As a doula, I use many skills. Each birth requires a unique ability to choose the combination of those skills that best fits this woman at this birth. One of the skills that maybe isn’t so obvious is my “eye for birth.” Using my eye for birth is a skill that has sharpened over the years. I have learned to tune into this skill and it has made all the difference. The more births you attend, the more your own eye for birth will sharpen. You can start to develop your eye for birth by considering the following three observations:

1.) What does the expecting mother’s posture tell you about the state she is in?

In part, this may be easy for some of you to answer when she is in labor. We know the more she leans into her support person or doula, the harder her contractions are. But while she is pregnant, that is another posture altogether!

Is she standing or sitting like a person in fear, scared, or happy?  Knowing her posture now while she is pregnant can help you during the prenatal interviews, phone calls, and maybe emails that follow on how she is feeling and how you can better help her in her thinking while pregnant.

I had a mom in a childbirth class one time that always sat as if she did not have a friend in the world. Her mother was her partner, and I had been told the father was out of the picture.  She did not ask for a doula. I was hoping that she would. I told them if they had any questions or concerns during the labor to call me. I did not take it any further than that and just thought her pregnancy was making her uncomfortable and was the reason she stood like she did.

When she went into labor, the mother called me and asked for help. She said her daughter was hysterical anytime the doctor or nurse tried to examine her. I asked a few questions and the mother finally did tell me this pregnancy was from a rape. I was shocked! Why didn’t I ask the right questions to her during the classes? But I was looking for the wrong information in how she looked or reacted in the class. They had to do a cesarean birth because she would not let anyone near her. I wish I had known at that time what to look for.

2.) What does your expectant mother’s expression tell you what she is feeling or thinking?

Is she expressionless, looks away when certain subjects are discussed, does not make eye contact, do her eyes fill up with tears, or is she always happy looking with the same smile you see on her each time?

Each one of these expressions can have a different meaning and usually they are not all good. It would be wonderful if as doulas we all had that degree in counseling to be able to understand what is wrong. But there is something that we can do.

You have probably heard this in your labor doula trainings many times. When she seems to be “stuck” in her birth, many times we find the right time to ask, “What are you thinking?” Sometimes after asking a few more questions, you are able to help her get over the place in her labor where she is not moving any further and her labor progresses.

What if you did the same thing during your visits with her prenatally when you could tell by her expressions something is just not right? Hopefully she will be willing to tell you. At that point, it may be beyond your scope to help her, but you do have your resource list of counselors in your area that can help her.  You cannot know all of the answers, but you can help her find her way by getting her to the right person.

3.) Take a look of the people around her. Are they supportive, indifferent, or absent?

You can usually tell fairly quickly if this is the situation with your momma.

It does not matter if it is her partner, friend, or relative, you know from the visit you have with them if her support person is on board with helping her or is completely absent.  Sadly, I have had many like this and it was before we knew as doulas to look for situations such as this. It was before we had the resources.

I had a mom in my childbirth class one time that took me aside and said she was afraid her boyfriend would hurt her. She asked if she could call my pager (yes, pager from back in the day) at the same time every night. She would just put in 3 numbers. If I did not get a page, I was to call the police. If that happened now, I would have at least 3 places that I could tell her she could go to for abused women.    I could find a counselor that would help her in her pregnancy and thoughts of giving birth. Those did not exist at the time. Thankfully we have those resources now.

What about the young teen mom where the family has deserted her because she got pregnant and was not married? I had a mom 16 years ago that hid her pregnancy for 6 months. She called our office and we were able to spend hours talking to her on how she would tell her parents. She found the courage to. They told her the baby would be given up for adoption and no one was to know that she was pregnant. She dropped out of school, and was not allowed to be around any friends or other family. It was a private adoption. We stayed close during her pregnancy since I was the only person she was allowed to talk to.

I was with her during her labor and birth. Her parents were in the room, but they were not there emotionally for her at all. She held the baby. Even then, I knew the importance of her bonding with this child.  I took many pictures for her to have of her baby.

She left the hospital and never saw her baby again. She asked me to hold on to the pictures. She was not ready to see them yet. Her mother, a week after she had the baby, took her to Disney World.  Taking her on this long weekend trip was to make everything better and back to normal.

About 5 years later, she was in my childbirth class with her partner and this baby she was going to parent. She took me aside and said her partner does not know about the baby the she had before and for me to please not mention it. She also told me she was still not ready to see the pictures from of her first baby. I told her I still had them and anytime she wanted to see them, I would give them to her. This past year, 16 years later, she asked for the pictures.

Never lose your heart that connects you to the expecting mother.  But train your “eyes” to see what others overlook, and you will be a doula with the power to empower!

Janice Banther CCCE, CLD, CHBE, CIMI, Senior Advisor Janice Banther is a nationally known childbirth educator and labor doula trainer. She is the founder and Executive Director of two non-profit agencies For the Love of Birth and Birth Behind Bars. She is the author of childbirth manuals and creates YouTube videos to help new doulas and educators.

Copyright CAPPA 2015