexual abuse, was skeptical I could sustain the intensity. How dare she!
In a storm, I found a cowboy. I was in awe of her ego and her stories of grandeur — the same way I was in awe of my mother. I was experiencing transference, when the feelings and dynamics from childhood relationships are applied to authority figures in adult life, or, in this case, to medical professionals. In the birth world we have a saying: we birth the way we live our lives. Now that I’m a doula I see it constantly — but at the time, I wasn’t capable.
I didn’t want my mother or any family members in the room during my labor. Little did I know she’d be there anyway; my midwife activated and occupied all the same spaces. There in my charming one-bedroom apartment in the middle of January I labored as a little girl, no one there to remind me how old I actually was, or what I was even doing there. Although my mother was across the East River in her own home, her tentacles reached in and grabbed us all.
After 24 hours of labor I felt my midwife’s disappointment. I was her last client before her vacation, and I couldn’t have the baby fast enough. The tension between us was thick and felt by everyone, especially the sweet young doula who also struggled with her authority. Doulas are there to support birthing parents, while midwives provide medical care, yet my doula broke like I broke, and was of little help to me.
After laboring at home for nearly three days, my fever rose. I was whisked to the hospital and diagnosed with a uterine infection, resulting in an emergency cesarean.
The experience inspired me to become a doula. I knew there was so much more I could have received emotionally during my labor. My partner at the time was terrified and exhausted, and my doula wasn’t in her power. What I truly needed was a nurturing presence to counter all the old energy that occupied my system around my childhood caregivers.
It has helped heal me to become that presence for others. These days I train doulas, and we teach them not to bring their baggage to the most important moments of someone’s life —because it’s not about them. We are there to listen and watch, and to help our clients meet their goal, whether it is a hospital induction without fear or a loving home birth. The relationship is a two-way street; when we meet our clients, we want them to pay attention to how they feel about us, too.
We encourage our clients to treat their doctors and midwives the same way, and to ask loads of questions: Do you follow evidence-based birthing practices? Do you differentiate between high- and low-risk pregnancies? If yes, how? If I am considered low risk in my pregnancy, will you want to manage my birth? If so, what can I expect? What is your cesarean birth rate?
[Doulas can be for everyone. Read our guide to choosing a doula here.]
When they ask these questions, we encourage our clients to note how their midwives and doctors respond to them. Do they make eye contact? Is their tone harsh or punishing? We want them to not only observe their medical caretakers, but their own feelings as well. Are they upset by their doctor’s harsh tones? If not, why?
One client of mine complained about her doctor every time I saw her. He’d rush her, give her evasive answers about procedures and protocols, and speak down to her like a child. When I helped her realize her feelings around it, she said, “But how do I ask for things if I don’t know they are missing?”
She wasn’t wrong. It’s challenging to make these connections to your past, and difficult to ask for things you didn’t receive in your most formative, vulnerable years. A provider who doesn’t set off every warning bell in your body will be a game changer for your birth experience, no matter the outcome of the delivery. Even if you have little choice of your doctor or midwife for financial or insurance reasons, there are volunteer doulas — so with effort, you can find a caretaker that makes you feel seen.
We don’t know what we deserve most of the time, but I’m telling you, you deserve better. Get louder, get bigger and surround yourself with extraordinary love when choosing your birth team. It might be the first time you’ve ever done such a thing, but I promise it won’t be the last. You can challenge your past. You can rewrite the play.