Doula to Midwife

A non-module-related post.

A couple days ago, I attended a hospital birth as a doula. It was the first time in what feels like a really long time that I was at a birth for my very own doula client. I've been to a few births as back-up or as a second doula, but this was the first time in awhile that it was my own client. It was also the first time I'd been to a hospital birth after I started feeling like a midwife. It was a pretty interesting experience.

Normally I wouldn't share any details of the birth (seeing as how it's not my story to tell), but this was a little different because it kinda marked a turning point for me. I'm sort of re-defining my role as a midwife who provides labor support, instead of being a certified doula. For example, when my client's water broke as she was laboring at home, there was some meconium. As a midwife, the first thing I would have done is listened to her baby's heartbeat, as meconium can be a sign that the baby is a little stressed. As a doula (using the DONA organization certification) and thus having signed an agreement saying I wouldn't do anything medical, my hands were tied. It was the most uncomfortable feeling. What I ended up doing was explaining to her as best I could in a non-alarming way what the significance of the meconium was and why we should head in to the hospital a little sooner than planned.

At the hospital, my client continued to labor and push without any pain meds. Having come from seeing births at a birth center and at home where there's no such thing as pain meds, it's not like anything out of the ordinary for me to see a woman have a natural labor. At the hospital, I was reminded, it totally is out of the ordinary. Each new nurse who came in the room asked my client if she was feeling her contractions. Uh, duh. They automatically assumed she had an epidural, since that's what like 90% of women in the hospital do. Overall, though, the nursing staff was very supportive and encouraging.

I did have one little tiff with a nurse, but it's kind of funny looking back at it now. At one point during the labor I went out to the nurses station to ask if there was an extra lunch tray for my client. I'm always super polite. The nurse looked back at the white board to see the progress notes indicating my client was in active labor. She looked back at me and totally gave me an attitude! She said my client couldn't have any food because, like, duh, she was in labor. The nurse gave me this whole, "are you stupid or something?" look. I gave her back the same look and was like, "uh, yeah, she needs food because, like, duh, she's IN LABOR." I'll never understand the hospital's ban on eating during labor. Makes no sense whatsoever.

Anyway, I got my dang food tray and went back in.

Due to a complication during the birth, the nurse-midwife turned over care to the OB. It has REALLY been a long time since I watched a surgeon deliver a baby. Watching her suture was pretty cool. At one point I saw her apparently decide she didn't like the way she had placed a suture, so she pulled it out. As I saw the needle coming backwards, I thought to myself, "cool, you do that too!?" I thought it was only silly inexperienced me.

I got some great comments from the nursing staff about my role as the doula. I felt like a whole different person than I was before my midwifery training. Guess I really have come a long way. I definitely feel like I earn my high fee now. I totally know what I'm doing! I felt good about my job there, but I also felt pretty good about the hospital staff as well. I have a lot of respect for the way they helped my client avoid major interventions. They were all pretty great and I was reminded why I really like working at Kaiser hospitals.

It's funny how, as a new doula, I would have totally encouraged the parents to question the fact that the nurse wanted to give the baby a small amount of formula after the birth. Now, I totally understood the whole situation and could see what was really going on. As I explained to my client that it would probably be a good idea to give the formula and that it wouldn't have a negative impact on breastfeeding, I saw the OB smile.

Guess I'm crossing over to the midwifery side now. Turns out I kinda like the view from here.