I have a theory. Connection is the single greatest act of activism we can take as a being on this planet--and as with all aspects of humanity--it starts with birth. In maternal care, we as a health community struggle with our birth statistics, we see the pendulum swing over what institutes evidence or best based practices, or is it better to have an Doctor or Midwife, or whether homebirth or water birth or cesarean birth is safe. We've produced incredible movies to spark awareness about the challenges facing us today: Microbirth, Orgasmic Birth, the Business of Being Born, Pregnant in America, Babies and What Babies Want to name a few. As important as these issues are the single greatest factor to safe, positive birth experience I still posit is the power of connection. Connection between mother and child along with their surrounding family and the care providers who support them. Connection between the teams of clinical staff and the organizations and communities they work in. And by connection i mean also to the every day human needs and rhythms: to eat, to sleep, to laugh, to cry, to pray, to be listened to, to be be accepted.
This kind of connection serves to support the triple aim of health equity, reducing costs and improving outcomes as seen in the doula studies and in programs like the Providence Pregnancy Care Package like the one I work where continuous support has become a major feature of the support system. The unexpected side affect to the continuous care has also anecdotally begun to shift the stresses for other care team members. Providers have commented how they make better decisions having the support to take a few minutes to eat and regroup about a patients medical needs (having a doula present helps creates more support overall in the room, thus creating more time). Nurses describe reduced stresses knowing they have an extra set of hands in the room and that observing doula support has changed the way they practice for the better by using the coping skills offered birthing families simultaneously with the families. (Anecdotal testimonials from the PCP program).
What this presents is an inkling to the underlying physiological hormones that initiates the power of connection: oxytocin. Yes oxytocin is well known for being the driving force in making labor contractions happen as well as its role in breastfeeding. Oxytocin has a history of being the foundation of love, lust and labor. But its role in actually bonding the birth team is less considered. It's the work of Paul Zak a.k.a. Dr Love that brought forth the idea that being intentional about our attention to oxytocin can actually create a culture of empathy. Dr Inga Neumann has research that points to oxytocin's impact on "pro-social behaviors" and emotional responses contributes to relaxation, trust and psychological stability.
As a doula and doula trainer who has supported thousands of birthing mothers, postpartum families, doulas and birth professionals (including doctors, midwives and nurses) in all variations birth settings, I have the privilege to witness the transformational powers that occur like magic when connection occurs. And I also understand that it is NOT magic, but very specific and intentional tools of simple awareness that our behavior in the birth room to support loving, trust-oriented behaviors and relaxation techniques that create that connection -- and the destructive powers when it doesn't.
A recent study proved that rudeness in healthcare can actually threaten peoples lives or re-traumatize both the patient or the caregiver. This is why I feel we have a huge reframing in healthcare to undertake to prioritize connection as a critical element and treated with as much intention as other forms of intervention. When I see doulas or other care-givers take on the role of "advocate" as a form of savior/ warrior approach or behave aggressively to "protect" the birthing person from the medical system, the family, or even themselves and their own choices I feel we are doing enormous disruption to the birthing process and increasing the stress levels of the people present by activating the fight or flight response for everyone in the room. Dr Sarah Buckley's groundbreaking work on the hormonal physiology of childbirth points to both the impacts on normal function as well as the potential inhibition of beta-endorphins for laboring women who may experience excessive stress in relation to their maternity care providers and birth environments.
Interestingly, when doulas (who are primarily identify as female) are brought into the stressful environment, we often naturally activate our own "tend and befriend" response, which Shelly Taylor describes is a biological response to the stress trigger presented to the attachment-caregiving system. In other words, it's possible that females naturally move towards connection in times of stress.
I came to birth myself, hoping to save the babies because of my own birth story. I myself was a 29 week premature baby--not my parent's birth plan! As a preemie, I spent the first 7 weeks of my life in an isolette in Southern Oregon where I developed double pneumonia and was given a 20% chance to live.
This qualified me for an a new program that had developed at the University of Oregon Medical School (now OHSU) and so I was the first baby from Southern Oregon to be Life Flighted to OHSU in a portable incubator and placed in the new Neonatal Intensive Care Unit (NICU) where my parents were invited for the first time to come and hold me, like the kangaroos do, skin to skin (Kangaroo Care). Within weeks I was healthy and able to go home with my parents. It was my own families experiences that initiated what is now the heart of my work--keeping mothers and babies together and the power of illuminating the heart of birth.
The state of Oregon in 2014 also saw the benefits of helping birthing families stay connected to their process and their care providers. Doulas were names Traditional Healthcare Workers primarily because of their singular role of maintaining continuous connection with the families they serve. Having the opportunity to come full circle myself and reconnect with OHSU to present the latest on integrating doulas was a moment of deep connection for my life. My talk at the OHSU Grand Rounds gives a comprehensive overview of the doula role as of November 2015. Other states like Minnesota are following suit.
On a global scale there are movements such as the Global Coherence Initiative that posit that not only do we benefit from seeking connection with each other but with the planet as well.
You might be wondering now--okay so how do I reduce the stress then? How do I connect? If I am a doctor, or nurse or doula or birthing mother, or partner? The power always exists within. We must start with our own inner intention to BE THE CONNECTION. Go out of our way to remember that we are all humans in this moment coming together to witness the passage of a new life arriving into our world. We all have a contribution to make in this moment. And we must moment to moment ask ourselves, what do I need right now? What does the person next to me need right now? What do they need to feel loved in this moment?
The answers to these simple questions can create a movement--to illuminate the heart of healthcare!