One of the key things about birth that I learnt from my aunt, a midwife in New Zealand, was the importance of having one qualified support woman (i.e. a midwife). More than any other factor, so the science says, influencing the likelihood of avoiding pain management and intervention is whether the laboring woman has another qualified woman who is dedicated to her from start to finish.
For that reason alone, when we realized that the Thai system was very different to New Zealand’s midwifery-based way of birthing, we decided to get a doula.
We couldn’t have hoped for more or better when we asked Mandy to be our doula. She strikes the perfect balance between providing support, counsel and advice during the pregnancy and labour, without overtaking the situation. During the pregnancy, she worked with me to help sift through the advice coming from many quarters, some of it helpful, some of it not, always helping us to remember that the decision remained ours.
There is so much about birthing in a different culture that adds to the mix compared to being at home. We checked into a hotel during labour – something Mandy had suggested – and I can’t recommend it enough as a way to bypass the eternal question of Bangkok’s traffic. We were free to labour without the anxiety of trying to decide when to go to the hospital – and when we did, it was a three minute straight shot down the street in the hotel tuk tuk…at 8.30am!
The benefit of having Mandy to navigate the cultural differences went right down to even small details like the heads up as we were about to head to labour and delivery, “They’re going to offer you a wheelchair. You don’t have to take it.” Without her heads up, I may have felt pressured by the hospital staff, when in fact the last thing I wanted was to be sitting down during a contraction.
Her support gave me such confidence to labour in whatever way seemed comfortable, secure in the knowledge that if there was a more ‘efficient’ way to keep this labour moving, she would let me know – stimulate those nipples, change that position, get in the pool, get out of the pool, climb those stairs, squat from that bench…! Mandy had the foresight and experience to know what the doctor was going to want to see in terms of progress, and would gently suggest when it was time to try ‘cranking up the dial’ so to speak, to lean in and intensify the contractions by natural means.
At one point, the doctor said we may need to augment artificially. I looked at Mandy: “Do we have to?” My husband and I were ready to do whatever needed to be done, and at the same time wanted to avoid interventions if possible. We knew Thailand tends to be on the conservative end, intervening perhaps more than is needed. “You can ask for a bit more time,” Mandy gently suggested.
So we did. We had the confidence to ask for another half an hour, where we stopped at nothing to intensify those contractions. When the doctor came back to check, I had dilated enough that she was satisfied I could keep going on my own. Of course, that’s a bit of luck too, a matter of my body responding as it did – but without Mandy, we would not have remembered what to do in the moment.
With all that support, we’re thrilled to say we managed a beautiful and empowering natural birth, 16 hours long, with little Peter Joseph coming out still ‘sunny side up’ (posterior). We had only a single shot of Pitocin during the last stage of pushing simply because I was so darn tired by then and the poor wee thing was having trouble coming out posterior.
A doula can’t replace doing your own preparation. It’s important to understand what sorts of things can happen and labour and what your options are. But in that moment when you can barely remember a thing, a doula is the critical element that helps present that information once again so you can make a decision that you feel comfortable with despite the pressure and intensity. Mandy did exactly that.
Last of all, Mandy is just such a sweetheart, such a kind, joyful, loving companion to have in the labour room. She would remind me during pregnancy that we were going to have fun during labour – and we did – she didn’t bat an eyelid as I sang U2 and Springsteen at the top of my lungs to ‘drown out’ the contractions. In between contractions we shared about our lives, our traveling husbands, our kids, our hopes, and more. Being far from home, and far from my friends with lots of kids, Mandy was somewhat of a surrogate in that regard.
I even joked with my husband that it might be worth getting on to having number two while we’re still here in Thailand, just so we can go through it all again with Mandy and our doctor. Thank you Mandy for helping us have that awesome experience of the natural birth for which we had hoped-without-hoping-too-much! You have such a gift that we are so grateful to have been blessed by!