I am often approached by women who feel a pull towards this work.  A common comment in situations like these is:  "But you know so much!  I don't know nearly enough -- how could I do what you do?"

There is a secret.  I learned this though years of personal observation and experience.  I would love to share it with you if you have come here in the hopes of figuring this out for yourself.  Are you ready for it?  Now, pay attention, because if you understand and embrace what I am about to tell you, you may gain a boost of confidence that can buoy you up in times of self-doubt and personal conflict.

Imagine this:  You are shopping in your favorite grocery store.  You notice the refried beans are no longer in their spot on the shelf.  You ask a passing employee for help.  She confirms visually they are missing and says, "Oh.  I don't see them.  I don't know what?  Sorry."  Then she leaves.  How are you feeling?  Frustrated, mad, let-down, unimportant?

Imagine now the same situation.  You see garbanzo, kidney, white, black -- but no refried beans.  Again an employee walks by and you ask about the beans.  She looks, sees their place on the shelf has been taken over by other beans, and turns to you to say, "I don't know, but let me find out for you."  Now how are you feeling?  Cared-for, worth it, appreciated?  That employee took more time to help you, admitted she didn't have the immediate information you needed, and in the end, she helped you solve your problem (the beans had been moved by the tortillas, salsa, and canned peppers!).

Women are coming to us for information, yes, and often they are needing comfort, reassurance, affirmation, compassion, an ear to hear and sometimes a shoulder to cry on.  It is so much more important that we encircle that woman in our attention and our care versus offering her the precise answers to her questions and then sending her on her way.  The surface problem she presents may be just the tip of the iceberg, and without skills like active listening, seeking clarification, reacting with appropriate body language, we can miss what's under the water.

When does a woman feel cared-for?  When she knows you are focusing on her and that you care about her.  The way to show this is by being present with her.  It is okay (and appreciated!) to tell her you aren't familiar with the issue, and you will aid her in finding helpful resources.

So the answer to the question, "Am I smart enough?" is this:


"Stuff" can be pulled out of books -- facts, statistics, information; this comes from without and slowly takes root within.  It can be sterile, static, and cold.

"Stuffing" is what you have to offer,  what makes a teddy bear comforting; this comes from within and (often, not slowly!) makes its way without.  It can be calming, assuring, and warm. 

One makes you a smart doula; the other makes you a great doula.

The Birth of Leah

Debbie called me at 8:30 am to let me know contractions had started.  I joined her and her best friend Lisa at the hospital – Debbie was 2-3 centimeters.  Debbie and I worked through the contractions.  She would really have to focus.  Lisa  and I would stand on either side of the bed rubbing Debbie’s arms and shoulders, smoothing her hair, and giving her space to focus.  Lisa  was not quite respectful of Debbie’s need to focus and go within herself to endure, and Lisa  would ask Debbie questions about unimportant things while Debbie was trying to concentrate.  I kept redirecting Lisa  respectfully, reminding her that Debbie needed space to focus, and could we wait until the contraction is over to get an answer?  A vaginal exam at 1:15 revealed Debbie to be 100% effaced, 4-5 centimeters dilated.  Debbie had AROM followed by her epidural at 2:00.  The contractions spaced out to 8-10 minutes, and Debbie’s blood pressure dropped dangerously low.  Debbie’s nurse, Mary, stayed with us in the room for almost 2 hours charting and watching Debbie and her monitors.  Debbie’s blood pressure did eventually increase.  At 4:30 pm Debbie was checked and found to be complete.  She started pushing at 6:00, and baby was born via Mighty Vac at 6:52.

Debbie is a single mother and she felt a doula would help her feel supported and informed.  My primary goal for Debbie’s birth was to make her feel special, strong, and empowered.  I knew Debbie wanted an epidural.  Debbie had a severe knee injury which happened about the time she became pregnant.  That, coupled with her being very overweight, greatly reduced her options for movement.  I helped a lot before Debbie got the epidural with coping techniques such as counting backwards through contractions, and massaging her hands, which grew tired from gripping her bed rails.  Debbie’s situation reminded me of something Penny Simkin wrote of a client who left an abusive relationship:  I think Debbie did not need to feel any pain on this birth day.

Debbie reacted well to her labor!  She really had to focus from about 11:45 until 2 pm.  She seemed to leave for a minute and find someplace in her mind where she could cope, and once the contraction was letting up, she would slowly open her eyes and release her grip on the bedrails.  When I would say, “Debbie, that was great.  You have found a place and you are really doing a wonderful job focusing and relaxing,” Lisa  would discredit what I was saying by replying with, “Yeah, Debbie’s thinking ‘Whatever,’” or “Debbie’s thinking, ‘Shut-up already.’”  I don’t think Debbie was thinking any of those things.  It really felt like I was being undermined.  When I would ask Debbie the, “What was going through your mind…” question she would usually reply “I just wanted to get through it.”  She never had a panicked or scared reaction.  Debbie reacted very sweetly to her new baby.

I learned some good people-coping skills.  Lisa  is a tough kind of gal.  When Debbie’s blood pressure fell, and then her legs went numb, Lisa  was upset and wondered why they didn’t stop the epidural?  Lisa ’s personal experiences left her to believe the numbing aspect of an epidural was abnormal (“That did not happen with my epidurals”).  I tried to explain how epidurals worked, but she got very defensive.  I finally said I did not know, and she should ask the doctor about it (he was also Lisa ’s doctor).  I learned sometimes it is better to “not know.”  I learned sometimes I need to stand away and be useless, like while the baby was being delivered and I was not by Debbie (Lisa  was to her left, doc at the end, nurse at her right).  After Leah's birth, I was able to help more practically.  Lisa had left, and Debbie was alone.  I stayed longer helping with breastfeeding and ensuring Debbie got a nice meal as well.  Debbie’s father arrived about an hour later, and I was able to help him hold his granddaughter for the first time -- he swayed and shooshed her right to calmness.  I learned even though a person only thanks you for bringing them dinner, that can mean a lot.