Birth workers are an amazingly dedicated bunch. The phone rings, day or night, and we answer, ready to roll. We offer comfort for the aches, balm for the fears, and remind our mamas to believe in themselves, find their power, love their bodies, and nurture their babies. We wipe away tears without judgment and celebrate joys without holding back. We are passionately committed to learning and growing. We offer the gift of our unending compassion, which continues to call us to this work we do. For many of us, this life of service to others includes the responsibilities of tending our own households, nourishing our own relationships, and parenting our own children. We are often asked, “How do you do it?” Is it any wonder that burning out is the biggest risk that doulas face?
Anyone who has ever been on an airplane has heard the pre-flight instructions, “In the event of an emergency, an oxygen mask will drop down. If you are traveling with someone who needs help, please place a mask over your own face, before assisting others.” Make sure to tend to your own survival first, so that you can support someone else without putting your safety at risk. It’s a pretty basic formula, and yet, how often in our working, our loving, and our daily living do we forget to put our own masks on first? This is where burnout comes from. Because we love so deeply, want so much to be “good enough” and offer the best service we can, we give our all and then some, with no complaining. We don’t want to be seen as selfish or indulgent, or any of the other negative labels that our mind chatter might stir up about “Self Care”. So, we get used up and worn out. Reality bites back hard, with anger and resentment and exhaustion. We begin to feel fizzled and hollow, with nothing left to give. We reach the point where quitting seems to be the only option.
It is time, now, to re-write the negative and limiting belief that excellent Self Care is wrong. Self Care is not an indulgence enjoyed by the lazy and selfish, but the responsibility of anyone wishing to have a joy-filled life. It is absolutely essential to make sure that your needs for nurturing and comfort are met. It is imperative to feel nourished and sustained enough to provide you with enough resource to give to others who are looking to you for support. Further, when we model this way of living for our mamas, we give them permission to love and accept themselves and meet their own needs, supporting them not only in birth, but in living more balanced and fulfilled lives.
Healthy Self Care begins with checking in, with love and kindness, to discover your own basic needs, and then working to meet them. In sharing the following list, I invite you to take a mental snapshot of your own lifestyle and your care provider style, and consider where some new Self Care baby steps might be beneficial. Please hold in mind that the intention here is not to guilt or shame about how you’ve been doing it so far, or to make you “feel bad”, but to encourage you to take a good, honest look at how you are caring for yourself while providing care to others, so that you have more than enough energy over a long period of time.
1) Sleep well. Six to eight hours a night, in a pleasant and relaxing sleep environment, is ideal. Having a good sleep routine and a consistent daily schedule helps make sure your body is rested and strong, so that the occasional all-nighter won’t leave you a total wreck. Learn to power nap, and if you have enough of a heads-up before the “come now” call, make time to close your eyes for twenty minutes so that you arrive fresh and rested.
2) Remember to eat, drink, and be well. Long births can mean stretches of time with little more than crackers and small cups of coffee. We encourage our mamas to drink 4 oz an hour, and snack frequently to keep their strength up. We encourage dads to take a break to eat something. It’s easy to get caught up in the idea that “I have to be here right now!”, and forget to do the same for ourselves. Remember to keep some healthy snacks in your bag. Eat something non-processed and good for you before you leave home. Bring your water bottle with you. It’s ok to tag-team with Dad or another support person to take a short break, step out, and eat something. While you’re at it, brush your teeth, splash your face, check your deodorant, and stretch for a minute. It might be hard to pull yourself away, but in the long run, your mamas will thank you. A grumpy doula suffering from hunger, exhaustion, and a need to pee isn’t doing anyone any good.
3) Be gentle with your body. Labor support is physically demanding work. We use our muscles to help mamas into different positions, and to provide massage, counterpressure, and a body to lean on in labor. It’s not unusual to leave a birth feeling like you’ve just completed a marathon. Be good to your body in the between times. Take your vitamins. Find fun ways to exercise. See your chiropractor regularly. Remember your yearly physicals from your doctor and gynecologist. If you can swing it, schedule a session with a personal trainer or physical therapist to talk about the physical maneuvers you use most often, and learn how to perform them in a way that uses your body to your best advantage, to avoid strain or injury. This is the only body you get. Treat it well!
4) Be prepared for quick change. A full-time doula must be ready to go at any moment. The last minute scramble to get yourself together and get out the door can be stressful, but there are things you can do in advance so that it goes as easily as possible. Keep your birth bag stocked and ready to go, and replace what you use up after each birth. Have a change of “hospital clothes” in your car, and another ready to go at home, so that you don’t have to think about it after getting a “come now” call. Have a support network lined up in advance, so that you already know who to call for your children. Keep a couple of easy-to-prepare meals on hand at home at all times, so that there’s no need to think about what your family will have for dinner while you’re away.
5) Know where your support network is, and reach out to them. Some births are hard. You might have questions, or your own need to process your feelings. Having a strong support system in place in advance can help you get through the bumpy moments with more peace and ease. You might find comfort in a qualified counselor. A more experienced colleague can be a good resource for calling when you need wisdom and advice. A support group for birth workers might already exist in your area, or you might find others willing to help you start one. Nobody has to go through this alone. We’re all in it together.
