When I was a new doula, I learned about attunement.
Let me take you back to the beginning. I was 28 years old, and the mother of 2 children. They were just babies; my youngest was 9 months, and my oldest was 5. As a now seasoned doula, I look back at my own births a bit differently, but at the time, birth for me, was simply, a means to an end. Boy, has being a doula for a quarter of a century changed my perspective…
Anyway… I was (strongly) encouraged to apply for a position as a Birth Assistant at a local birth center by a dear friend who was a midwife (Thanks, Sue!). She believed I’d be really good at helping people find their strength during birth and she basically wouldn’t take no for an answer.
After a short bout with self-doubt… I obliged her. She was a Certified Nurse Midwife who worked at a freestanding birth center on the grounds of our local hospital. She instructed me to pick up an application and fill it out. I delivered it to human resources, named-dropped my friend the midwife, and got the job!
I was officially a “Birth Assistant!” Now, to figure out exactly what that meant…
I started my training in the hospital by observing births. Now keep in mind, birth is not actually a spectator sport so having extra people standing around watching you do it is.. well.. really weird, and often inhibiting. Nonetheless, I didn’t make the rules, I was just following them.
In those first weeks of training, I did lots of things. I learned about stocking and labeling shelves, warming blankets, refilling ice and water, making coffee, and a whole bunch of other non-birth related things.
But I also learned some really cool things about birth.
- I learned about the sounds related to birth.
- The sound of active labor vs. early labor.
- The sound of transitional labor vs. active labor.
- I learned about the sound of pushing a baby out.
- I learned that whether pushing was voluntary or involuntary, the sound was often the same.
- I learned the sound of defeat when an unwanted cesarean birth became necessary.
- I learned the sound of loss, and the echo it left behind.
- And I learned the sound of a proud family as they ushered in their next generation.
But the thing that I learned that was the most profound, and that has come with me to every birth I’ve attended and every doula curriculum and training that I’ve ever produced or taught, is that attunement is the most powerful gift we give our clients.
Let me explain…
I was a few weeks into my training as a birth assistant and sleeping with one eye open #lifeoncall when my pager went off (anyone remember those??). I picked up the phone and called the birth center. They said a patient who sounded “active” was on their way in, and they needed me to head over.
I jumped up, brushed my teeth, slapped some mascara on, whipped my clothes on, and hopped into my not-so-trusty ole’ Ford Bronco…
I arrived 13 minutes later. A laboring woman (who we’ll call Marie) and her husband (who we’ll call Joseph) were getting settled. Sue, the midwife, and Diane, the nurse, greeted me with enormous smiles, and introduced me to the couple.
While Diane was completing the necessary paperwork, Sue was assessing Marie. She checked her vitals, asked a few questions, listened to the baby’s heart tones, and suggested she get in the tub. Marie thought that was a fabulous idea and Sue asked me to fill the bath.
Do you know that at the time, I was so insecure, and so worried that I would do something wrong, that I asked Sue to feel the temperature of the water to make sure it wasn’t too hot, or not hot enough??? Can you imagine the level of self-doubt it takes to make you question your ability to run a bath…
*Side note: New doulas – You don’t have to start with confidence, you just have to start!
Ok, new doula, back to the story!
I was running the bath and obsessively checking the temperature when Marie and Joseph came into the bathroom. Joseph supported Marie and helped her out of her clothes so that she could get in the water. She faced the tub, lifted her right leg and placed her foot in the water. Her left leg followed and then she sat on the edge of the tub for a moment.
I’m not sure what prompted it, it definitely wasn’t intentional, but the words, “That’s it, you’ve got this” came smoothly out of my mouth. They were soft and gentle and apparently, really well received. Marie looked at me, and we locked eyes for the first time. She grasped my arm and softly said, “I’m so glad you’re here.”
I remember feeling like I knew this woman. But not in real life.
I felt like I knew her in an ancestral kind of way. In a way that connected us; a way that said we were equal.
The connection was deep, and it came quickly with only a few words between us. I don’t mean to sound cheesy, but we had what one might call, “a spiritual connection.”
Whatever it was, the connection brought me confidence, and her courage.
Marie’s labor progressed, and Joseph watched in awe. She spent the next hour on her knees (wide open), leaning forward, arms folded on the edge of the tub facing me. Her hands were in mine, with our fingers interlocked and her head was resting on her arms. As each contraction began to build, Marie picked up her head and locked eyes with me. Together, gazing deeply into what felt like each other’s souls, we breathed. Big deep breath in… long… slooow… breath out. Big deep breath in… Long… slooow… breath out.
As each contraction ended, she took another deep breath, and on the exhale, released herself from the work and discomfort of labor (for a moment).
We were a well-oiled machine. We were predictably laboring, and resting together in a steady rhythm. She was in control; strong and powerful. I had heard it said that contractions come like “waves” and that it’s important to stay on top of them rather than work to swim out from under them as they crash down upon you. Marie was not only staying on top of them, she was riding them like an experienced surfer on the North Shore of Oahu.
I felt the presence of someone else in the room.
A tall woman with spiky blonde hair had walked in and was standing behind me. When Marie’s contraction ended, she said, “Hey Marie, looks like you’re doing great. I’m sorry it took me so long to get here.” Marie looked up and smiled at her, and then put her head back down onto her arms to rest.
The woman knelt down and placed her hand on my back. She softly introduced herself and said, “I’m her doula. I’ll take over from here.”
Not sure what a doula was, but definitely recognizing that she had a relationship of some sort with Marie and Joseph, I excused myself, unlocked my fingers from Marie’s and disappointedly exited the bathroom. I walked into the kitchen area where Sue, the midwife was making a cup of tea.
I poured myself a cup of coffee and asked her what a doula was. She started to explain that the doula was a hired support person that provided physical, educational and emotional support to the birthing couple. Before she could finish, from the other room, Marie started yelling, “I need the lady with the black hair! Get the lady with the black hair! Joseph, go get her!”
Sue took the coffee out of my hand and said, “Go to her. She needs you!” The walk/run was literally just down the hall but somehow, my mind had time to process this.
“She needs me?”
“I’m really making a difference for her?”
“I can’t believe this.”
“I was just doing what came naturally to me.”
“She must have been feeling the same connection I felt.”
As I walked into the bathroom, the doula stood up and I slipped back into my spot. Marie was relieved. She grabbed my hands identically to how she previously held them, and within seconds, her next contraction began. Once again, together, gazing deeply into each other’s souls, we breathed. Big deep breath in… long… slow… breath out. Big deep breath in… long… slow… breath out.
Marie and I experienced a phenomenon called social entrainment.
We synched up and connected deeply and rhythmically. We attuned to one another and that sense of attunement made Marie feel secure and capable. Joseph was connected to Marie as well but in a different way. He protected the space, and knowing that he was there brought Marie comfort. His ability to watch what was happening between Marie and I, made him feel confident that Marie was ok. His belief that she was safe, contributed to her ability to feel safe. He offered sips of water. He stroked her hair (between contractions). He offered whispers of love and encouragement. And he felt connected and proud as he and Marie welcomed their child into the world.
Attunement is best described as an intuitive reactiveness to the emotional and physical needs of another person.
It is the foundation on which relationships are established. During labor and birth, as Marie’s story indicates, attunement can be established very quickly.
Attunement generates confidence. It allows a person to feel a sense of togetherness which enables an increase in their confidence and a reduction of their fear.
Simply put; It’s what doulas do!
Authored by: Randy Patterson, ProDoula CEO
Part 2 “When I was a new doula, I learned about Business” coming soon!