Deciding to Do the Doula Thing

When I was pregnant with Eliza, I knew I wanted to hire a doula to be a support system during labor and delivery.

Of course, when I was pregnant with Eliza, I knew lots of things.  I knew I wanted a non-medicated birth.  I knew that I wanted a husband-coached birth (with doula support).  I knew that if I ate enough protein (carefully tracked in a notebook, of course), and did all the right exercises (prenatal yoga, but also labor relaxation practice) and read all the right books (you name it, I read it), and got plenty of sleep, and listened to my hypno-babies CD every night before bed, that I would have the perfect birth and the perfect baby.  I would have earned that, right?

And then the bottom fell out of my world and I didn't know anything.  How did I go from being a low-risk pregnancy and a fully-informed advocate for myself and my baby to having my baby die?  What had I missed? What had I overlooked?  How could this possibly have happened to me?  I had no answers.  I knew nothing.

I didn't trust myself.  I didn't trust my body.  I didn't trust my research.  I felt like such a fool.  A heartbroken, ill-advised, know-nothing fool.

It's been hard for me to figure out how to balance all of the information I sought out and readily absorbed the first time around with my cautious approach to the "if's" and "hopefully's" of this pregnancy.  As I've mentioned before, I haven't done any reading about pregnancy this time around.  I'm not doing prenatal yoga on a nightly basis.  I'm not tracking how many grams of protein I consume (although I do think about it a lot).  I'm not visiting breastfeeding groups, I'm not taking classes, and I am not going on a hospital tour even if I decide to deliver at a different hospital.

I still find that I can't really see past 34 weeks.  And yet.  I have what is known as a Viable Baby in this belly, and one way or another, this baby will come out of me sometime in the next 11 weeks.  (I'm still not sure I've fully absorbed that).  My non-stress tests start Monday, so I'm officially Almost There.

I think that the most motivating factor, though, has been the number of people I've come to know who having babies after losing a child.  Many people in my "generation" of bereaved parents, who had a loss in 2010 or early 2011, are now holding their "rainbow" baby in their arms, or anticipating having that baby any day now.  It's made it seem so much more real and possible for David and me too.

We've talked only a little bit about what labor and delivery might be like.  Would we be happy?  Would be overwhelmed by post-traumatic stress?  Would we be scared out of our minds?  We haven't said much about this because everything is unknown.  I know my OB will absolutely be there to deliver this baby (bless his heart), but I don't know which hospital I'll choose, I don't know what my emotions will be (except, probably, all over the place), and, worst of all, I don't know that we'll end up with a baby to bring home.  I'm hopeful, but it still feels like a big fat maybe.

Anyway, back to the doula thing.  We'd hired a doula for Eliza's birth--a nice lady whose website I found online.  We met up with her at Bread Co. and chatted for about an hour.  She was fairly new to the practice, so her price was lower than some others I'd looked at, and she seemed friendly and reassuring and excited to work with us.  We planned to meet again a few weeks before my due date, but that never happened since I went into labor five and a half weeks early.

The night Eliza was born, of course, we didn't even call the doula until it was all over because neither one of us thought about it.  David and I were both in complete denial that my labor was progressing so quickly (remember, I was fully dilated by the time we got to the hospital after about two hours of tolerable contractions, and I had NO CLUE that first time labor could happen that way--I believed on the whole car ride over that they were going to give me medicine to stop my contractions.  So much for being aware and informed...).  David called her after and explained what had happened and she offered to come up, but he said that wasn't necessary.  She later mailed us a sympathy card and refunded our deposit.

I wasn't sure if we would want a doula this time around.  For one thing, I've done this before, under the worst of circumstances, and managed.  For another, I have superstitiously wanted to avoid replicating the things I did with Eliza.

But after our 20 week scan, I started thinking about it a little differently.  I have no expectations for an ideal birth this time around.  But as a friend said to me last night at dinner, there's no reason to think that I automatically won't have the birth that I want.  So, in an ideal situation, I would absolutely want to have a med-free birth with a happy ending.  I would love to have another experience of labor and delivery that ends happily.  I would love to prove to myself that I can do this again, that I can trust my body and myself to have a healthy baby.  I would love to get a chance to share that experience with David.  And I know from all the research I did last time that a doula can help make that process easier for us.

