It’s been almost two years since I have attended births regularly as a doula. I wish I could have continued supporting women during my nursing/midwifery studies, rubbing their backs, wiping their brows, holding them through transition, and watching in amazement as they pushed their babies into the world, but life as a student has not left me with the kind of time necessary to provide full-scope doula support. Not that I haven’t been immersed in birth in many other ways. I spent 170 hours on a labor and delivery floor as part of my nursing training, and now that I am one-semester deep into my midwifery studies, I am preparing to dive deeply back into the world of supporting birthing women, this time with hands outstretched, ready to catch (or to help women catch their own) babies.
I am often asked why I decided to become a midwife, and while it would take pages enough to fill a book to fully answer that question (the reasons are many–and they are ever-evolving), my life as a doula provided the final push I needed to take the plunge and pursue this path. I loved connecting with women, hearing their stories, their dreams, their deep desires for their families for their babies, for themselves. I loved their determination and confidence in their bodies and in their babies. I loved being a sounding board where hopes and fears and doubts could be expressed openly without judgement. I loved watching her step into the fullness of her power and ask, with clarity, for exactly what she needed. I loved watching partners and family members supporting her choices, holding her (physically and emotionally), loving her, and experiencing first hand, the magic that is birth. I loved the moment when she realized that this power rushing through her body was hers–her power, her body, her baby. I loved so many things about bearing witness to this intimate moment where life transitions from one medium to the next.
But there exists a hidden darkness in my decision to become a midwife. As a doula, I went with women no matter where or with whom they chose to birth. I was there to support them emotionally, physically and to provide education where I could, but I had no control over the hospital protocols or the behavior of their health care providers. As a new doula, I naively believed that if I did my job correctly, I could shield them from some of the less savory aspects of the modern paradigm of birth. I was wrong. Just plain wrong. For every beautiful, calm, empowered birth I witnessed, I also witnessed arrogant displays of power, manipulation, control, and heinous demonstrations of physical and emotional abuse, played out upon the bodies and psyches of women. It is hard to describe in words what it feels like to be a bystander during subtle (and not-so-subtle) expressions of abuse. At one birth, a mama I was supporting, was relaxing in bed, fully-dilated, waiting for a strong urge to push. The room was calm and dark with the thick, still air that permeates at 2am. The labor had been long, and this moment of rest was much-needed after hours of hard work and pain that this mama pushed through. She was breathing deeply, her husband and I taking turns talking through visualizations of opening buds and calming waters. In a moment that felt like the uncontrollable wave of a tsunami, the nurse, a large, gruff woman who, for the duration of our time in the hospital, refused to acknowledge my presence (even when I asked questions), came into the room, and without asking, pushed my clients legs apart, drove her fingers into her vagina, and instructed her to start pushing. My client yelped in pain, a look of panic and confusion on her face, while her husband and I implored the nurse to stop. I remember the feeling of being invisible, of opening my mouth to speak and feeling my words disappear into thin air, unacknowledged, as if they’d never been spoken. The nurse wouldn’t even glance in my direction as she kept up her assault. It was as if time was standing still. I felt utterly and completely powerless to stop this aggression. Shortly after came the doctor, who took over in instructing her to push. The physician was un-phased, unmoved by the site of my client writhing in bed, close to tears as the nurse lorded her physical power over her. From there, my memory goes fuzzy. When did the assault stop and effort of pushing the baby out begin? Why was it necessary to force this moment rather than allowing it to unfold from within my client’s body? How is it that any human being could witness this display and see it as normal? There are many questions I could pose, but the question that lingers for me is why couldn’t I stop this from happening. I felt tremendous guilt for lacking the power and force to be able to stop what I had seen. I wanted desperately to erase this experience from all memory. Weeks later, this mama shared that she felt like she was being raped during her birth.
Let that sit with you…raped. during. birth.
There are too many women walking away from their birth experiences feeling that their bodily integrity has been compromised. What is going on with birth that this kind of behavior is ever acceptable? I have stories upon stories that rival this one. While some center around more subtle abuses of power–like coercing women in to making specific health care choices by suggesting that their babies will die otherwise or questioning their statements of pain (one mother I worked with yelled while pushing her baby out, “it feels like my insides are coming out (which it does!),” to which her physician responded, “no it doesn’t! stop being ridiculous!”) –each story is representative of a larger problem–that there is a struggle for control going on, and the battleground is rooted firmly on the back (or in the womb, as it were) of the mother.
Had I only been privy to the beauty and bliss that empowered birth can offer, I may not have felt so compelled to become a midwife. The deep satisfaction I felt working as a doula was unparalleled by other joys I felt in my life. But the dark moments, the sickening feelings of being a powerless witness, were too much for me to bear. My choice to become a midwife has been largely driven by deep belief that all women deserve to be treated with respect during their births, that mothers, whose bodies are the alpha and omega of the birth experience, are the only ones who have the right to absolute power. Of course women invite others to share in the experience–sisters, mothers, aunts, doulas to share birthing wisdom; midwives, nurses, doctors to impart knowledge and expertise from the body of evidence that exists and to hold a safe space for the birthing woman to do her work; family members and friends to support her, rejoice with her, to love her. Of course women are concerned with the their safety and the safety of their babies. In no way should promoting safety lead to the conclusion that pregnant women need to hand over complete control of their bodies to an individual or an institution. And in no way does aggression or force or coercion or physically controlling women make birth safer. When the mother’s physical, emotional, psychological and spiritual integrity is honored, preserved and respected, the highest safety prevails.
The irony of my journey towards becoming a midwife is that parts of my journey have taken me squarely into the belly of the beast, and I have found myself dancing with the devil, so to speak. Sometimes we have to confront that which we oppose so we can work to transmute it. I could have chosen a different path to become a midwife, forgoing training as a nurse, and focusing solely on out-of-hospital birth. In fact, I have deep respect for those who have chosen such a path, and some days, I feel crazy for having chosen differently. But when I was called to midwifery, I knew this would be my way. I felt wholeheartedly that women choosing to give birth in hospitals deserve practitioners who believe in them, who believe in birth, and who are fully committed to bucking the system, and ushering in a new paradigm of birth. There is a much larger conversation to be had about how our current system has unfolded and what can be done (not only by midwives and doctors, but also by women, and by the larger systems that drive the current paradigm), but that discussion is for another day.
For now, I try to relish the vast beauty of birth and let my darker memories continue to fuel the fire of my motivation. Doulas are, in many ways, the eyes and ears of modern birth. The pain and abuse they witness are often left unspoken, not only to protect the integrity of their clients, but also to shield themselves from having to re-live the guilt, sorrow and powerlessness they often feel. We need their eyes, their ears, their perspective. We need doulas to bear witness and to speak of what they have seen. We need their stories so we can begin to wake up to a new reality of birth.