“Are doulas only for ‘natural’ births?”
Image: My Birth by Carmen Winnant
“Are doulas just for ‘natural births’?
I hear this question come up alot from curious parents, and it’s a valid one to ask. Maybe you’re floating the idea of a doula for your own birth or perhaps you know that you want one — yet you’re still wondering what their role might look like and if they align with your hopes for this experience. So, lets unpack this question a little more.
Firstly, what is a ‘natural birth’? The term was first used by Dr Grantly Dick-Read in the 1930s, becoming more prominant in the 1960s along with the natural childbirth movement and second-wave feminism. This movement pushed back against the emerging techno-medical model of childbirth, encouraging women and birthing people to take back control of their births by moving away from medical intervention.
So what does ‘natural birth’ mean today? While the term remains somewhat of a nebulous descriptor, I’ve found that it is often used to describe unmedicated vaginal births with little or no medical intervention. And while it might seem harmless to label these birth experiences as ‘natural’, the implication that people whose births fall outside of this ideal — whether they had a cesarean birth, needed to be induced or desired pharmaceutical pain relief — must somehow be ‘unnatural’ is divisive. And there is enough shame around birth and birthing bodies already! When women and birthing people are seen, heard and respected in their informed choices — all birth, whether unmedicated, medicated, vaginal or cesarean birth — is natural.
Image: My Birth by Carmen Winnant
This idea that doulas are only for people planning a physiologcal, unmedicated birth is a common misconception. Just as there are a range of different ways to prepare for, navigate and experience birth, there are a variety of birth doulas with different values, beliefs and boundaries surrounding birth support. Some doulas don’t attend planned hospital births — and others do. This is great! We need doulas doing work they are aligned with, so that they can show up in sustainable ways.
This week I attended two births where both clients birthed their babies via ceasarean section* — and I wanted to share a little about them from my perspective . For both of these women, their individual birth experiences were transformative, powerful and life-altering, and not without their own unique challenges.
The first birth was at 41 weeks gestation following premature rupture of membranes and three days of latent labour, at which point the the family made the informed decision to go into their local hospital for some monitoring. Turns out their baby was frank breech (surprise!), and while a this is a variation of normal there were some indications that a cesarean birth would be needed. My client had hoped for an unmedicated, vaginal birth, and to be faced suddenly with the prospect of cesarean birth was a HUGE practice in surrender and self-compassion. Still, she went into her birth feeling safe, supported and heard — knowing that this was how she would meet her baby.
This mindset and the ability for deep surrender, in what was a very challenging moment, was all her. This was her drawing on the embodied wisdom which she had practiced and connected with throughout pregnancy. This was the foundation of her informed decision making, and the inner knowing of what was right for her and her baby.
We explored these different (and often unexpected) pathways to birth in our antenatal sessions together, and I was with her during those days labouring at home. Allowing her partner to get some much needed rest during the night, making snacks and bringing drinks, and offering reassurance, love and presence when they decided to go into hospital.
Image: My Birth by Carmen Winnant
The second birth I attended that week was an elective ceasarean section, following the devestating loss of my clients first baby shortly after birth. Pregnancy after the loss of a much wanted baby is no easy thing — and two pregnancies and births so close together can be both emotionally and physically exhausting. In order to feel safe (emotionally, physically and psychologically) through this second pregnancy, what my client needed was continuity of care, compassion, and predictability — which included the support of a cohesive, known, trusted care team that she had built a relationship with.
In the lead up to and on the day itself my client and her partner were surrounded by the same team that had supported them with the birth of their first baby, and that continuity of care was so impactful. This birth was the healing, family-centred experience that her and her partner had hoped and planned for — incorporating a maternal assisted delivery, gentle emergence of their baby and immediate skin-to-skin. I was privileged to attend the in-person and was able to capture the birth on camera, including that anxiously-yet-joyfully anticipated, first breath and cry. There wasn’t a dry eye in the room.
In both of these birth experiences, it is my responsibility as doula and birth companion to hold a compassionate container for my client (and their partner), to create space for them to make informed decisions, to trust in their autonomy and intuition, to advocate, and to offer gentle guidance when / if needed. Neither of these births would fall into the category of ‘natural birth’ as it was originally defined, yet, they were both so natural and deserving of loving support.
One of the guiding principles in my own practice, is providing full spectrum person-centred care — creating space for birthing people to discover and share their own intuitions, intentions and hopes for their journey. Sometimes this is a home birth. Other times it’s a planned cesarean birth or hospital birth with an advocate by their side. Every birth is different AND all birthing people deserve reproductive care that is affirming of their individual informed choices.
Currently I support people who are planning to birth at home or in the hospital. I see all these experiences as an opportunity to show up for birthing people in meaningful ways, to bring compassion and magic to both the clinical and the familiar spaces. To ensure there is trusted support available on your journey — however it unfolds for you.
I believe that birth is a rite of passage. An opportunity for transformation. I believe in the physiological processes of birth. And, I believe in the capability of women and birthing people to birth in a way that feels right for them and their babies.
Choosing a doula that you connect and resonate with is an incredibly personal process — and an important one. As is choosing a care provider / birth place that aligns with your intentions for birth. Find a doula that is willing to get to know you and your needs, wants, desires and intentions and walk with you on this journey — however it unfolds. If you’re considering a doula but unsure how they might fit with your hopes for birth, I’d love to chat.
*A cesarean section (also called surgical birth, belly birth or cesarean birth) is the birth of a baby (or babies) through a surgical incision that is made in the birthing persons abdomen and uterus.
20.11.2022
