Back to August 2007
Feature Story – August 2007
What it Means to be a Doula A Conversation with
Three Women
by Nicole Pugh
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The word “doula” originates from the Greek and means “servant to mother.” Nowadays, the term is used to describe a woman who provides non-medical emotional and informational support to other women prenataly, during the birthing process and during the postpartum stage. In California alone, there are dozens of family centers and community health organizations that provide doula services to their communities. One such organization is Ama Mama Holistic Healthcare for Bodacious Living in Encinitas, California. Vision Magazine had a chance to speak with some of the dedicated women who work with Ama Mama about their experiences and thoughts on childbirth. Konuwena Perryman (KP) has been a doula for the last seven years. She is a childbirth class leader and has been trained in both hypnotherapy and hypnobirthing. She has two daughters, both born at home. Donna Hooyen (DH) has been a doula for two years and is an apprentice midwife under the mentorship of Ama Mama co-founder Barbara Herrera, LM, CPM (see accompanying article). Donna has nine children, the last six of which have been born at home. Finally, Kim Schuster (KS) is a Certified Colonic Hydrotherapist and serves a vital role as office manager at Ama Mama. She has one daughter.
Speaking with these three women in Ama Mama's cozy inner office was a real treat. Their calm insights helped to shed light on one of the most miraculous of human phenomenon—that of giving birth.
Vision Magazine: Do you have to be a parent to be a doula?
Donna Hooyen: There are many doulas that have never had children. In recent years, there have been organizations that have supporting doulas, training them and helping to set up guidelines as far as scope of practice and things like that. There are doula trainings throughout the country.
VM: Do you find that most of your doula clients have traditional births or do they birth at home?
Konuwena Perryman: The majority of my clients birth in the hospital. It is important for me to get to know the couple prenatally and to go over what is important to them. I can't make decisions. I don't really even talk to the doctors. But I can let the couple know that they can ask questions. By them asking questions and getting answers from the medical people, they can make their decisions based on that information and what they want.
DH: There is a definite difference between being a doula at the hospital and at home. At the hospital, like Konuwena says, there is a lot more reminding and helping them understand what is going on and what is being said. At home, it is much more about giving the physical support and encouragement for the whole family. It is more about being that physical emotional presence. The doulas also work very well with midwives at home.
VM: So midwives and doulas work together at the time of birth?
DH: Absolutely. [Although] I would say that most home births I have seen don't have doulas. This is usually because [these skills are] something that a midwife brings with her as well.
KP: Also, people at home have a lot more opportunities to have the support of the partner…In the hospital, often a doula can cocoon the couple together whereas at home you don't have that same need.
DH: At home, the cocoon is the house. And everybody in the house is there supporting the mom. They are not doing things to her, but with her. At home, the midwife's attention is on that couple. There is nobody else. There is not another person in the next room giving birth.
KP: In the hospital, there is probably somebody who wants that bed. So breaking the bag of water to speed up the labor may be more convenient to the hospital than it is to that particular couple.
KS: A lot of it boils down to educating and informing, letting folks know what their choices are. What the doulas and the midwives do is create a great balance to meet the needs, to answer questions and concerns and to help guide and direct them to make the best choice for what they [think they are] comfortable with.
KP: I never say negative things about the hospital. I just let them know what to expect when they are there. A lot of peoples' ideas about birth are misconceptions that we learn through movies, media and fear. People tell you all the time, 'Birth is scary. It hurts. It is painful. It is like suffering.' So when people start learning the truth about what happens in their body and the wonderment of connecting with their baby, they realize that it is not something that is happening to them. It is something that they are doing. It is their body. When they start to get into that space, they feel excited and honored about it. Then the way they perceive the labor shifts. When people can participate in their birth, they don't suffer through it. It is work but it is valuable work.
KS: It is about honoring what they want and helping to support them, encouraging them and making the best experience possible out of whatever they choose— birth center, hospital or home.
VM: Konuwena and Donna, do either of you have an experience or situation that stands out in your mind as one of the highlights of your career as a doula?
KP: Sometimes when I am in birth, it feels like all the laws of life are being lived in that one moment. I was recently at a home birth with a mom whose husband was in Iraq. I was her primary support person. It was very emotional for me being in her home. Her husband was calling on the phone. Usually my emotions are pretty stable but I got pretty choked up while he was on the phone, just knowing what he was experiencing and how he was so far away from them. I felt very honored to be there with her through the experience.
