The secret role of a physiology-informed birth doula

Recently, I happily encountered a mother whom I had supported during her labour and delivery several months ago. It was exciting to see her with her baby, now older and with more personality.

Naturally, the topic of her birth came up.

“I can’t ever forget your sweet voice and calming presence,” she told me. She jokingly added that she’d love to support me for my birth as well.

I so appreciated her loving feedback, but I was also a little surprised at her memory. All she remembered about my doula role was my emotional support even though I vividly remembered much more than that.

Upon thinking about it, I realized that the role that doulas play during birth are so profoundly subtle yet powerful.

This was something I had to tell myself before deciding to pursue this profession. I’ve played and continue to play various professional roles as a person. Other than being a doula, I am also a researcher and a community organizer.

But I enjoyed likening my role to something more prophetic, inspired by Messengers of God. I remembered Jesus (peace be upon him) washing the feet of his companions, or Prophets David, Moses, and Muhammad (peace be upon them all) as shepherds of their herds. I remembered that prophet Zakariyya (pbuh), who was a scholar and caretaker of the distinguished woman, Mary, as being a carpenter.

What all of these exemplary figures have in common is that while they played a vital role in guiding humanity towards their highest potential, they were also people of service. They served their people with simplicity and humbleness.

As a doula, I cannot ever compare my spiritual level to that of the prophets, however, I enjoy thinking about myself as a woman of service, following the lead of prophets.

As a woman, I love the idea of serving other women in subtle and powerful ways.

I remember the day when that particular mother was giving birth.

When I had arrived at the hospital, her active labour had barely started even though she had been labouring for more than 20 hours.

The nurses informed her that the baby was having a hard time descending from the right occiput anterior position and was at a -1 station. Very technical terms which mean that the baby was still a little high up, not in the best position, and needed to descend lower for labour to progress.

Having this information was important for me. There were several techniques I had up my sleeve, but she was very tense and did not feel comfortable in changing positions very much for me to help her. She was also clenching her jaw and the pillow in her hand.

I knew she needed some release work in the sacrum, pelvic floor and abdominal area, so I decided to start with the sacral release. She was already in a suitable position being on her elbows and knees.

The sacral release is a craniosacral therapy technique originally developed by Dr. Carol Phillips and popularized by Gail Tully, midwife and founder of Spinning Babies.

I gently placed one hand above her sacrum, and one hand above her lower abdominal area, and synchronized my hands with her body. I held it in this position until I felt her fascia mobilizing around her pelvic region.

I then went on to massage her jaw and head so she could relax them, and gently reminded her to breathe out with her mouth open, as a clenched jaw would also create resistance in the pelvic region. The body is an interconnected single unit.

I could see she was stressed out, because whenever I asked her what went through her mind during the previous contraction, all she could tell me was how she wanted the baby out, and pain, pain, pain!

The nervous system here needs down-regulation. With her approval, I turned on the oil diffuser I brought with lavender oil, massaged her back during contractions with olive oil, and guided her breathing because she had been holding her breath every time the waves came on.

It is so normal for mothers to feel frightened and tense during labour. It is also absolutely necessary that they feel supported and loved during this process. Mothering the mother is what we doulas do.

Well, some of the things I did seemed to work, because now she was finally able to express her willingness to stand up! Yay! This means that she was starting to feel safe in her body and listen to her intuition.

I held her in my caring arms, and could see her finally tuning in to her physiological instincts. I don’t think she was aware of it, but it was powerful.

Her baby needed to descend from the mid-pelvis towards the outlet. As a professional, I knew she needed to do asymmetrical pelvic movement.

As a mother, she instinctively knew it, too.

I didn’t need to tell her in that moment. She started swinging her hips side to side. The contractions continued to intensify. She said she needed to sit.

I asked the nurse for a birth ball. She sat on it, and declared, “I need to poop!”

The nurse and I looked at each other knowingly, because that was a great sign that the baby had further descended lower!

We helped bring her to her bed now. The nurse told her to imagine her butt relaxing to let the baby through.

Well, as a Body Ready Method℠ doula, I knew why she used these specific instructions. I went on to feel her glute muscles. They were very tense from the top all the way to the bottom.

I applied firm but gentle pressure on her sacrotuberous ligaments and massaged her glutes.

What the mind has a hard time doing consciously, a physiology-informed doula can do physically to support the labouring mother through. Sometimes, imagining your muscles relaxing isn’t enough, so physiological interventions are helpful.

In a short while, she was finally at the second stage of labour.

The baby ended up being born with no complications on the mother’s end.

It’s hard to say how the labour would have turned out if I didn’t implement my low-risk and highly affective techniques on her.

Perhaps she would have had a slower labour. This is highly likely. Perhaps more force would have been indicated by her doctor (pitocin). This is also highly likely. Some other outcomes could have been instrument-assisted birth, or in the worst-case scenario, a cesarean birth (less likely, but possible).

I am glad she remembers my calming presence. Really that’s all that matters at the end of the day- that she felt loved, supported, and heard.

Being a doula, especially a Body Ready Method℠ doula, has been an exceptional, humbling experience. That is what is profound about it.

Mothers may not remember much about what I do to help them during birth. But I can happily remember the blessing of supporting their birth experiences, and helping them feel more present and empowered throughout that process.

One mother and one baby at a time, we doulas can start making the world a better place.

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