Day 9: A Doula for My High-Risk Pregnancy

Today's guest post isn't so much a birth story, but a pregnancy story. Often when families face high-risk pregnancies, even if the problems resolve at some point in the pregnancy, it is hard for families to let go of that fear and those feelings they lived with for so long. Evelyn had an advantage here in that she had a doula by her side early on, and I believe that helped her stay on track once she was cleared for a normal, vaginal birth. It isn't always like this. Some families aren't prepared to become "low-risk," and medical interventions during birth (and even after birth) are wanted and expected, and even though they aren't necessary, parents seek assurance that everything really is "okay." It is a hard place to be, for sure. 

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When I think back to my baby's birth, I am reminded it wasn't all sunshine and rainbows. I had a low-lying placenta early on, and my doctor was unsure if it would move enough to avoid a cesarean birth. This was a huge worry through my pregnancy. I had a couple times of spotting, which made everyone nervous. It wasn't until I was 32 weeks that I was cleared to move forward with a vaginal birth. Seeing I might have been facing a cesarean, I had many ask why I wanted a doula? What could she do for me if I needed a surgical birth?

I had my dreams of birth and how it would be. I read birth books before I ever even got pregnant. I think I drove my husband nuts, and it made for surprises to family members to come over and see my stack of books on the coffee table or in the bathroom when we weren't even trying to get pregnant. After a few initial, "Is there something you need to tell us?" conversations, they realized, like so many things in my life, I was just gearing up to the main event. Don't even ask me how many TVs we had to look at before I felt we had found the best one according to specs, price, and pas reviews!

I felt like I was very aware of my options. And one thing I knew we would incorporate into our birth experience was a doula. 

With the threat of a cesarean birth looming over my perfect, dreamy, pre-planned birth, my husband suggested we wait until we knew for sure we could attempt a vaginal birth before hiring a doula, "Just in case." But just in case is never how I operate. Besides, I already had the list of local doulas before I was pregnant, and I had contacted a few for interviews when my spotting began. I can understand his concern. He loves me and wants the best for me. But in light of this new news, I really felt I wanted the support a doula could bring if the pregnancy ended up with complications, and if we had a cesarean.

In thinking back to that day, I have made a list of why procuring a doula early on, when faced with a cesarean, was a good idea for me. 

The resources she offered! I was amazed that it seemed like she had more information on all the random things I would mention. Sometimes I wanted a place to find out more, and I knew that; sometimes I thought I was satisfied with what I had, and she offered me more, always framed as, it is here is you want it, not, let me overwhelm you. 

The way she treated me. Because of the issues I faced, every appointment came with an ultrasound, and in a big, busy office that meant many staff members were coming and going, doing things but not able to tell me results, and I felt like I was being passed from one person to the next. I understand that. And sometimes I felt like just a piece of paper that data was recorded on, not a person. This made for a lot of awkward conversation between my husband and me, trying to be positive and feeling nervous in our cores. From my doula I got that personalization I needed, I got the acknowledgement I needed to check in with how I was feeling when all of this was happening around me. She knew the questions to ask to help me bond with my baby and forget about the high-risk situation I was in.

She helped me sort things out. After these appointments, I would walk away overwhelmed bu so many people invading my space and acting like I wasn't there. On the spot, I just wanted to get home, and I never knew how to compose my thoughts to ask meaningful questions that could help my state of mind. My doula would help me debrief by just letting my stream of consciousness roll. She helped me figure out where my questions for my doctor where in all that mess. She had the time to hear my worries and help me place them within context of my world, so I knew what to bring back to my doctor, either through a phone call if it was a higher-level worry, or at my next appointment if I just needed more clarity about something.

I could call her anytime. If I had a concern for my doctor, I was usually told to come into the office, even if it was something minor I just wasn't sure about. I was told by the receptionist to come in, without ever getting to run something by my doctor. I knew the big, scary thing to watch out for (bleeding), but looking back now, I see I was so worried I often needed someone to talk me down when there wasn't anything really going on. This was where I could call my doula. She understood if I said I just wasn't feeling "right." She would ask the right questions to probe my issue, and often I worked it out as we talked. Once in a while it was something I came to see I should call my doctor about, but most of the time I needed reassurance that the things I was feeling were a normal part of pregnancy. 

​She didn't treat my like I was going to explode. When you have a high-risk pregnancy, and you have a lot of appointments and even some trips to the hospital, it is easy to feel like everything else is out of control. I found 

​​​even though I had no restrictions ordered from my doctor, I was hesitant to go anywhere or do anything, and I was treating myself like a precious object. My doula encouraged me to look into prenatal yoga (where I met many friends I still have today!), select our childbirth classes, and prepare like normal for our baby's birth.

When things were too heavy, she gave me the number of a great therapist. One quality I really grew to love about my doula was her sense of knowing her boundaries. She knew what she could handle, and she knew when it was out of her skillset. We had many frank discussions about what a cesarean birth would be like, and that if the placenta hadn't moved enough, there was simply no way around that. I prepared all I could so it wouldn't catch me off guard, and then I hoped and prayed it could be another way. My anxiety really got hold of me and I felt frozen in my tracks. After a few conversations with my doula, she gently suggested it might be helpful for me to talk to a therapist she knew who met with many women prenatally or postpartum, when "feelings feel too big for your body." I needed her to tell me that to realize, she couldn't be all things to me, and that was good. I wouldn't want her to be acting parts she didn't have the training to be. 

She helped relieve the pressure off my husband. Because I had so many appointments, and because of the bleeding scares and hospital stays, my husband had taken a lot of time off here and there. Once I felt more stable and things were looking good, no bleeding in a number of weeks, he asked if I could attend some of my appointments by myself so he wouldn't miss work. I agreed. That first appointment alone had me nervous. When I mentioned this to my doula, she offered to come along with me This was one thing she did that lightened his load, and especially when it came to labor and birth, or course there was much more! 

After the birth and we finally had our baby, she melted into the background. I was happy for her help, I don't know how we would have done it without her. Once our baby was born, she seemed to turn into the wall as we met and examined our baby. But she was there as soon as we needed something, had a question, or wanted breastfeeding help. She also ran out and got us lunch. Once she was sure we were feeling good, she said her good-byes and took her leave. Having her near was a security, her being quiet and mild was her gift to us. 

I could write another list of all the amazing things she did for us as we were in labor and birthing our baby. To me, that seems a lifetime away from how she helped me during my complicated pregnancy...a post for another day. I don't think our doula knew what she was getting into when she took us on as clients. But I am so grateful for how she cared for us!

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Evelyn and her husband, James, live in Austin, TX with their two daughters. Their second pregnancy was very uneventful, much to the relief of all involved! And yes, they used a doula.