I’m embarrassed because I intended to write this over a year ago (this post was created on 2013-09-03), but it was very important to me that I properly convey the gratitude, respect and admiration of someone that my wife[^exwife] and I had on our team during the birth of our daughter.

Doulas

doula: n. a woman who is trained to assist another woman during childbirth, and who may provide support to the family after the baby is born.

When my wife was pregnant with our daughter, we came to the decision to have a doula with us during delivery. I wasn’t really excited about it at first, but I very quickly saw numerous benefits to working with one. In particular, our doula: Jun-Nicole Matsushita and her practice: Bamboo Birth Services. I wanted to write about why we made that decision, and to give a very strong endorsement of Jun-Nicole and the service she provides.

Why a Doula?

Liz had many anxieties about the arrival of our daughter, mostly centered around hospital births, her perceptions of medical interventions, and not being confident that the medical staff at our local hospital were going to be supportive of my her wishes for a natural childbirth. Perhaps equally anxiety-inducing was Liz knowing that I was likely to fold like a house of cards in the heat of the moment, if it was clear she was uncomfortable and someone suggested she would be more comfortable if they could give her an epidural.

Neither of us wanted to experience the birth as it is commonly portrayed on television: sterile, scientific, and as procedural as an assembly line; the mother strapped to a table and the father irrelevant. Visits with the midwives and nurses at the University of Iowa Hospitals & Clinics Women’s Health Clinic were positive but fairly limited. Liz’s pregnancy was low-risk and proceeded as expected, and of course that’s exactly what we wanted, but it meant that even though everything was brand new for us, it was completely routine for everyone else.

The midwives reassured us that our wishes for the birth would be respected as much as possible, but there wasn’t a dedicated time to go over those wishes in our many 15 minute visits. We didn’t see a lot of opportunities between tests, scans, and paperwork for us to establish our values and wishes with the people who would be involved when the day came. We often felt like we needed someone who could advocate for us, and who would be invested in the birth of our daughter in a way that the medical staff could not be.

We had briefly discussed having a doula a couple of times, but it wasn’t a profession I knew much about and I was somewhat skeptical. Sometimes it was in the context of a home birth instead of a hospital birth, and I found that proposal almost as anxiety-inducing as the prospect of a hospital birth was for Liz! As we talked through our options, we decided Liz really needed someone present at the birth who we trusted, who was experienced and knowledgeable, who would work with us over an extended period of time, and who would have our backs. She was confident a doula could help her and help us have the best possible outcome and she quickly put together a list of doula recommendations.

The community of doulas in Iowa City

We had our first interview with Jun-Nicole a week later, to get to know each other and get an idea of our respective personalities, and to assess our expectations, goals, and values. One thing I wasn’t expecting to learn was that the doulas in Iowa City know each other and many of them back each other up in case of last-minute changes or emergency situations that call them away from a birth. Having a community and network like this was very reassuring. I don’t know why it surprised me, it is very much in their best interests to support each other as a community. This gives clients some uniformity in the services provided and also reduces the anxiety of putting your birth on one individual working alone.

Expectation management is a large part of what Jun-Nicole did for us: while some people will talk about your Birth Plan like it’s an immutable document, in many circumstances that is setting yourself up for disappointment and feeling like somehow there has been a failure. There are innumerable opportunities for things to deviate from the ideal course of events, and if you aren’t able to roll with them and quickly make decisions they could be made for you. Jun-Nicole was careful always to refer to our ideal birth as our “Birth Wishes” rather than our “birth plan.” She evaluated Liz’s tolerance for interventions and optional medical treatments, and she ensured we knew what was likely going to be non-negotiable, and under what circumstances those interventions can occur. It turns out, we didn’t really have to compromise on much of anything with the midwives at the Clinic.¹

It’s who you know

I’m not saying we wouldn’t have had a positive birth without Jun-Nicole, but I will say I wouldn’t do it any other way. First of all, Jun-Nicole knows just about everybody in the clinic — and more importantly, they all know her. She had a rapport with them that we never could, and it was obvious that she had their respect, and that they were peers who have worked together during numerous births.

When Jun-Nicole joined us in our birthing room at the clinic she talked to the midwives and nurses, and quickly ran down our birth wishes from a folder that she then handed over to them. The hospital staff were instantly on the same page with us even though Liz and I were quite occupied with contractions and anticipation. I can’t imagine either of us would have had a lot of patience for answering questions and discussing anything with anyone at that point, so having the majority of it be taken care of so quickly and without our direct involvement at that moment was great.

