Caring Deeply Within A Densensitized System
Hi friends,
I appreciate you taking the time to read and ponder alongside me. This blog, which you may recognize if you’re subscribed to my newsletters, is geared towards doulas and birth workers, but I hope can be helpful for anyone who has given birth, is planning on giving birth, or knows someone giving birth. 😉
My mind never ceases to be blown after every birth, and even after 7 years I learn something new every single time. This mind-blowing comes in many different forms. Sometimes I am elated, sometimes overwhelmed, sometimes heartbroken, and often very very tired. Each birth is incredibly different, and there are many factors at play. During a recent birth, I was reminded about how big of an impact the staff, the day, and the flow of the hospital can make on someone's experience. This impact can often be amazing, and other times reminds me of how broken the healthcare system is.
I also want to start off by saying that I witness beautiful, easeful, and empowered births at the hopsital frequently.- I am so thrilled when I hear of and see people walking away from their birth feeling uplifted, respected, and excited! It often happens! Yet, there's also the other side of the coin- and that's what I'm going to be sharing about here.
Giving birth is one of the most vulnerable experiences of someone's life. Part of why I only attend 2-3 births a month is so that I never ever want to become desensitized or laissez faire to the complexity and importance of birth! When giving birth, you are cracking open to welcome your new baby into the world, and in this cracking open, a profound vulnerability comes forth.
The set and setting are essential to a positive experience. Who is there matters. Your environment matters. Feeling safe is key.
When I show up to a birth, I hope with all my heart that I’m not the only one there who reveres birth as the life changing experience that it is. Oftentimes, I am delighted by the synergy that is created by the whole team. When your doula, nurse, and doctor or midwife are working together and collaborating, it creates a magical bubble unlike any other. It feels incredible to be a part of something where everyone respects each other's role, sees each other as human with valuable skills, and are coming together for a common purpose: to prioritize a positive experience and support the family in ushering this new soul here. It’s a beautiful thing! But sadly, this dynamic is not always the case.
As your doula, I try my best facilitate this environment of care and respect. I want to leave a positive and lasting impression on the hospital staff and create a culture of collaboration. Yet, again and again, I am humbled and deeply disappointed by the ways in which so many people working in the birth field are desensitized to the power and importance of giving birth.
And unfortunately, it’s not even their fault. I know that they came into this work with good intentions, with a heart full of so much to give, and with experiences and amazing skills of their own that they are bringing to the table. The healthcare system, especially for profit hospitals, do not support those working within it, and the issues that I’m seeing are not a fast fix- they are born from a system that is built off inequality, hierarchy, and efficiency. Doulas are in direct opposition to the broken system, trying our hardest to bring care into a healthcare system that was designed without it.
I’m not sharing any of this to scare folks out of birthing at the hospital or to instill negative or fearful ideals about hospital births on to doulas. Truly- that’s the opposite of my intention! I want to talk about this so that we can all prepare, practice our advocacy skills, educate ourselves, and be the best we can be in any situation. I understand that for most of our clients a hospital birth may be the only option and feels like the safest choice. I totally get it! I’m sharing this to illuminate the reality, because by illuminating it you can prepare for it. By illuminating it, we can continue working to change it- as so many doulas, policy makers, and BIPOC mothers and birth workers have been working on for decades as birth outcomes clearly show the injustices ingrained into the system.
It has had me thinking, how do I continue to support folks within a broken system? How do I have the biggest impact possible, while only supporting 2-3 families out of hundreds giving birth at the hospital every month in our community?
I don’t have a solid answer, but I have a few ideas. I wanted to get more creative than “hire a doula!” or “take our childbirth education class!” because I know that if you’re reading this, you already know that! Here are some ideas for doulas on how to improve people's experiences when they’re giving birth at the hospital:
Don't sugarcoat birth. There’s far more power and productivity in having upfront, honest, conversations about the many paths that could unfold at the hospital. Until I see a clear change, I will be even more honest about the possible bumpy paths so that folks can make a plan to maintain their feelings of safety, comfort, and care if things don’t feel great at any point.
De-center yourself. You can not assume how your client is perceiving or feeling about a situation or interaction. Navigate this through asking questions.There is so much power in a witness. Best case scenario, there are beautiful conversations that come out of prioritizing clear and direct communication. If at any point my client doesn’t feel supported by anyone, they can request a new person.
Mentor and educate other doulas. If there are more doulas with more confidence and more people talking about the work we do- my deep hope is that more people will hire doulas! Only 6% of people giving birth hire doulas, which is NOT enough and makes sense why many people in the healthcare system don’t know how to collaborate with us. If more people are showing up in the hospital as compassionate, caring, present, support people- the quicker the system will shift in tangible ways.
Have conversations with people working within the hospital system that have big hearts and good intentions. These people are truly our allies as doulas! We have to connect with the doctors, nurses, and staff who are working from the inside out. These are the folks who are not desensitized and really want things to change. By connecting with them and sharing our experiences as doulas, we create a culture of communication and ideally encourage simple changes within the system that improve everyone's experience.
Where to go from here? Keep talking, keep learning, keep teaching.
Pregnant folks, if you’re giving birth at the hospital soon, please do not be afraid. That is not my intention. I simply hope this inspires you to assemble the best team possible, and know that you are the boss of your birth. Practice speaking up throughout your pregnancy and voicing your needs, so that if anything comes up during birth that doesn’t feel right to you, speaking up comes with ease.
And despite how it may seem, these challenges are exactly why I feel so at home supporting families in the hospital. I feel extremely skilled at navigating these dynamics and having though conversations in a thoughtful way. I understand why many doulas move away from attending hospital births, but it’s where I feel like my skillset shines and I have the greatest impact.
With warmth and care,
Evan