The room is dark and quiet. Martin is sat on the birth ball. Sara is in the pool on her knees. She is leaning on the edge of the pool nearest Martin, her head resting sideways on a towel. Martin holds her in his arms, wrapping her around her shoulders, kissing her head, whispering the occasional encouragement, or something. I cannot hear.
He has not moved from her side for the last four hours. His focus is totally on her. When the music ends Martin calmly reaches one arm up for the phone and restarts it, his eyes hardly leaving Sara. The midwives are stood at the opposite side of the pool, grinning. I am their doula. I sit in the corner, nearby; if they need me they need only turn their head towards me.
Martin is Sara’s rock. Through the waves of labour she clings to him. Earlier she was standing arms around his neck, rocking, as if slow dancing. Then in the bathroom with
her on all fours, just the two of them. And now in the pool; they carry on the dance of labour. His presence protects her, strengthens her, enables her to let go into herself. Quiet and strong. He is just there. That is what she needs him to be.
Many men worry about what their role is in labour. Everything is focused on what the woman does and the well-being of the baby. I have heard men say that they don’t want to get under the feet of the midwife, or in the way of the doctor. Even famous obstetrician Michel Odent has gone on record saying that dads should stay out of the labour room; that their presence interferes with labour; that the birth hormones flow best if the woman is undisturbed, with just the quiet support of a trusted midwife or doula.
I see a different picture. I see men and women entwined. As they made the baby together, so too, they work together to bring the baby into the world. The dance of labour is also the waltz of hormones and the tango of life. Indeed, the saying goes that orgasm and birth are but one event, separated by time. Oxytocin, the accelerator of labour, is the love hormone. Released in sex and in labour, it flows when we feel secure, safe, unobserved, and loved. No one can give that to the woman more than her partner. Not me, not the midwife. It is her partner who knows what to do to make her go weak at the knees; or to show devotion in a kiss to the forehead. Doulas bear witness to the power of that kiss, or loving
word, to swell a contraction. Internationally renowned midwife Ina May Gaskin recommends a good snog in labour! Which is why I often leave couples for a while and sit in the other room, or the corridor.
Endorphins are the clutch, and the crutch; nature’s morphine, it helps the woman cope, which means labour can go up a gear; and so more oxytocin is released making the contractions longer, stronger and closer together; and then more endorphins, spiralling up to the crescendo at birth causing mum and baby to fall in love at first sight. Cuddles, touch, laughter trigger the endorphin rush. Cuddles, touch, laughter, soften and open the woman’s body to let go and roll with the waves, riding the power that comes from within her.
Adrenaline is the break on birth. The evolutionary safety switch to ensure we survive danger. In labour danger presents in non-animal forms. It is the ticking clock or the whispering midwives, or the smell of the hospital pillow or a throw away word, triggering deep biological responses, that though we rationalise away, still cause the switch to fight or flight.
No one knows better than her partner how to spot the signs of her adrenaline release: the slight change in her face, the nuance of her stance, that speaks of worry, or stress. No one but he knows how to speak to her fear and put it away, to ‘keep the fear tigers at bay’, as one man I worked with understood it.
I can help. Women find the presence of another woman reassuring, especially one who has given birth and witnessed others. I can tell her she’s doing well, that everything is unfolding as it should, or that it is good to have the expertise of others to call on, if the buzzer is pressed. Men often agree to a doula because they see the comfort it gives to their beloved. I can give her my love and my touch. But I am not her home. I am not her sanctuary. I am not the other half of her soul.
But what if the fear tigers are his? If the sounds and smells are triggering his limbic system? What if he feels out of his depth, at risk of being swept away, in a world of language and procedures that he is only half aware of. At work instead of antenatal appointments or NHS antenatal classes; struggling to stay awake at evening ones, men are largely excluded from antenatal care. And though it has improved, it is often as if the world has forgotten that it is his baby too. He is also making a transition to fatherhood.
Mark Harris, midwife and author of ‘Men, Love and Birth’, talks about the role of the man’s hormones. Men cope with stress by releasing testosterone. Testosterone inhibits the release of oxytocin. The immediate
instinct is to fix it, to make it better, but thinks he lacks the tools of the experts, so he steps aside to let the professionals to their thing. All he can do is be there, not realising that is exactly what she needs; not just to feel better, but for the birth to go well, for the baby to be well. Just like her, he has the tools, the power, inside him all the time.
And so I am a doula for dads, as well as for mums. I am there to reassure him, to build on his talents, to give him ‘permission’ to do what his instincts are telling him when he wants to hold her, to tell her how wonderful she is. I can show uncertain hands where to massage and how hard. I can fetch him drinks and food; to care for him so he is free to focus on her. I see so much love in the eyes of men as they watch, in awe, as their partner rides the waves that bring their baby into his arms. I can also give him a break if he needs to take a breath of air, or go to the loo. For long births we tag team sleep breaks. I can sit with him as he waits in scrubs to go into theatre. I can stay with his partner when he goes to visit their baby in special care.
Don’t just take it from me, though. Here are Martin’s own words: “At first I was sceptical about having a Doula. I didn’t know what she’d do, I didn’t think it would be worth the money and I was worried I would be pushed out of the birth experience. In reality I found it very reassuring to meet with someone who has attended many births especially as we had a home birth after c-section which is unusual. During the birth Catherine reassured us that everything was going as it should which was great and something that had been totally lacking from our previous experience. I didn’t feel pushed out at all. She sorted out the pool so I could focus on helping Sara and having Catherine with us actually made it easier for me to relax and focus on Sara and the birth without worrying. The whole experience this time was so much better than our first birth and having a doula was a large part of that.”
Back to the birth pool. Sara is holding back. She rises up instead of bearing down. She is repeating the word ‘no’. Martin reassures, but his face shows concern. I quietly remind her this is where she wants to be, at home, in the pool, with Martin by her. I don’t know if she hears me, or if she hears her inner self, but something changes. ‘Yes’, Sara whispers,
‘Yes’. Suddenly, the baby is here. A healing birth for Sara – and for Martin. I back away. This is family time.
For a while I was a temporary member of their close family, a trusted friend. It is a tremendous honour and privilege to serve families in such a way at such a time. I leave them, I hope, happy and strong together, ready to face the challenges of parenthood. And the baby? They named her Catherine.