Chapter 27: Doulas and Dads

One night I watched the British PBS TV series Call The Midwife! which is set in the 1950s and ’60s. In the episode the drama being played out was between one young couple as the mother went into labor while the Korean War veteran dad-to-be was suffering symptoms of what was referred to back then as “shellshock,” which we now recognize as PTSD. As soon as their baby girl was born, the wise midwife hands the baby to the father. He sees blood, one of the “triggers” that has been setting him off since the war, but this time it is “good blood,” as the midwife tells him. He is healed as he holds his tiny miracle. His wife has been through the worst with him and now he is no longer the victim and not only supports her but shares this amazing gift of life with her. It was a very moving moment.

As I watched, I was struck by the coincidence since I had been thinking very much about two recent births I had attended. Under two very different circumstances neither mother was able to hold their newborns immediately after birth and in both cases their babies had been left alone on warmers at the other end of the room.

Only a month earlier I was privileged to spend time with Dr. Nils Bergman, a researcher from South Africa. Dr. Bergman speaks all over the world about his findings about skin-to-skin contact, or “kangaroo care,” especially the benefits to premature infants. He goes so far as to say that preemies will actually do better if kangaroo care is introduced immediately at birth and we do away with incubators all together. My own research into bonding, or maternal-infant-maternal attachment, also points to zero separation at all births and is now being scientifically confirmed by Dr. Bergman’s and others’ studies.

Conchita and Enriké had come from Spain to study at the University of Minnesota. Toward the end of Conchita’s pregnancy, they asked me to be their doula. It was their first birth and Conchita had been dealing with multiple chronic health issues that she was quite successful in controlling with natural methods. They had really done their homework and were determined to have a natural birth. We were able to squeeze in two visits before her labor began. We had put together a birth plan, listing all of their wishes and all of the things they hoped to avoid, though they were very realistic about the possibility of interventions in their case.

A week later they called in the middle of a snowstorm. I met them at the hospital as the nurse was hooking up a monitor on Conchita’s belly. Baby sounded fine. Her midwife was called and luckily she was in the hospital. She walked right over to check Conchita’s dilation. We were breathing through each contraction, which were very regular. I thought Conchita was handling this stage very well and expected to hear she was two, or maybe four centimeters along at that point, since it was a first baby. When the midwife announced she was eight already I was surprised.

With a flock of nurses now setting up the room and the midwife gowning up, I continued to breathe with Conchita. With the next contraction she instinctively pushed for all she was worth. I knew she didn’t need to be checked again, but the midwife wanted to be sure she was fully dilated, which of course she was. Two more mega pushes and the head was out. Another contraction and their beautiful baby girl slid out, followed by a rather impressive river of blood. It looked like a lot to me, so I waited to see how I should back up the midwife’s next move. The nurses also saw that there would be something other than the regular plop-baby-on-mom’s-tummy program happening next and carried the baby to the warmer after hastily clamping the mother’s end of the cord and cutting the baby loose.

Dad Enriké had never seen a birth so he thought all of this was routine and very normal. The midwife was talking to Conchita while the nurses were hooking up an IV with Pitocin and fluids. She was in good hands so I turned my attention to the baby, concerned that she not be left alone. I went over to the warmer and learned the baby was doing beautifully with a Apgar score of ten.

Especially after my own work on bonding and then hearing Dr. Bergman talk, I was, and am, completely convinced that babies are born fully expecting a continuum of contact: there should be zero separation from the first moment. Not only are human babies fully hard-wired with this expectation, they will not fully thrive unless it is provided. Some researchers are now suggesting that the multitude of developmental disorders that are mysteriously proliferating in this century—in spite of all of our advanced science and medical knowledge—may very well be due to unnecessary separation and lack of attention in some cases.

No one was paying much attention to the baby at this point. All of the drama was across the room while everyone was trying to figure out where the hemorrhage was coming from. So I loosely wrapped up the baby and replaced her soggy little hat with a dry one while I talked to her. I held her close and walked to Dad, who was still standing at the head of the bed by his wife. The midwife was trying to sound calm and reassuring as she explained to them that she was poking around down there trying to find the source of the bleeding.

I walked Dad back to the other side of the room and motioned for him to sit down in the rocking chair by the warmer. I suggested he take his shirt off and keep his baby nice and warm and skin-to-skin until Conchita could take her. He did what I asked immediately. I find that dads are especially compliant at this stage and will do absolutely anything I ask them to. I could have just said, “Strip,” and he would have.

His baby girl had already started blowing bubbles and was rooting around when I picked her up. I told him she already knew him and his voice and was smelling him as she got to know him. The look on his face said it all. He was smitten. As she cuddled into his chest I could tell he had probably never held an infant. Then she started throwing her head back and wiggling. I told him just to hold her close as I wrapped them both in blankets. When she reached the point where her head was cradled in the crook of his arm and her cheek was touching his furry chest, she stuck out her tongue and started licking his nipple! Dad looked up at me with tears in his eyes. He completely melted. I just repeated to him that she knew him and needed to stay with her parents.