And it was interesting for me as well because she ended up having to transport from home to the hospital because of the position of the baby. We all transported together. The midwife came and her mom was there. It was just wonderful to see the energy, the love, the power and the purpose of the birth. None of that shifted, even though we needed to get in cars and drive to another place and have other people come in to it. There was really a sense of gratitude for the experience.
DH: There are attempts to guide things in the way that people want them to go but ultimately there is no controlling a birth. The baby and the mom's body are working together. A lot of who I see are first-time moms. Seeing them after the birth, they have this look of amazement on their face that says, 'I actually did it. I actually have this person who came into the world and I brought them out here.' One of the births I was at was a vaginal birth after a cesarean. The mom pretty much had been told that she couldn't do it by her previous doctor. The mom very late in her term switched to a home birth. I was not attending the birth in any official capacity. I was just there. I try not to let out too much and to give the family their emotions, but I could not stop crying at that birth because it meant so much to her. She had had so many doubts about herself as a woman. When someone tells a woman, 'you can't have a baby' because of whatever reason, it is a blow. For a lot of women, their status and their self-esteem is connected to their fertility and to their ability to bear and take care of their children. So for her to do it after hearing that she couldn't, she felt really empowered and capable. It was a really big change in her.
VM: So women can go through this experience and grow from it in many ways.
KP: No matter what the experience, there is meaning and there is growth. What takes away the meaning for moms is when they feel that they aren't heard and that they aren't honored, when they don't know if (what happened) was necessary or if it was something that was convenience for someone else. For the mom whose husband was in Iraq, we transported her to the hospital and were grateful for the help. They can have the information and feel that sense of participation and growth from the experience.
KS: I think participation is a big part of it. It is about being a part of that decision making process and understanding why is it necessary. It is really about what is appropriate for the woman and the child in that moment in time.
BARBARA HERRERA, LM, CPM-
OVER 800 BIRTHS AND COUNTING
Barbara Herrera, LM, CPM is a Licensed Midwife, Certified Professional Midwife, Certified Childbirth Educator, Certified Doula, photographer and writer. She is also co-founder, along with her partner Sarah M. Hubbard, of Ama Mama Holistic Healthcare for Bodacious Living. Ama Mama's services include chiropractic, reiki, acupuncture, colonic hydrotherapy, birthing services and more. She has attended over 800 births in hospitals, birth centers, and homes since 1982.
VM: What led you to work with moms and families as a Certified Childbirth Educator, Certified Doula, and Licensed Midwife?
BH: I began being asked to attend births with friends back in 1983. After [repeated requests], I thought I should start studying. It wasn't until after my second child was born at home that I was transformed into a natural birth fanatic. While I absolutely understand and believe there is a need for Western medicine in childbirth, its indiscriminate use is disgusting; judicious use would serve women and their babies so much better. I began as a childbirth educator first, then as a doula and finally as a midwife—believing women know exactly what to do to birth their children with a minimum of intervention, either physically or spiritually.
VM: What have you found to be the biggest fear or misconception for moms and families going through the pregnancy and birth process?
BH: That women can't do it without drugs! When I first started, an epidural wasn't even an option for women, so women birthed just fine without it. When I was assisting migrant women on Medi-Cal in 1990, an epidural wasn't an option for them unless they paid cash for it, so they didn't get one; those women birthed their babies perfectly fine, too. Women who don't have an epidural option don't ask for one nor need one…Labor hurts infinitely more in the bed than when "dancing" around the room. The mother and baby are meant to move together in labor—she to open her hips –the baby to rotate to a great position. In bed, neither can do their dance.
VM: What is the most important thing that a women or couple need to know or do as they prepare to give birth?
BH: That the woman's body doesn't live in the 21st century. Our bodies know nothing of clocks, calendars, doctors' schedules or something called "Braxton-Hicks contractions." Trying to shove a Spirit into a box causes nothing but anxiety. I encourage women to pretend they live in a jungle and quit thinking so much. Just be in their pregnancies... stay in the moment, yet busy enough that you don't focus on every single twinge that happens in your body. Unsure if it is something serious? Ask your care provider.
For more information about Ama Mama Healthcare for Bodacious Living or to contact Barbara Herrera, LM, CPM, visit www.AmaMama.us or call 760/944-3987.