It was obvious that Winnie's labor was going to be long, even though this was her second pregnancy. I remained at her home all day, making sure she took it easy, rested, ate, drank plentifully to stay well hydrated and avoid an IV once she was in the hospital. I massaged her feet and back with lavender oil, reminded her what her body was doing, encouraged her to stay relaxed and loose, and asked her to rest. By evening we took a walk to stimulate labor, which only worked for awhile. Later she took a bath, got some sleep and I went home to get some rest too.
The next day, after she had been in active labor for awhile, we went to the hospital labor and delivery area. Winnie's contractions were 3-5 minutes apart, she was dilated to 5 cm, 90 percent effaced and baby at zero station. As her doula, I was so proud of her progress, and she was amazed. She was still considering an epidural, but her doctor said she was so far dilated that she might just get this labor over with quickly. I encouraged her to wait, reminding her of her wish to labor naturally, and she began to think she could really do it.
Within the next hour Winnie was at 7 cm and her doctor told her it was decision time: she could get the epidural, but it wasn't recommended (great doc!). Winnie decided she didn't want to give up her freedom of movement, so she opted against it. At this moment I knew she was going to get the best birthing experience she wanted.
Winnie chose to stay out of bed. She mostly stood by the side of the bed, and during each contraction she squatted, got on all fours, or leaned over a birth ball. The nurses and doctors stood around watching while I rubbed her back, did counter-pressure, talked soothingly and was one hundred percent there for her. The hospital got a good look at a normal labor!
At 9 cm Winnie had wonderful urges to push. I suggested she go with them but not hold her breath and push on top of them. What amazed me was how she was still standing, even though she was in transition! When she reached 10 cm it took only two pushes to get her daughter into the world.
Because there had been no interventions other than fetal monitoring, Winnie was up within the hour and moved to postpartum right away. She was up and about later that day, thrilled with her birth experience. She was grateful for my support in staying with her throughout the long labor, and was convinced if she had been alone she would have been tempted to go to the hospital early.
I'm certain that the best a doula can offer is her trust in the labor process and her unwavering support. This calms the mom and other family members. I now truly believe most of labor should happen at home where mom is comfortable with her own pace and where Mother Nature can do her best work.
Sue Coffman is a certified doula who lives in Orange, California.
Reprinted from Midwifery Today E-News (Issue 1:22, May 28, 1999)
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