My name is Sharon Gonsalves and I attended the Sacred Birthing Foundation’s Doula Training Program from January through April 2009. Barbara Essman was the lead instructor and author/founder/midwife Sunni Karll was very instrumental in delivering the training. There were about 10 women in the class and I learned so much from each one. Many had had their own babies and others were preparing for motherhood or healing from their own births and childhood experiences. I wasn’t sure if I’d follow through and complete the certification requirements, but once I attended my first birth I was sure I wanted to serve the community as a doula.
I had conversations with two different expectant moms before finding my first doula client. I learned in the training that it’s important that a doula be a good fit for the couple who she’ll be assisting. Although I was disappointed that those first two nibbles did not pan out, I was really happy when I found someone who definitely wanted to work with me and invited me to her birth.
My client, Joanna, was relatively new on Kauai, had 2 grown children and was about 7 months pregnant when we first met. She moved here from Denver, where she says 65% of births are attended by doulas. Doulas are not very common yet on Kauai and we’re having to educate the community about what a doula is and how having a doula can really help ease the birth process. Joanna was very sure that she wanted a doula at her birth and was planning to give birth at the Waimea Family Birth Center at KVMH. She and her husband would be attending childbirth classes at KVMH and they invited me to join them which I did.
Joanna was very clear that she wanted a natural birth without drugs. Her first 2 were natural – one at a birth center and one in a hospital – and while she knew she was able to give birth on her own, one labor went very long and she was concerned that might happen again.
As Joanna’s due date approached, we talked on the phone once a week just to check in about how close it might be and how she was feeling. Then one morning at 4:15am I got a phone call from Joanna’s husband. They were at the hospital and labor had begun. It was time for me to join them.
I showered and dressed and before getting in the car I turned on my computer and sent an email to a list of Joanna’s friends to let them know that baby Leila was on her way. I asked them to please keep the family in their thoughts. On the way to the hospital I called in all my guides and helpers, and asked spirit to surround the birth team with support.
When I arrived at KVMH, the hospital staff was expecting me and the nurses, doctor and especially Joanna and her husband, Michael, were happy to see me. Joanna was tired. She’d been up all night and was walking to keep her labor progressing. At last check she was 5 centimeters dilated and 60% effaced. Her contractions were a few minutes apart. I gave her lots of encouragement as she and her husband and I walked the halls stopping for every contraction. While she leaned on Michael, I gave her some back relief by pushing her hip bones together allowing more rooms for baby’s head to move down. We spent most of the next several hours this way. I gave Joanna water to drink after each contraction as they made her very thirsty. Periodically the doctor checked her progress. She stayed at 6 centimeters dilated for a while as she became more effaced. Her waters were broken to help keep things moving along. When she was hooked up to a monitor for a few minutes we could all hear the baby’s heart beat – the first time I’d heard that sound. No signs of distress at all.
Contractions were getting stronger and Joanna was getting more uncomfortable and more tired. She labored on a birthing ball for awhile, resting between contractions. I saw ‘bloody show’ for the first time and finally understood what that was. I suggested she try laboring in the shower for a while to see if the hot water would help her relax a bit. After her shower she labored in bed for a bit, actually sleeping between contractions as she was thoroughly exhausted. She was now almost fully effaced. Within an hour she went from 6 to 9 centimeters dilated, then things started happening pretty fast.
Joanna started feeling the urge to push and she seemed a little scared. Her contractions were becoming more painful and she said she didn’t want to do this any more. She wanted drugs. This was our clue that the baby would be here really soon.
In the doula class I learned that often as women progress through labor they start saying “oh God, please help me”. Then they start asking for drugs. Then they push and the baby is born and they are totally in love with their child. Well, in this case that’s exactly what happened.
So the urge to push set the hospital staff in motion. The bed was readied. The doctor’s instruments were laid out. The lights were turned on and the doctor was in position to catch Leila as she entered the world. Joanna was sitting up at about a 45 degree angle, and Michael and I stayed on either side of the bed and told her what a great job she was doing. One of the nurses coached her through the pushing – chin to her chest, hands behind her knees. I let one of the nurses know that they’d been doing perineal massage to stretch her tissues and no episiotomy was performed. Within 3-5 pushes the baby was out and Leila was on her mom’s chest.
The actual birth was the most intense time for me. I didn’t want to look between Joanna’s legs at all. I just wanted to stay right at her shoulder encouraging and supporting her. The pushing was a bit uncomfortable for Joanna and the nurses were so great in the way they coached her to push into the burning sensation that was making her hesitate. She did great and I was really happy for her that things had gone so well. Leila was born at 11:26 am September 13.
Then came the really cool part. Joanna and Michael met their daughter for the first time in the light of day and they loved her. Meanwhile, the doctor prepared the cord for cutting (which dad was invited to do), then he put some gentle pressure on the umbilical cord and placed a pan at the end of the bed to catch the placenta. Within about 20 minutes after the birth, a placenta the size of a very large grapefruit was expelled along with more fluid from the uterus. Wow! Fascinating!
The hospital staff cleaned up in a flash and mom, dad and baby got acquainted. Mom was encouraged to breast feed which would start the uterus contracting to stop any bleeding from the placenta detaching from the uterine wall. Baby latched on right away – a successful beginning to a new relationship.
At this point I made myself scarce so that very important initial bonding could take place. Before leaving the room, doc gave me a ‘thumbs up’ which brought tears to my eyes. Everything went really smoothly.
I felt really welcomed by the hospital staff and very high from the whole experience. Some of the staff had met Barbara and Ronda when they visited the Family Birth Center a few weeks before. This really made me feel good, being associated with a group that intended to work together with a hospital to ease baby’s transitions and support mom, dad and hospital staff through the birth process. It felt like a good beginning for all of us.