Thursday, August 26, 2010

Dueling

I'm not entirely sure what the progressive verb of "to be a doula" is, but my dad calls it dueling.  That amuses me, and so......
This weekend I am the on-call doula at the birth center for both Friday (my day off at my 9-5 gig) and Sunday and hope to be dueling both days if a couple of babies decide to be born.  On days I am on-call (which is about four 24-hour periods a month), everyone in the world seems to have a bun in the oven.  My P-dar goes berserk and I start wondering "will she be my client?  How about her?"  And because I could be called at any moment, I do a few things to get ready:
I go to bed early the night before.  I learned my lesson last month when I was called Sunday morning for a birth that lasted until 7am Monday morning, an hour and a half before I needed to be at work.  That day hurt (like hit-by-a-distracted-driver hurt), but would have been a bazillion times worse if I hadn't gotten my z's the night before.
I shower and brush my teeth.  Again, who knows how long you are going to be without a shower?  And I've heard horror stories about laboring moms smelling someone's bad breath or body odor and throwing up all over the offending person.  I choose not to be "that girl who got thrown up on."
In case I do become "that girl," I dress in my doula costume (this costume is neither uniform from doula to doula nor required...nor does it include a mask or cape...sad).  In my case, it is comfy shoes (although I need to find some less nice ones to make my hospital shoes), easily washable comfy pants (they have to be something I can nap in, and that dry quickly in case I have to help someone in to the shower/tub and that I don't care enough about that I could abandon them for a pair of scrubs is something biological happens to them), and a variety of layers on top since the hospital fluctuates from freezing to boiling depending on the day.
I keep my doula bag at the ready.  My bag has a bunch of handy things in it, such as:
  • Rice sock - you can stick it in the microwave and it stays warm for a long time.  This can  be used  to relieve pain (I use one for myself after a particularly hard round of weed-pulling at the garden).  They are easy to make: men's sock, white rice, tie a knot.  Bam!  Rice Sock!
  • Paperwork - to get my certification I have to document everything.  I have consent forms, data forms, and evaluation forms I have to get filled out for every birth.
  • Change of clothes - in case I get wet in the shower, or thrown up on, or end up in the hospital for way too long, or just have cold toes and want another pair of socks to wear.
  • Lotion - something about the air conditioning in the hospital makes my hands dry.  If I were taking private clients, I would have them bring their own lotion for massage, etc, but I don't want to lend mine as you never know who is allergic.
  • Tooth paste/tooth brush - smelly breath=never ok
  • The Birth Partner by Penny Simkin- awesomist book.  I recommend it to everyone who is supporting someone who is having a baby, whether a doula, a partner, or just a friend.  I gave away my other copy already.  Going to have to get more copies as more people I know get pregnant and I need gifts.
  • Trail mix/granola bars - the last birth I attended, I didn't eat enough before hand and got really super light-headed at a critical moment.  I had to step out into the hall and put my head between my legs and drink some juice so I wouldn't pass out.  The nurses thought I was scared of needles.  Mostly, I just needed to eat more.  Now I eat early and often.
  • Gum - again with the bad breath.  Just no.
  • ID Badge - the labor and delivery floor has some fierce security.  This is what allows me to get in.
  • The phone numbers for the midwives on call/birth center instructions - I call the midwives on duty in the morning to let them know I am ready!
  • Money for a cab - The bus doesn't run at night.
  • Knitting - a long birth when a mom has an epidural and is able to sleep for a while feels reaaaaally looooooong without something to do.  I feel bad about reading, though, cause that takes too much of my attention.  If I knit something easy, I can still pay attention to what is going on.
  • Business Cards - to leave with the mom and midwife when I leave.  I always encourage the moms to call if they need anything later.  They usually don't but I feel better about leaving them if I know they can reach me if they wanted to.
I realize that most of the things in my bag are for my comfort rather than the mom's.  Some doulas do carry a birth ball or a rebozo or a lot more informational materials.  If you have met previously with the mom, you might have a copy of her birth plan.  You might have a gift for the family (I am seriously considering carrying a slew of hand-knit booties in gender-neutral colors for this purpose).

For me, I've discovered that the most important tools I have in my arsenal are my hands, my ingenuity, and my compassion.  I use my hands for pain reduction techniques like applying counter pressure to the hips or lower back and comfort techniques like holding hands or brushing the hair off her face.  I use my ingenuity to make a rebozo out of a bed sheet, to produce a hot pack out of wet wash cloths I put in the microwave, and to increase a baby's heart rate by helping to get her on her side despite an epidural. 

But I've discovered that more than anything a laboring mom wants acknowledgment that this is tough but that she can get through it.  She wants to know her partner and other loved ones are cared for and that she doesn't need to worry about them.  And she wants to know that what is happening to her is normal and that she is doing a good job.  I try to use my compassion to give her those things.

So wish me luck with my dueling this weekend.  I will let you know how it goes.

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