The Role of a Doula as a Container

AIMS Journal, 2023, Vol 35, No 3

By Tomoko Holloway

Introduction

The journey of becoming a mother is a life-altering experience that goes beyond the physical act of giving birth. It is a rite of passage that brings forth new dimensions of strength, trust, and self-awareness. As a mother of three children, I can attest to the profound impact that each birth experience had on my life, not only as a mother but as a person. Each birth opened a gateway to my inner power and authenticity. With the dedicated support of my doula, I discovered the essence of autonomy in my body and making my own decisions for myself. The seeds of this newfound autonomy, planted during my own birthing journey, have the potential to sprout and flourish in the lives of my children and future generations, should I nurture and demonstrate it in my daily life. Thus, childbirth is not just an isolated event; it exerts a continuous and profound influence that reverberates across generations. This transformative nature of my own childbirth experiences ignited a passionate call within me to embark on a journey to become a doula.

Spreading the Wisdom of Birth

When I started my doula training course, my passion was ignited to spread the knowledge and wisdom of the natural physiological power of women to give birth. In the picturesque landscape of Mid-West Wales, where I practise, when there is a demand for a doula, it is often from a woman/birthing person seeking a home birth who doesn’t want unnecessary medical interventions. So it is true that those who are interested in physiological birth hire a doula. However, soon enough as I proceeded with this course, I learned that we doulas are there for any type of birth, from Caesarean birth, birth with anaesthesia to home birth, just as women/birthing people wish and choose. Birthing a baby is a sacred and transformative event that holds the power to shape the lives of women/birthing people and their families. Therefore my deepest desire is for every woman and birthing person to have a ‘positive’ birth experience, regardless of the chosen mode of birth. However, my journey as a doula has taught me an essential lesson about what truly constitutes a ‘positive’ birth experience.

It is a great honour to be a doula and witness women and families during one of the most sacred and significant experiences of their lives. Yet, this journey is not without its challenges and emotions, akin to riding a roller coaster through moments of immense joy and moments of grappling with disappointment and self-doubt.

The Power of Joyful Moments

When I witness my clients experiencing the birth they had hoped for, it fills my heart with deep happiness and fulfilment. I vividly remember my first-ever support for a birth client. She expressed her previous unsatisfactory birth experience and her determination to have a positive one this time around. Despite the challenging circumstances posed by the pandemic, she explored and embraced her innate physical ability to give birth, resulting in a short and smooth birth, just as she had envisioned. Her radiant joy and satisfaction validated my role as a doula, and these joyful moments further bolstered my confidence in supporting women/birthing people through this transformative journey.

Embracing Unforeseen Challenges

However, the journey does not always unfold as we hope for. One particular encounter with a mother expecting a baby remains etched in my memory. Having experienced a positive and relatively smooth birth with her previous baby, both she and I anticipated a similar outcome this time around. However, the birth took an unexpected turn, ultimately leading to an assisted birth involving forceps. Witnessing a forceps birth for the first time, I was taken aback by the absence of the warm, gentle process I had come to associate with birth. While the baby arrived safely and the mother was well, I couldn't shake off the feeling of guilt and responsibility for not being able to welcome the baby in a serene and peaceful manner. I couldn't help but feel that I had failed to create the serene and peaceful birth environment she desired.

This experience, though challenging, offered an important learning opportunity. During the early postnatal period, the mother shared that she considered the birth to be a positive experience. Surprisingly, my presence during that time made all the difference. Drawing from my knowledge about birth and trauma, I realised that sometimes, ‘being’ there for someone, rather than ‘doing’ something specific, can have an extensive impact. The experience could have been vastly different and potentially negative if she had faced it without someone who was physically and emotionally there for her.

This raised an important question: Who gets to determine whether an experience was ‘positive’ or ‘negative’? Ultimately, it is the mother or birthing person who decides. As doulas, we don't steer them in any direction; instead, we walk alongside them, not on the main path, but from the side. They remain at the centre of their journey. It is not the outcome of the birth that matters most but the process itself. As doulas, our role is to offer unwavering support, ensuring that the mother or birthing person never feels alone and trusts their ability to navigate this journey in their own unique way, whatever it is. While imparting knowledge about birth is essential, the most valuable contribution we make as doulas is simply being there for them. Witnessing the power of this support has left an indelible mark on my heart.

The Role of a Doula as a Container

The more I support mothers and families, the more I understand the role of doula - we are a container, keeping the inside empty yet holding and supporting the emotional and physical experiences of those we serve. Whatever they choose, we will be there for them and support them. This beautiful act of being a doula is profoundly humanistic, and it is precisely why I am so passionate and love being one. This role as a container requires a delicate balance of holding space and offering dedicated support, while also ensuring that our own energy and well-being are preserved. It requires me to acknowledge and confront my own ego when it arises and to let it go, so I can fully be there for the woman or birthing person. During the on-call period, I prepare myself to be fully present, mentally and emotionally, for whatever the birthing journey may entail. Trusting myself and the woman/birthing person is paramount; I trust that I can be a container to hold the whole of them and that they have the strength to navigate this unique path.

While knowledge and skills are essential tools, I have come to recognise that self-care and energy management are equally crucial. During the on-call period, I make a conscious effort to ground myself, not just physically, but also mentally and spiritually. Spending time in nature, prioritising good sleep, maintaining a healthy work-life balance, surrounding myself with positive energy, and getting support from other doulas when necessary are all essential elements in replenishing and organising my energy.

The Importance of Listening and Continuous Support

Throughout my journey as a doula, I have come to recognise the profound significance of providing continuous support and engaging in deep listening. Building a foundation of trust and rapport during the prenatal period is essential to shaping a positive birthing experience. Every individual is unique, and clarifying how the woman or birthing person wants to be supported at birth is crucial to offering the most effective support. However, it is also essential to acknowledge that their preferences and feelings may evolve during the birthing process. Thus, I assure them that they have the autonomy to change their mind, and together, we establish open lines of communication to ensure that their true voices are heard.

Equally important is the early postnatal support. This period offers an opportunity for emotional and practical support as families navigate the early days of parenthood. Providing a space for the mother, parent, and family to reflect on their birth experience, free from judgement, fosters healing and understanding. This reflective process aids in postnatal recovery and cultivates a sense of empowerment, resilience, and confidence in their motherhood and parenthood journey. The continuous care and nurturing presence that doulas provide significantly contribute to the overall birthing experience.

Conclusion

In conclusion, being a doula has been a journey of self-discovery and growth, both as a professional and as an individual. The privilege of supporting women and birthing families during such transformative moments is a humbling experience. It is a role that demands unwavering compassion, presence, and non-judgemental support. As doulas, we embrace the diversity of birthing experiences, honouring each woman’s/birthing person’s choices and walking alongside them with an open heart. This journey has taught me the significance of self-care, managing energy, and the power of being present.

As a container, I accept the entirety of my clients' journeys without judgement. The journey of a doula continually teaches and reminds me of the immense power of compassion and presence. I strive to be fully aware of my imperfections and acknowledge them when they arise. Continuously polishing myself as a doula is vital to remaining effective and authentic in my support for women and families. The transformative journey of a doula is an ongoing process of growth and discovery, and I embrace it wholeheartedly.

Author Bio: Tomoko Holloway, a mother of three children, a birth and postnatal doula and a Mother Nature Circle facilitator. Originally from Japan and now residing in Wales, she finds inspiration in the beautiful nature of her surroundings. Her unwavering passion lies in supporting women and families on their transformative journey through pregnancy, birth, and beyond.