The Intimacy of Birth – Different Roles

I was reflecting this week on the different roles I have when attending births - doula, photographer, or midwife assistant. Each role is unique, but there's a level of intimacy with all of them.

As a birth photographer I generally meet with the couple before the birth, then we stay in touch as they get closer to term. I join them once active labor is established and remain a couple hours postpartum. Depending on circumstances and location I may see them once again to deliver their CD (though now I give them a flash drive!) For clients further away I may mail it to them or deliver files by Dropbox, so after their birth we may not see each other again. (A perk of working mostly in my own town, I do get to see clients and their sweet babies around town! I also invite them to attend my baby park dates.)

While photography a birth I am a quiet observer, I'm not providing any verbal or hands on care and I know only limited details about the clients - what they are hoping to have photographed or not included, who will be attending the birth, any special concerns or things they want me to be aware of. They are entrusting me with capturing their birth, however - and then keeping those images private as I edit and prepare them for their gallery. It is a significant level of trust to invite someone with a camera into your birth! Because I then spend hours editing those images it also feels like a special level of intimacy for me, as I get to essentially witness the entire birth again through those photos.

As a doula I am meeting with the couple ideally a couple times before the birth, between our consultations and two prenatal visits. They fill out paperwork for me with all sorts of details - special concerns, their birth history, health issues, family relations, their care team, emotional and physical worries. We then talk at length about these things, and so much more! Then we stay in touch and talk once they hit term, talking during early labor and then I join them in active labor. I'm providing verbal and physical support through touch, massage, words of affirmation ideas for their partner to support them, and reminding them of their concerns and birth hopes. We're holding cold wash cloths to foreheads and rice packs to their lower back, rubbing feet, doing hip squeezes, holding legs while pushing! It's a huge statement of their trust in me that I'm being invited to be part of their care team. After the birth we meet again to discuss how things went and I share their printed birth timeline, something I've written off of notes I take during their labor. As I write that I'm reliving their birth, thinking of special moments I witnessed and funny things I heard! Because I include photography as part of my doula package I have also spent time editing those images and creating their online gallery. When we have that final meeting I feel like we've become friends, and I love to hear updates from these families and see their babies at the reunions I plan.

Being a doula is physically and emotionally intimate, and something that does create a bond between clients and doulas. It's a special relationship! Sometimes families share information with their doula they may not have disclosed to their care provider because they think it's not relevant. (If it is relevant I always ask them to PLEASE share it!) But because of our special role parents may be comfortable confiding in us in a way they may not with other members of their care team.

As a birth assistant I don't meet the couple until at their birth! Though many have attended the childbirth class I help teach, which is always a fun surprise. But until I get the call or walk into the birth room I don't know the mom's name, and it's only then that I can review her chart and learn a bit about her. Depending on how early I am joining them in labor I may spend several hours with a mom, monitoring her and baby and offering some support - or I may arrive and mom's already deep into transition and doesn't notice me sneaking in and then a baby arrives soon after! While I may be offering some suggestions for comfort techniques and some hands on care or verbal support, most of the time I'm quietly observing and seeing what I can do to help out. My primary role, however, is to be a second set of hands for the midwife and to focus on the medical well being of mom & baby. I stay at the birth center until the family has driven away, and then stay after to finish up my duties. Depending on where the family lives I may get to run into them again, or we may not ever see each other again as some families live so far away. While I never forget any of the births I attend, my role in their birth experience is relatively brief and they probably don't remember me. 🙂

But this last month I attended several births and part of what struck me was the physical intimacy of being a midwife assistant (and even more so for the midwife, of course!) We are listening for heart tones on their belly, palpating to determine where that little one is snuggled in... we're taking blood pressure and their pulse and other vitals. During the actual birth we're up close and personal, helping hold legs and cleaning mom up after. We're providing ice packs and supporting mom as she walks to the restroom, then helping wipe down those shaking legs. We massage their fundus (top of their belly) and check their bleeding, we help them pull up their Depends and get dressed. Moms are always so sweet and grateful, and sometimes embarrassed. I know how humbled I felt needing to be walked to the bathroom after giving birth! But it's also such a neat experience, to be allowed to be involved that up close with someone who has just birthed. I never cease to be amazed by their strength and their joy, their exhaustion and their smiles of relief and happiness. I'm also in awe of their trust in me, their comfort in having me there to serve them in such an intimate capacity.

So it's three very different ways I get to serve at births - but I love them all!

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