I also know how scared I am.  I know that if someone in a white coat with a stethoscope tells us to do something, I would do it without question, even if it was for that doctor's convenience rather than the health of my baby.  I'm more than willing to have a c-section if that's the best choice for the Deuce, but I don't want to make that choice out of fear without understanding why it needs to happen.  I don't imagine that I will be in much of a position to make rational and informed decisions once I'm in labor with the Deuce.  And I don't want to put David in a position where he doesn't know what to do and is scared for me and scared for the Deuce.

After talking it through, it just seemed to make sense for us to have someone else there, someone who would support us no matter what decisions we make (last time I swore I would avoid induction if at all possible--this time I would really prefer not to go past forty weeks...), and someone who would advocate for us, ask questions and get clarifications.  I also would like to have someone there whose perspective of birth is happier.  Someone who can remind us both that the vast majority of babies are born healthy.

I should add that I absolutely adore my OB.  He is not only kind and compassionate, but extremely smart.  He is soft spoken and has a calm and soothing demeanor.  He also has a sense of humor.  And, most remarkably (this is based on what his patients and colleagues say about him), he's one of those doctors who can perform a flawless c-section under pressure, but who can also sit back and respect a mother's wishes to have a natural, med-free delivery.  I know he will be fantastic, but I also know that he won't be there to hold my hand throughout my entire labor and delivery.  I also know there's no guarantee I'll get the amazing nurse I had when I delivered Eliza (bless her freaking heart).  If the Deuce arrives before 37 weeks, I'll choose to deliver at a different hospital, the one with a bigger, better NICU, which is also just a bigger hospital (they call it the Baby Factory) and less natural-birth friendly.  It's true that having a med-free birth is no longer the priority it once was, I don't want to lose that opportunity for no reason but my own fear.

So we got in touch with a doula--one whose card I'd picked up when I was pregnant with Eliza but who was more expensive than the doula we'd chosen before.  I knew that she was well known in the local area, offers lots of classes, is very experienced, is also a certified lactation consultant, and a real-life friend of mine had used her and liked her very much.  She called me back right away and was very kind and sympathetic about Eliza.  Most importantly, she assured me that while she absolutely supports and helps with strategies for a med-free birth, she will support us in whatever decisions we make (after all, that's what we're paying her for). She has attended over 650 births and has worked with a couple of other people who've had babies after a loss.  Her doula services include two home visits before the birth, unlimited e-mail and phone consultations, staying with us for the duration of labor (I don't plan to do much laboring at home, so she'll probably meet us at the hospital), sticking around for a couple of hours after the baby is born, assisting with breastfeeding, and visiting us at home within a week to talk through things.

We met with her back in February for an interview, and I know you're supposed to interview a few doulas and see who seems like the bet fit, but that idea was too daunting.  She was it.  There was no way I was meeting with other people and going through our story and explaining why I wanted to hire a doula but not really talk in detail about actually giving birth...  ugh.  One interview was hard enough.  So we signed a contract and sent in our deposit.

She came over to our house earlier in the week for one of our visits, and I was relieved to discover that I still liked her.  In fact, I liked her more than I did the first time (maybe because I wasn't quite as freaked out about the whole "jinxing" thing).  David asked her a lot questions that I didn't even realize he had, and I saw how anxious he was about being able to support me and advocate for the baby and make the right choices.  I know it will help us both to have someone else there who understands (as much as she can) what we've been through and where we're coming from, but who is also more objective than either of us could possibly be.

To be honest, I was surprised that this felt like something we wanted to do.  But after our meeting, I felt positive about how things might go down.  It really felt like a move in the right direction, an acknowledgement that good things are possible.  We are all too aware that we can't predict the future, but I'm also trying to remember that we don't have to live in constant dread of the worst case scenario.  Sometimes the right thing to do is to actively assume that the ideal IS possible, and to do what we can to make that happen.  We certainly can't control much, but  I can control this decision.  I know it's not the right choice for everyone, but I'm glad to say that I feel good about it.