Do You Doula?

The plan is to give birth.

My therapist made another recommendation. It’s called a doula. I have never heard of such a thing. They are unlicensed, unregulated labor and delivery coaches.

Kara arrives at my house at three o’clock p.m. She is about five feet ten inches, has blazing red hair, and a huge bosom on which might as well hang a flashing neon sign that reads “GOT MILK?” The sun is beaming in through the huge Victorian paned windows, and I ask Kara to have a seat in the living room. I lumber into an overstuffed, burnt orange chair and summon Buddy to sit with me. I think about offering Kara tea, but I am so sick of tea.

“Make yourself comfortable,” I start. Although Kara is already on the chaise section of the sofa with her feet propped atop a pillow. Which one of us is pregnant, I wonder?

“I know very little about doulas. I’m single, and all of my family is on the East coast, so I may need a little help. My mother plans to be here a few days before my due date, but obviously I can’t assume that the baby will be on time. So, what do you do?”

“Doulas provide support and attend to your emotional needs through labor and child birth.”

“Kind of like a surrogate husband?” I press.

“I prefer to say I am there to mother the mother.”

“I don’t really care for another husband or another mother. What I do need is a ride to the hospital. So, do you do that?”

“When you feel the labor coming on, you’ll call me. I will come over right away.”

Kara moves her feet from the pillow, turns to face me and leans in as if she is about to tell me something terribly important.

“We will drink tea and take walks. We will do everything we can to keep you comfortable and advance the labor process as far as possible.”

“Drink tea?” I ask incredulously.

“Hospitals jump to medical intervention too quickly. They want to get you in and out as fast as they can. You know, ‘drive-thru deliveries’?”

Now she is almost whispering, “if we go too early and they think things aren’t moving fast enough, they will give you Pitocin. Do you know what that is?”

“No,” I say.

“Pig semen.”

Buddy had quite enough. He jumps off my lap and I hear the back and forth sway of the doggy door in the kitchen.

“Did you say pig semen?”

“Yes. That’s why we want to keep you out of the hospital until you are ready to deliver. We’ll try visualization, aromatherapy, and massage. Many couples have sexual intercourse to move the labor along because semen does enhance the contractions. Nipple stimulation can also help, but it’s a big time-commitment. We are probably talking about three one-hour sessions of nipple manipulation each day.”

I couldn’t believe my ears. Didn’t she hear the part about me being single and not wanting another husband? I hadn’t had sex since the day the baby was conceived. It’s pretty clear where that got me. And who was going to lick my nipples? Buddy?

“What I really need to know,” I press, “is if you will give me a ride to the hospital. I called my doctor’s office and they told me I shouldn’t drive myself.”

Kara scoots to the end of the couch, sits on the corner cushion and looks at me intently.

“Let’s talk about your birth plan. Do you have one?”

“Birth plan? Yes, I plan to get the baby out of my body.”

“What kinds of things have you done to prepare?”

“I signed up for three different Lamaze classes, but I haven’t been able to make it. I was going to go with a friend of mine, but she suddenly had to go to Costa Rica for a mosaic tile installation. It’s kind of a long story. Actually, it’s not, she just wanted and really needed to go.”

I feel Kara’s eyes fall on me with sympathy. She tucks her hair behind her ears.

“The first thing we should do is work on a birth plan together. I’ll bring you some books and videos. You need to understand the risks associated with episiotomies and c-sections. We will do everything we can to avoid these. If you plan for a natural birth, I can support you and we will make sure you keep control over your delivery. Your body will remain whole.”

Kara carries on with her list of important things for me to know. She thinks I can control this? Or, perhaps more to the point, that she can? Here I have to add that I bought my first copy of Our Bodies Our Selves when I was sixteen. My second year of college, I took a course entitled female physiology and gynecology. I had a Teaching Assistant who hosted a self-examination party at her house. When I was eighteen, I sat in a circle with a group of other women and a pile of plastic speculums and hand mirrors. I did a gynecologic self-exam. I have seen my own cervix. It’s not that I don’t know what goes on down there. It’s just that this time, and under these circumstances, I am totally unable to hear it; emotionally and intellectually, totally unable. I have to leave it to American obstetrics. It has to be out of my hands.

Kara isn’t listening to a word I say. I’m certain of that, because she responds with a list of rules for the doctor:

• No breaking your water (otherwise known as rupturing the membrane, which, as I hear Kara describe it, is presumably done with an ice pick);

• No epidurals (we will labor together through the pain, to which I think in my head but don’t say out loud, “what ‘we’ white woman”?);

• No Caesareans (because according to Kara more maternal deaths are caused by C-section each year than by vaginal birth);

• No episiotomies (here she recommends that I find someone to massage olive oil on my perineum and lower vaginal wall once a day for five to ten minutes, another job for Buddy?);

• No giving birth lying in a bed (it looks like my mother was right and it’s going to be The Red Tent after all, I’ll just squat in the backyard and see what happens); and

• No narcotics (okay, but maybe just a few after it’s all over).

It is becoming entirely apparent to me that we are not going to be a good fit, but I am still worried that I will go into labor in the middle of the night, need a ride and have no one to call. So I ask her again.

“You will drive me to the hospital when I go into labor, no matter what time, right?”

With her yes, I write her a check for four hundred dollars and tell her I will be in touch.

* * * * *

On my front door step sits a baby blue painted milk box, a relic of delivery days gone by. I use it as a mailbox, and when I get home from work tonight, I find a videotape wrapped in a brown paper sack inside. A note from Kara is taped to the paper:

Dear Ali,

These videos will help you begin formulating your birth plan. I was thinking maybe you could make a list of some CDs you would like to listen to during labor, and some scents that make you feel relaxed. We could start by putting together a bag of things you want to take to the hospital.


What is it with the Goddamn plan? The plan is to give birth. It all seems very straightforward; I plan to stick my head in the sand until the doctors pull it out. Nonetheless, for amusement more than anything else, I pop the tape into the VCR.

The stories were obviously filmed in the early nineteen eighties and follow three different women giving birth. In the first, a man with a wispy mustache holds his wife’s hand as they stroll the hospital gardens, sunlight streams down on her permed hair. Over Andy Gibb’s, I Just Want to Be Your Everything, the narrator explains that they are walking to advance the labor and avoid the use of drugs. The second woman has a midwife and she has chosen to give birth at an alternative-to-a-hospital facility while her two children watch! The third woman is in her office (no doubt amongst books by Simone De Beauvoir and Gloria Steinem). The lights are low, and seven of her closest friends assist her in giving birth in a squatting position. Her husband holds her hair and ices down the back of her neck.

This is exactly what I don’t need to see. Each story has something I don’t – a husband. I’m seething mad now. I am the single mother! Isn’t the whole doula thing a feminist construct? Shouldn’t Kara’s anti-American obstetric tirade cater to women like me? Am I going to go it alone against the whole pregnancy industry? Apparently so; it’s like Hillel said, if I am not for myself, who will be for me? Not even my doula. I am never calling her again. I will take a taxi to the hospital if it comes to that.

Anyway, as I was flipping around the channels tonight, I found something much better to help me prepare, The Learning Channel’s Maternity Ward. It is on every night at eight o’clock. The show follows two high-risk births to their conclusion. Most of the babies are delivered by c-section, and sometimes the women are even single. The neonatal intensive care unit is often involved, but they always make it. And best of all, nearly every time, the women give birth behind a big, beautiful curtain.


This story is part of a memoir that I've written about being single by choice and pregnant by chance in Salt Lake City. Details on publication forthcoming...


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