In the meantime, the room had now filled with a couple of doctors and additional nurses. They had found the source of the bleed. Its apex was behind the cervix in the posterior or back vaginal wall that rides above the rectum. One of the medical issues that Conchita had been dealing with was a problem with the clotting factor in her blood. Because her baby had descended down the birth canal so very quickly, where most women would have stretched slowly as the baby’s head molded, her tissue had simply parted and broke open. It was about the worst fourth-degree tear I had ever seen but they were tying off the bleeding veins and soon had the situation under control.

Enriké was somewhat oblivious about what was going on. I was glad I could reassure him and get him and the baby away from the electric vibes on the other side of the room and create a safe, sacred space for his baby during this time. Within an hour we were able to get the baby girl onto her mother’s chest where she immediately raised her head and latched on the first try without any direction from us.

I visited them the next day in the hospital and the day after that at their home and both times found Enriké still holding his baby with his shirt off. I marveled at this continuum bonding as I had rarely seen it.

I wondered how I could do this more. How could this affect father-baby bonding especially? I did not have long to wait to find out.

A week later I was at a birth at a different hospital with a couple who were living in one of the most crime-ridden neighborhoods in the city. You can automatically add social and economic poverty to the list of things this family was dealing with. It was this mom’s third baby, though it was his first. He was clueless. But it was his baby and he was going to be there.

Unfortunately, one out of every three children in America (thirty-three percent) live in homes without a father. The African American community continues to struggle with the highest rate of absentee fathers in the nation, with nearly two in three African American children (sixty-four percent) living in father-absent homes.

I knew all this but wondered if bonding could lead to a reversal of those statistics. While I was busy pondering this, I was referred to Sh’neice.

I was able to meet with Sh’neice four times in the weeks before her guess date. She was taking very good care of herself and her other children and we had enjoyed getting to know each other.

At her request, I went with her to her last prenatal clinic visit. She had hoped to have a VBAC (vaginal birth after Caesarian) but her OB wasn’t budging. The doctor convinced her that after two C-sections already, another was the best choice for her. As a doula it wasn’t my call. As much as I would love to have supported her having a VBAC, it would have only undermined her relationship with her physician, so I bit my tongue. Hard.

I met her at 7:00 a.m. at the hospital on the appointed day. When she was finally wheeled down to the OR at 11:00 a.m. her boyfriend and I put on the scrubs the nurse had handed us. He looked at himself in the mirror and I could just barely hear him say under his breath, “I will not faint . . . I will not faint . . .” I realized then that this was his first-ever birth. Was there any way I could involve him and have him feel intimately a part of this birth? I wondered. It was easy when a dad is at an all-night birth and I can have him rubbing Mom’s back, fetching juices, wiping her face with cold cloths and walking the halls for hours on end, but this was all going according to hospital protocol and I didn’t know what I could do to fit him into this picture.

I did all the usual things I do at C-sections. He took pictures as his baby was taken to the warmer and he held his baby’s hand as the baby was assessed. I usually also direct the dad to hand the baby back to Mom, but Sh’neice was still quite uncomfortable and the doctors had a lot to do to repair, not only the incision but also the extensive scar tissue from the two previous Cesareans, so she was not ready to hold her baby when he did return.

Dad was happy to just sit and hold his fat bundle where she could see him. I checked in with him periodically to make sure he was okay. He did really well, and I told him so.

When it was finally time to move into the recovery room we all followed the bed out of the OR and down the hall, Dad proudly carrying his very own baby. As soon as we got there Sh’neice began vomiting, which is not all that unusual after surgery. She needed a little more time to recover. She still was not ready to hold her baby.

I looked over at Dad standing nearby, rocking from side to side with his little bundle in his arms. He was in his own world with his baby girl. Good, I thought. I pushed over a glider-rocker and, offering to take Baby, suggested he take off his shirt and hold her skin-to-skin to keep her warm. Of course I had him under my spell by now, and he would have gladly done whatever I requested. As he sat down I handed him his baby and helped him unwrap her. I wrapped them both back up then with a warm flannel blanket.

The next time Sh’neice looked over to see where they were, she saw him talking to his baby, who was now looking up into his eyes. She had not tried to open them in the OR with all the bright lights.

I thought, This is right. Only this baby can change this big dude with his huge, tight abs and fly swagger. Only this baby can turn him into a real dad.

 

 

 

 

“The truth for women living in a modern world is that they must take increasing responsibility for the skills they bring into birth if they want their birth to be natural. Making choices of where and with whom to birth is not the same as bringing knowledge and skills into your birth regardless of where and with whom you birth.”

~Common Knowledge Trust