Elaine’s Story, Part 1

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Throughout the years, I’ve worked with many amazing women and families. I’ve noticed some trends come and go, and others stay. I’ve become very quick to recognize what is “normal” – which has a very broad definition – and what is beyond a normal emotional and physical recovery. Unfortunately there are many beautiful families who suffer in silence when things are beyond “normal” because they aren’t aware of what to expect and aren’t aware of available services. In order to explain how we help, I’d like to paint a picture; and in order to honor confidentiality, I will combine several client experiences and refer to the client in this example as “Elaine.”

Elaine called Doulas of Los Angeles to hire a doula for the birth of her second baby, stating that after her traumatic first birth she suffered debilitating postpartum depression. I assured her that one of my first and most important jobs as a doula is to actively listen without judgment or interruption and asked if there was more that she would like to say about her experience.

She explained that she had an emergency cesarean after 9 hours of active and painful labor because the baby’s heart rate indicated the baby was experiencing distress. She was unaware of what was happening and what to expect for herself and for her baby, but there hadn’t been time for the medical staff to explain. She just wanted her baby to be safe, but she wanted to know why she had to have a cesarean. Her husband was not able to enter the operating room and she felt alone, and intimidated by the cold, sterile environment.

When the nurse placed the surgical securing bands around Elaine’s arms, Elaine felt claustrophobic and vulnerable; she tried to tell the nurse that she couldn’t breathe, but the nurse didn’t respond because she was busy with another preparation. During the cesarean, the thought, “They won’t listen to me,” kept running through her mind. She explained that she felt alone, confused, in-danger, and fearful for her baby.

After she finished sharing her experience, she suggested that with this birth she wanted to attempt a Trial of Labor After Cesarean (TOLAC), and needed a doula who would advocate for her and speak for her to the doctors this time, to ensure that the plan went according to her wishes.

After listening carefully, and taking copious notes, I asked her if I had understood her experience clearly and repeated back to her some of the phrases that she used: “she felt alone, confused, in-danger, fearful . . .” She confirmed this.

Then I explained that although we don’t speak for our clients, one of the ways we address these particular feelings is by taking some time prenatally to help her find a care provider whose philosophy of care matches the client’s philosophy of birth.

Then we’ll help her to open a dialogue with the care provider regarding the priority items. I explained that with this relationship of open communication, she will be less likely to experience the anxiety of the previous experience.

However, should circumstances at the time become as urgent as they had during her first birth, we would help HER to ask questions and articulate her feelings in the moment. We would also be able to help her put a postpartum plan in place to assist the family, with special consideration to the postpartum depression she had previously experienced.

She said that sounded fantastic and she hired one of our labor teams right then and purchased two 40 Hour postpartum contracts. We scheduled our first prenatal meeting for one week from that day, during which time we would put down on paper her expectations for this birth.

To Be Continued . . .