Doulas and Restraint

Restraint.  When folks ask me what is the hardest part of being a doula, I answer “restraint.”  We doulas get riled up about doctors and midwives who use unnecessary interventions.  “Humph,” we complain.  Why can’t they simply respect birth?

But we are often guilty of the same thing.  When I first began as a doula, I thought I was supposed to whip out all my tricks and tools.  I figured these families were paying me to do something.  My thoughts went something like this:  “Ok, I need to do x to keep her labor from stalling.  I should do y to make sure the baby descends.  I must do z to encourage her to release more oxytocin.”  You realize what I was doing?  Using unnecessary interventions.  Maybe they were harmless and maybe they even helped but they may not have been necessary.  And sometimes, they took away power from the birthing woman.
Why couldn’t I simply respect birth?
Do you remember those early studies on doulas–you know, the ones that showed incredible reductions in c-sections and other interventions and incredible increases in mother satisfaction?  Most often, the mom didn’t even know she had a doula.  The doula was simply present as part of the medical team–it was a blind study.  Her mere continued presence resulted in positive outcomes.  How could that be?
It is a tricky profession.  In the aftermath of a normal birth, it should feel like the doula or the midwife/doctor didn’t do anything.  Our goal should be to fade into the background of the story.
Now don’t worry–this rambling doesn’t mean that I’m not going to give my clients nice foot massages or help them relax during your labor.  It does not mean that if I suspect any roadblocks (positioning, difficulty focusing, etc), I won’t pull out a trick or two.  But if labor is progressing normally, sometimes the best tool I have is simply to be there.  To be a gatekeeper or lifeguard; not a director.  And yes, I struggle with this.  I want to jump in and save the day.
Ah, but women don’t need to be saved.  This journey is hers and she are the hero in this adventure.
This quote was written to midwives but I think it applies to all those who are invited into the presence of birth:
Do good without show or fuss. 
Facilitate what is happening rather than what you think ought to be happening. 
If you must lead, lead so the woman is helped yet still free and in charge.  
When the baby is born, the woman will rightly say, “We did it ourselves.”
–from the Tao Te Ching