Student NT editor for midwifery Holly Morse reflects on what led her to undertake midwifery training.
I trained in 2007-2012 as an NCT antenatal teacher and doula before beginning midwifery training in 2016. Throughout my training I have often grappled with the frustrations of trying to give woman-centred care within an an understaffed, overstretched, fear-based framework.
This experience from 2011 highlights six points I hold dear to my midwifery practice and continues to evoke for me the doula within the midwife I want to become. I still carry their thank you card in my placement bag, seven years on.
While training to become a doula I was asked to speak to a woman (Debbie*) who had been referred due to her major anxiety in her second pregnancy because of her traumatic first birth.
I visited Debbie and we talked at length about our experiences and how women can feel “….invaded, betrayed, damaged, exposed and even emotionally abandoned as well as inadequate in themselves in not being able to give birth to their babies….[and] how the doula’s role is to help the parents avoid, as much as possible, events that could cause such severe stress reactions.”
Due to their traumatic experience and little antenatal education I planned three further meetings with Debbie and her husband, hoping to allay some of Debbie’s fear about birth by giving them both an understanding of the normal process and by immersing her in some positive images of childbirth she could try and focus on these rather than her traumatic memories.
Debbie’s fears, previous experience of birth and lack of antenatal education made it crucial that I support them both with information before the birth. With a brief overview of the physiology and stages of normal birth they both felt more confident about the process and in me.
“The sessions we had really did change my expectations about what labour could, and should be like, and gave me the confidence to support Debbie as best I could in the safety of our own home for as long as we did” (Rhys).
During labour I provided support to help Debbie move from the sofa, to use the birth ball to great effect to manage contractions, to focus breathing and optimise position. I also gently reminded her to relax her face and drop shoulders after each contraction to release the tension and did lower back massage.
I was aware of transition when Debbie began demanding I tell her exactly how many more contractions she would have. It took firm but gentle words to focus her and keep her with me. Without any visible pushing the baby appeared into the water. For me, Debbie and her baby remained one entity – I was not distracted from her need for reassurance and help by the birth being completed.
I reflected afterwards on how my focus remained instinctively with Debbie even once the baby was in the room and when they were separate. I learnt that birth is a moment within the whole experience, with the mother continuing to rely heavily on support immediately afterwards too.
“I can’t even begin to thank you for being such an important part of bringing [baby] safely into the world. I never imagined I could have felt so supported, and that it could just be everything we’d hoped for in a birth to follow and maybe even make up for a little bit for the nightmarish experience we had last time. I would not have worked as it did without you” (Debbie).
I visited the family a week later and was amazed at how different Debbie was in personality. It really hit home just how scared of labour and birth she had been when we first met – and the difference my involvement had made to her. It was fantastic to see her chatty, bubbly and bursting with pride over her baby – and birth.
This experience moulded the doula I became, shaped my ability and desire to truly be ‘with woman’, ultimately leading to midwifery training. It boosts me on the difficult days, where there seems no way to offer this continuity of care, that somewhere on the horizon is the opportunity to caseload as a midwife, to build meaningful relationships, support healing and to catch babies in love not in fear.
*names have been changed