Happy New Year 2020! It is time to bring yet another Christmas season to a close and look forward to the coming year. It’s time to breathe some life into my blog. To start, I’d like to share a particular realization I had about a year ago. Perhaps my traditional thoughts may challenge your own.
In December 2018 I watched a media presentation of the nativity story. The birth of Jesus is not an unfamiliar story to me, as it probably isn’t to you. I’ve heard it and celebrated it every year of my life. But last December, that dramatic presentation caught my attention in a whole new way. It specifically made me think about that birth from a cultural and historical perspective, as well as from the perspective of a doula. Whoa! Lights went on!
Mary birthed alone. Mary birthed ALONE! (This was my Aha moment.) That was not the cultural norm! Now, I’m not discounting Joseph’s role in this story, but culturally his presence at the birth was definitely NOT the norm. Men were simply not a part of the birthing process then. (Have you ever read The Red Tent? It’s a great read and very culturally relevant to the nativity story.) Labouring women were surrounded by other women. Yes, plural. One would have been the identified midwife, possibly with an assistant (doula?), and historically, it may well have included her mother, a sister (or two) and even friends. I like to refer to them as the sisterhood. The women would have come together to mentally, emotionally, and physically support Mary, to help her pass the time of especially the early labour.
Mary had…Joseph. Imagine how difficult that must have been for her!
Anthropology shows us repeatedly, that globally, women did not birth alone. It takes only a little research to see consistent representations of birthing women as at least a tri-union of women. There are almost always three figures represented in every birth scene from every ancient culture of the world. Central in each image is the birthing woman. She is looking at or birthing into the awaiting hands of the second woman, the one we describe as the midwife. The third woman is beside or behind supporting the birthing woman. This is the doula. We get the word doula from ancient Greece – “the helper”.
There are still many cultures around the globe today which retain the sisterhood surrounding a birthing woman. However, there has been a significant shift in this practice in especially North America in the last 100 -150 years. Typically, midwives have been replaced by doctors (GPs), if not specialist doctors (OB/Gyns); supporters are much more likely to be husband or partner.
Mary’s birth experience was abnormal for her time; our western culture has turned an abnormal circumstance into the norm. We’ve isolated ourselves. We have become dependent on the medical establishment and caregivers for all of our care and yet whose job is simply to give medical care when needed. And we also can’t forget that with this shift to strict medical focused labour and births, much wisdom has been lost about the physiological birthing process, including breech births, multiples and self-directed pushing. Sadly, most hospital protocol now requires surgery for breech and multiples, and birthing moms rely on the doctor to direct their birth, regardless if they have an epidural and can’t feel the natural surges created by their own body.
Most people will argue the shift to medical focused care is due to medical and technological advances making hospital births safer. Not true. In fact, the three factors that have had the most impact in decreasing infant mortality rates in the last 100 years or so has been better hygiene practices, better nutrition making women healthier overall, and the invention of penicillin for fighting infections. Recent evidence actually shows that home-births are just as safe as hospital births.
Mary was abnormally ill supported because of her specific circumstances. She would have been supported by a local midwife and a “doula” or other experienced female(s) known to her. Here’s another point to consider. The female support were mostly (or all) women who were familiar to the birthing mother.
Comparatively, most births in North America (minus the <10% of women who choose to hire a doula) are supported by medically qualified staff who are typically unknown to the birthing woman, and whose primary role is dictated by hospital protocol. It’s not uncommon for women who work in a hospital setting to choose a different facility to birth so her caregivers (specifically nurses) ARE unknown to her. She may or may not have further support from a partner or female family member, but they often do not present an unbiased, knowledgeable, experienced presence for her. These support people may well have the same mindset that birth is a medical issue to be treated, and the medical team is the priority. Her body is not trusted to do what it has done for thousands of years with little to no intervention. Even though we now have a better understanding of how her amazing body works to birth a baby – thanks to advancements in technology and research – medically, her body and the birth process are not trusted, are too often rushed, and she often feels isolated, unsupported, and unheard.
That typical modern birth experience may be “the norm” but it is pretty biologically and culturally abnormal. What about our mental and emotional care?
Why do we as women do this to ourselves?? Why do we fall into this mental and social trap? Well, that’s what happens in society as institutions become bigger and have more influence. And then even when the individuals within KNOW better, and understand the shortcomings of current protocol, the bottom line is money and efficiency of the institution. Understandable? Yes. Best practice for mom and baby? Not so much.
I may be a traditionalist at heart, but I’m guilty of following the social thinking too. I had three hospital births with no support other than my husband. There are many things I wasn’t aware of or didn’t understand the impact enough to advocate for in my own experiences. In hindsight, I would have “discussed” in much more depth with hubby my desire to have a home birth with our first! Yes, regrets.
I believe there is wisdom from the past we can and should use in modern birth practices. The determination that unbiased, knowledgeable and experienced support, a doula, as a normal part of any and every birth team is a significant shift in modern thinking. And there is a growing movement within and outside the medical community on the value of doula support. Families who choose a doula to be part of their birth team consistently report higher levels of satisfaction of their birth experience than families who do not have a doula.
Doulas are NOT a luxury. The profession is an acknowledgement and acceptance of thousands of years of cultural wisdom. Doulas are the bridge between the medical caregivers and the birthing mother and partner. She is someone you can build a rapport with in the months leading up to the birth. Her job is to support the choices – preferably well informed choices - made by the parents. She is also there to share the wisdom she has learned and believes in.
Do you value the wisdom of the past?
PS. The only reason I didn’t specifically include midwives in this article is because, locally, that option is not yet available to us without a huge commitment to driving. But if you have the opportunity and desire, DO IT! Hire a midwife, AND a doula. That would be capitalizing on some serious wisdom.
Photo Courtesy of Lem and June Collections LEM_2104-copy