6) Know your triggers and your coping skills. The more deeply you know, love, and accept yourself, the better you will be able to provide support for others in their own times of vulnerability and learning. Knowing in advance, from experience, what hasn’t worked well for you before will help you communicate clearly to your clients what your own needs are. How you respond to the more challenging moments that life brings your way is what builds your strength and shapes your character. It’s hard to come up with creative solutions in the moment when you’re in the middle of a crisis. Having pre-rehearsed coping strategies on-call for yourself will help you provide better care for everyone.
7) Watch your self talk. We tell our mamas to be mindful of critical self-talk because their bodies and babies are listening. The same is doubly true for us. “I’m no good at this”, or “I’m not as good as (some other person) is”, does nothing to make us better at what we do. It tears us down and takes the wind out of our sails. Remember to affirm that you’re doing your best, and you’re learning all the time. The same can be said for “I’m better than this other person because…” Don’t compare yourself to others – compare only to the self that you were before now. None of us can learn everything at once, and all of us have something we can learn from one another.
8) Create a Re-Entry Ritual. When we are present to the miracle that is bringing a new life into the world, we get to experience the Birth High that is one of the most enjoyable parts of this work. The Doctor is so proud, the Mama is ecstatic, Daddy is weeping, Grandma can’t stop hugging everyone in the room, and there’s warm fuzzy love flying all over the place. It’s easy to forget that it took us hours to arrive at this state, and that the rest of the outside world might not be experiencing it with us. It’s very easy, in this state of being, to get emotionally bumped. We can get completely thrown off by traffic on the way home, or dishes in the sink upon our arrival, or a partner who needs to tell us right away that there are crayons in the toilet and oh, by the way, your mother called. We can go from the highest of highs to a very grumpy low in a matter of seconds. After leaving a particularly challenging birth in my first year of being a doula, I once paused at an intersection for several seconds before realizing that I was waiting for the stop sign to change! A re-entry ritual is simply and intentionally taking a minute to get back to center and adjust ourselves to be ready to deal with the outside world again. Stop, take a deep breath. Acknowledge the wonderful experience you just had, and allow yourself to transition back to the daily world now. Stomp your feet on the ground to wake yourself up. Eat something with protein. Drink some water. Then, you can drive yourself home again. Get in the shower, take a nap. It doesn’t need to be complicated – just make sure it works for you, and follow through with it every single time.
9) Practice gratitude. Attitudes are easy to catch and easy to cultivate. We cannot be in a state of gratitude and a negative frame of mind at the same time. Gratitude is one of the best tools we have at our disposal to increase happiness and satisfaction. Being grateful for the goodness that is already evident in your life will bring you a deeper sense of contentment every day (see: More Like This, Please! for more on how this works.) Make a daily practice of beginning and ending each day by naming three things you are grateful for, and watch how much easier the interactions with your family, your friends, and your clients will become.
10) Make time to laugh. Make time to slow down and enjoy the joy. In a doula’s world of birth among the stimuli of flourescent lights and beeping monitors and constant comings and goings of people and staying on top of the latest research and remembering to return a phone call and reschedule the two appointments that had to be changed for today, we can forget to embrace life’s enjoyable experiences. The simple things in life can be the most rewarding when we remember to fully experience them. Make time to read funny books. Giggle with your kids. Make time to honor your friendships. Do something just for fun. It’s ok to be silly. Birth is serious work, but not every moment must be intense.
11) Know how to release the negative. Forgive yourself for your shortcomings. Forgive others for the buttons they pushed. Your brain doesn’t know the difference between an emotion you are currently experiencing, and a past experience that you are vividly recalling. So, when you have a negative thought stuck in the hamster wheels inside your head, they are constantly wearing you down. They tear holes in your energy, eat away at your endurance, and weaken your immune system. It’s very hard to take care of yourself and provide care for others with this going on. Learn what works best for you to let it go – whether that’s through prayer, meditation, writing it out, calling a friend and having a good cry – whatever it takes, release it. Everybody benefits.
12) Remember that life is bigger than you. Take a moment in each day to notice something beautiful, and stop to be fully present with that feeling of appreciation. Take time to connect with nature, whether it’s letting the sun hit your face for a minute, taking your shoes off and standing barefoot on the earth, or keeping a flower in a vase where you will see it. Find a moment in each day to do something to remember that life is bigger than you. Let go of the silly notion that you are the biggest thing going on. You are not responsible for anyone else’s decisions. You are present in service, but not in control. You are part of someone’s story, but not in charge of it. Embrace your connectedness as part of a greater whole. Especially if you are doing work with your life that you feel passionately called to do, finding a moment to connect with that calling can provide you with the strength and comfort to get through even the most difficult days.
Doula-ing is challenging work, and immeasurably rewarding. Take the time now to cultivate the Self Care habits that will serve you well, and you will be better able to have what you need to provide support for others for years to come.
So, doulas, midwives, docs, birth workers – let’s hear it! How do you avoid burnout? When do you feel most susceptible to it? What keeps you away from it?