So, I think I've mentioned a couple of times that I'm working through the required reading part of my doula training over the summer, right? And that in the fall I'm going to attend my various classes/workshops, and then right afterwards I have my first birth lined up? (!!) I'm very excited for the workshop part. VERY. I would have done it a lot sooner but it's a pretty intensive three day process, and you aren't allowed to bring babies older than six months to the sessions. AAAAAND even if I were allowed, I sure as heck WOULDN'T be bringing my wriggling, squirming, teething, not exactly crawling but sure not staying in one place, either, almost ten month old into a classroom of any sort. So, I'll be going in November, when Jameson will (oh pleaseohpleaseohpleaseohplease) be sleeping through the night, and probably only nursing in the morning and evening; i.e., missing me less AND on a schedule that won't require me to be running back to my room to pump every few hours.
Anyhoo. Long winded introduction to the thing rattling around my brain when I woke up this morning, which was what exactly my goals as a doula are. One of the books I've been reading lately (not actually required but I'm reading anything I can get my hands on right now, basically) is called The Doula Advantage, and something it talks a lot about is finding the right doula for you. Some doulas have a certain agenda, albeit unspoken and probably even unacknowledged in their own minds, of getting all of "their" moms through labor medication and intervention free. That is, it is a failure on the DOULA'S part if the mom ends up needing or wanting either of those things, so she has motivation that goes beyond simply trying to support the laboring mother's wishes.
This, obviously, is a problem, or at least is a problem if the laboring mother's wishes happen to differ from the doula's. It is especially a problem if the laboring mother's needs change during labor but the doula is not sensitive or respectful to that due to some prior dedication to an ideal of "natural" childbirth. Most doula clients, probably, go into childbirth hoping to avoid medication, but in some cases even the most passionate normal/natural labor advocates will admit an epidural (or a sedative or a shot of Stadol or whatever) can be the difference between a vaginal birth and a c section simply for lack of progress brought on by exhaustion. A dedication to drug-free labor at all costs is an unhealthy and unprofessional mindset for a doula. One of the things The Doula Advantage really stresses is that the job of the doula is to support, empower, reassure and inform the mother, but not to impose the doula's own opinions or preferences on her at any point.
It also talks about how a doula's presence at an epidural or c-section birth can actually be just as important as at a vaginal, drug free delivery, if not more so! Since most doula clients aren't planning for either of those things, they might be upset, feel stressed or confused, and, at a vaginal delivery, need a lot more coaching during the pushing stage if they are still numb enough not to feel the natural urge to push. A c section, especially first time and unplanned, can be very alarming to both parents, but a doula who has experienced this before (or at least studied it extensively) can be a very calming presence for both mom and dad.
This was something I hadn't really considered before, that a doula can be just as useful at a birth with interventions as during a completely drug free labor. This makes me really happy, because the birth I'm scheduled to attend is for a mom in her thirties, who hasn't given birth in almost fourteen years and who I know experienced a long labor the first time around and was quite happy with her epidural decision. Her doctor has told her that since it's been so long in between births, and since she's at an advanced maternal age (worst term ever!), her body may very well handle this baby just like a first baby and that labor may be long/difficult. (I have my own thoughts about practically setting someone up to dread their labor with all this negative talk, but whatevs.) The point is, I think she may be planning on an epidural at this point, and it's nice to know that whatever she decides, I can still offer support and information.
Having had a doula myself, twice, I certainly know what was helpful for me during unmedicated labors and births. When thinking back on the boys' births, these are the things I feel our doula did for me: helped me go over, out loud and on paper, any specific wishes we had re: hospital policy; encouraged me to visualize and discuss ways in which I hoped to cope with labor pain and how I hoped to be supported by Jim and Stacy; during the birth, with massage, counter pressure, company during a long, restless night when I wanted the rest of my "team" to be resting up to help me later (!), aromatherapy when I felt nauseous, reminders to eat, drink, and rest, music (she brought her ipod and speakers,) discussion about pros/cons when we were deciding when and if to have my water broke, position suggestions as we tried to rotate a sideways baby, and then a lot of verbal reassurance during a fairly rapid transition/descent stage, and gentle reminders about staying loose and opening my pelvis during pushing. This was really helpful since pushing is generally the roughest part for me, mentally, and I always go through this little stage of physically resisting it and trying to fight it back.
So now I at least have my own experiences to go on in terms of what was helpful for me, what I might have liked even more of, in retrospect, and also what was helpful/what wasn't so helpful at other births I've witnessed. What I'm hoping you all can tell me is what YOU would have found helpful if you had had a doula present with you for labor (including how you think a doula might have helped other people there supporting you.) Or, of course, what you DID like/didn't like if you did in fact have a doula. I'm especially interested in how your doula supported and helped you if you chose drugs/interventions right from the start, or how she helped you if you hadn't wanted those things but ended up choosing or needing them.