Wednesday, September 15, 2010

A Chance to Do Something I've Never Done Before or Is this What it is Like to be a Nurse?

One morning recently I was getting ready to go to a La Leche League meeting when the phone rang. It was another doula, a friend, and she needed some help.She was stuck at an airport far away and one of her client's had just called to say her water had broken. Unfortunately her back up doula had been at another birth all night. Would I go to the birth? Of course! My friend said she would connect with her birth client and let them know I would be calling.

So as I pulled my pick up truck onto the freeway in Pismo Beach I answered a call back from the dad. He was fairly calm. We discussed how mom was doing. He said she was in labor but handling contractions well. I asked if he wanted me to come right over to their place? No, he thought I should go on to my LLL meeting as planned. I asked if I could talk to her? When he took the phone to her I could hear the labor sounds she was making; a deep breathy moan. Hmmmm...I'm thinking. Then dad came back on the phone and said she couldn't talk now. Hmmmm...I'm thinking. He said he would see me when the meeting was done. I drove towards SLO I'm thinking that didn't sound like a mom in early labor. Hmmm...My gut said I don't think you're going to League today. So I drove past SLO and on over the grade to their place.

Driving down their windy country road I wondered what this would be like. I had never supported a woman I had never met. Usually I have spent many hours with my moms sitting in their homes, chatting, educating, answering questions, calming fears, instilling confidence and creating relationship. As the birth nears I become a unique blend of confidante, experienced guide, friend and mother hen. So I wondered what would this be like? Could I be effective? Would she respond to me, a total stranger?

When I pulled into their driveway dad came around the corner with a puzzled look. I introduced myself and he visibly relaxed. He took me to the sunny deck where mom sat leaning back in a chaise lounge looking very uncomfortable and obviously contracting. After the contraction subsided I introduced myself and told them their doula was very sorry she couldn't be there with her. Then we got down to business.

I suggested she would be more comfortable in a different position. Could I help her move? After getting her into a leaning forward position I began to gently rub her shoulders as I assessed where she might be in her labor by the rhythm of the contractions, her response to them, her flushed face and unfocused eyes. I thought either this was going to be a long difficult posterior labor or things were moving very quickly.

"When had she last been to the bathroom" I asked? "Could she try to do that with me?" We slowly worked our way through the sliding glass door and into their bedroom. From the deck across their bedroom to the bathroom counter was 3 contractions. We never made it past the bathroom counter. Leaning onto its' smooth surface with me giving sacral counter pressure she swayed and moaned and contractions flowed through her like a torrent.

I turned to dad and calmly asked when he had spoken to their midwife and what she had said. He informed me that she said she would come some time this morning and check how things were progressing. I instructed him to call her again and tell her I said it was time to come. He left the room.

Alone together my hands sent waves of quiet calm into her being. Then I felt her knees begin to buckle with the power of her contractions. Her body was being lead in the primal birth dance, rocking, swaying, head rolling, opening to the flood of sensations that would bring her baby. Having been a birth dance partner for many women I could sense where we were in our journey together, so I was not surprised when I heard her give a soft grunt with the next contraction letting me know her uterus was pushing.

Dad came in and I inquired what the midwife had said. "She's on our road" he announced. "and will be here any minute." I breathed a sigh of relief. I am a doula not a midwife. I am not trained in catching babies. I have non of the necessary equipment. A few contractions later the midwife walked in, assessed what was going on and calmly went into action readying her supplies, talking to the mom and dad and smoothly stepping into the primary support role.

Usually a midwife has a trained assistant but it was clear to us that this baby wasn't going to wait for an assistant to arrive. As best I could I worked with the midwife, getting supplies, holding things, and handing things, while at the same time talking to the mom to give her confidence in her abilities to birth her baby, taking photos, and guiding dad into positions where he could remain a connected part of the process. Very soon a beautiful baby girl emerged into this world and into her moms waiting arms, healthy and happy.

I continued in my new dual role during the mother's repair and clean up, alternately fetching for the midwife, stroking mom's hair, taking more photos, cleaning up their rug, putting their towels in the washing machine. Finally it was time to go. Mom, dad and baby were in bed glowing and in love. Food and drink were at hand, family was arriving. They thanked me once again for being there, for not listening to dad's suggestion to go ahead to the League meeting and for everything I had done. Then I walked out of their door.

It has taken me weeks to process this new experience. I still don't know why she listened to me. Why she willingly followed my every suggestion. Why did she have confidence in me?

Is this what it is like to be a labor & delivery nurse? You walk into a room with people you don't know and yet you need to be able to guide them during one of the most intimate and intense moments of their lives. You have to assess where the laboring woman is in the process in order to call the doctor or midwife to come in time for pushing. When they arrive you have to support the mom at the same time playing step and fetch it for the doctor. When it's all done the family walks back out of your life and the connection is broken.

I can tell you I have worked along side some excellent labor nurses. Women that have known how to seamlessly flow from one role to another. The best ones are able to instill confidence and a sense of caring within minutes of entering the room. They are able to enter a room without disturbing its' energy or the rhythm of the labor. They listen to the mother as she progresses through labor and will try to encourage the doctor or midwife to honor the mother's wishes for her birth. Apparently I have learned a lot from these wonderful nurses.

Of course I have learned just as much from struggling with nurses that do not have an aptitude for being with birthing women. They don't generate the right kind of energy for laboring with a woman.

A good doula or nurse needs to be able to emanate confidant guidance without taking control. Their presence needs to create a sacred space in which the woman feels secure to birth. They become the mother's sanctuary in the storm. Now I know this can happen within minutes of meeting if the labor guide brings an open & intuitive heart to the birth.


  1. From Jessica Elliott:
    What an absolutely beautiful birth story Jennifer. This family was very lucky to have you be there as a support and guide!

  2. Elena Anderson wrote:
    Beautiful and so touching-thank you Jennifer!!!

  3. What a lovely story. One of the things I love about being a labor and delivery nurse is that connection. Often times it is not broken, I go on to care for moms and babies as their postpartum nurse. Outside of the hospital we are part of the community of mothers. We see eachother at the park and library for story time. Our children may be in the same class. How blessed we are to share in such an amazing window of time in the life of families!

  4. What a beautiful thing to say Lindsay! We are so lucky to be part of a close knit small town community. My favorite nurse at my son’s birth turned out to live down the street. She was wonderful. It was nice to have her watch Joe grow and know she was there the moment he arrived in this world. Her name is Jeanette Cutner and although we have lost touch I have never forgotten her.