Movin’ it, doin’ it

During the labor and birth, everyone had a job to do and each person got to work on the things they were the best at. We turned to Jun-Nicole for movement, support, and to set the pace and tone; and the monitoring and medical care was administered by the midwives and nurses. In retrospect it was pretty remarkable how well the wheels turned. I believe that without Jun-Nicole in the room we would have been drifting and alarmed at each transition and felt considerable pressure to perform, which would have made for a very tense labor and delivery. The midwife who delivered our daughter was excellent, but she was in and out of the room during the long labor, and with Jun-Nicole there we were never alone or lost.

When we were working with Jun-Nicole a couple of months prior to the birth, learning the birth movement exercises seemed a little silly to me. It was hard to imagine the way it would all eventually come together.

Similarly, the movements and exercises we learned in our Mindful Birthing class² also felt awkward at first—in both cases we had to trust that practicing the choreography would give us enough familiarity and comfort with the movements later, when it counted. Working with Jun-Nicole and taking the Mindful Birthing course wasn’t at all a duplication of efforts: what we learned from Jun-Nicole reinforced, complemented, and furthered what we learned in the course, and in the birthing room it was invaluable having someone there to spot us and make adjustments to our form while we moved, stretched, and facilitated our daughter’s eventual arrival into the world of bright lights and very emotional parents.

Our daughter couldn’t wait

Liz went into labor a couple of weeks early, and over the course of a day she wanted to labor at home as long as possible; not only so she could continue grading her students’ finals and I could put together our daughter’s play-yard but because Liz was more comfortable that way. We both felt confident staying at home through early labor with a doula on-call!

When Liz talked to Jun-Nicole on the phone for a status report Saturday afternoon, Jun-Nicole recommended we use a “sifting” technique to reposition the baby and relieve some pressure from Liz’s lower back. It worked, and suddenly some of the other movements were useful as well. We walked laps around our neighborhood, stopping regularly and somewhat unpredictably for Liz to lean on me during contractions. The exercises using a scarf were especially useful for movements to and from standing positions, and for helping me to support and assist Liz. We used these same movements and exercises regularly throughout labor, and being able to do them easily and maintain my presence in the moment without analyzing everything I was doing was very liberating. I had never seen a human birth in person before, but I felt confident and sure-footed, even while I was also often bewildered by the awesome spectacle of it all.

Laboring at home worked very well for us. Liz and I worked together up until the early morning of Mother’s Day, May 13th, 2012.

Mother’s Day

Having someone as experienced and confident as Jun-Nicole was an essential part of our birth. Even now over a year later I still think of Jun-Nicole as a source of strength for Liz and me; she could quietly fade into the shadows only to appear when needed. Whether she was in my peripheral vision, right beside us, or letting me take a quick nap, I knew we had someone protecting us and looking out for us.

Jun-Nicole is gifted in reading the room and knowing the right approach to take. I was petrified of not being active enough in the birth, and in hindsight having a doula to coach us through it took a lot of pressure off of me, and took away so much of my fear and anxiety. It made it so much easier for me to be an anchor for my wife; maintaining our footing together and staying in-step was simpler because of her presence.

Now when I think about that day, I see myself differently from how I had before. I had a new confidence and was a source of strength for my wife and daughter. Immediately following the birth there was a small complication and Jun-Nicole was the only person in the room who could explain what was happening to me without being clinical about it all, and she kept me on my feet instead of heading into a panic. I was able to enjoy those moments with my minutes-old daughter because I trusted Jun-Nicole’s assessment of Liz’s condition. I know with certainty I would have had a very different experience without Jun-Nicole’s training, guardianship, and advocacy on our behalf.

If we ever catch up on sleep and forget how exhausting our daughter can be, it’s possible we’ll want to do it all again. Should that day come, I would love to have Jun-Nicole beside us. There was a time when I was reluctant to have a doula, but now I would be apprehensive without one, and especially without Jun-Nicole! She missed her own Mother’s Day so we could celebrate our first. Over the years to come, not a single Mother’s Day will go by that we don’t think of her and her family.

Afterward

I would recommend Jun-Nicole without hesitation as a doula, especially to people who are a little high-strung like myself. Her calming influence and the still confidence that radiates from her create a powerful aura that can quiet me at my most manic, and that’s not a trivial task.

She was exceptional at learning how Liz and I worked together, what we needed and when we needed it. Her instincts and intuition are fantastic tools and as a doula everything she does seems completely natural and effortless.