Doula Self Care

“When you can lovingly be present to yourself, your presence to others takes a deeper quality also.” -MacRina Wiederkehr

The saying goes that for every day a doula is at a birth, she needs about two days to recover. That means for those births in which mamas howl with the rise of two moons, it takes a doula almost four days to rest and rejuvenate.

Few doulas find the time or ability to sleep during long and steady births.    There is water to be boiled to warm the birth tub, counter pressure to be applied, food (and wine) runs to the market, partners to support and tend to,  encouragement to be lovingly doled out, and options to be discussed.  And lots and lots of sitting on hands.

What “Longer” Labors Look Like for a Doula

First some background…

Often, longer labors are due to babies in positions that require the “tincture of time” to get engaged in the optimal position for birth.   Perhaps they are posterior or maybe acynclitic.  In that case, the uterus is doing most of its work in an attempt to rotate baby to the anterior position or help baby pass through the pelvis   These labors can be challenging as cervical dilation can take many hours, or days, to “change” until baby is applying continual pressure on the cervix.

These mamas often assume active labor positions to help rotate the baby and descend, including walking.   Having a doula to offer advice on positions, as well as ensure the client alternates activity with rest, is quite helpful.  Since these labors may be challenging, many women also respond to continuous encouragement and a doula who gently loves them through the process.

Oftentimes, if a client chooses for labor to be induced, a doula can support her for well over 24 hours.    To avoid the many hours of “just waiting” for labor to begin, some doulas ask that clients call them to come once active labor has kicked in.

Just Take a Nap, Leigh!

Personally, I rarely sleep during births.   This is not necessarily a good thing, as an exhausted doula isn’t giving 100% of her focus.   There is too much “birth” in the air for me to rest my body and mind, too much anticipation.   However, when I hit the wall with exhaustion, there is little that can be done but give in to a bit of well-needed respite.

If I’ve been up over 24 hours, I may take a 20 minute nap if the client is in a relaxed and confident overall space.  A perfect time for this is when a woman and her partner have a good flow and connection going and giving them space would help aid in the progress of her labor.

I’ve been known to take 2 minute power naps between the surges of labor (you should see a whole room full of support people doing this!).    And if the mama’s labor has slowed down noticeably (so that she can rest) or she chooses an epidural, I may find a cozy spot to sleep for a few hours.

I finally learned that when I client says “I don’t know what to do…I kinda feel like everyone’s just sitting around watching me” – that’s my cue to take a nap.  Really!  It helps the mama relax, perhaps rest a bit in between contractions herself, and re-center her awareness and deep work.

The Return

When I return home after a birth, I make every effort to head almost directly to bed.  I have a simple ritual to help with that process.

I wash the clothes I was wearing, take a hot shower or bath, eat and drink some hot chamomile tea, and try to cuddle up in bed for a deep, long rest.   My husband often takes the kids out to the park, or on a fun date, so that I can sleep uninterrupted in quietude.  Even after a long labor, the “birth high” may linger and it can be tempting to stay up and ride those waves.  But with three little kids, this mama cannot afford to not sleep.

If I have engagements planned for the next day, I postpone them so that I can recuperate and spend some time with my family.  And truth be told, it’s often a lazy movie day for my kids so that I can catch a few extra winks.

I also focus on getting outside for some fresh air and a Vitamin D boost.   Being out in nature gives me time to drink in the beauty of the birth I just attended.

Tips to Avoid Doula Exhaustion

Trust me – you don’t want to invite in sleep deprivation at a birth.  It’s happened to me before and it’s killer.  You feel loopy and unable to articulate and make decisions.  And of course it’s unfair to your client. And the worst feeling in the world is trying to drive home after you’ve been awake for three days straight – DON’T DO IT.   I’ve pulled over in a safe parking lot and slept before (call someone to tell them first so they know where you are).   I’ve stopped at a friend’s house to nap.  Do whatever you need to do to even get half an hour of rest before you make the journey home.

A doula deserves to take care of herself just like a laboring mama.    Here’s a few tips for staying “in the game” while at a birth:

  1. Stay nourished and hydrated.  I always pack food that offers quick energy and that doesn’t smell offensive (nuts, bits of cheese, PB&J sandwich, fruit, carrots, chocolate, trail mix, granola bars).   Sometimes I carry protein powder and if I’m attending a homebirth I can pour a bit into a glass of milk and chug away.  When I’m on call for births, I often boil eggs and keep them in the fridge.  Before I leave, I scarf down and egg…and then promptly brush my teeth. :)  I’ve also been known to bust into my honey-stick supply from my birth bag.
  2. Drink up! I always pack a water bottle for births and packets of Emergen-C or energy booster of the like.  I also have bags of tea with me in case I need a pick-me-up.
  3. Do your body and brain a favor and take occasional breaks.   While this is hard, there is always a chance to take a 5 minute break.   Getting some fresh air is a huge way to boost your oxygen level, relax your mind, and give you a bit of rejuvenation.   The bonus is that stepping away is also a good thing for your client as sometimes they can feel like a watched pot!  Coming back from a break also brings positive new energy.into the birth space and literally clears the air.  Make a phone call, do a crossword puzzle, finish knitting that baby hat, take a dropper full of flower essence.
  4. Arrange a Back Up.  Many doulas rely on another doula to be their backup for births.  But an added benefit to this is that you can always call in your back up so that you can get some rest.   I’ve had the great honor of attending a number of births with my former doula partner, Jen.   Besides all the extra support for our client, and the insights I gained from her, we were also able to be more present because we could take breaks and alternate support.  This was priceless.
  5. Stretching and Breathing.  If you can’t find time for a quick break, you can stretch and do some deep breathing/meditation.   The classic neck and shoulder roll is an awesome way to relax.  Loosen your jaw, rub your neck, do some quiet alternate-nostril breathing.   If I’m sitting on the floor, I may even do a modified and unobtrusive yoga pose (see examples of some great sitting poses here).  Again, the benefit to all of these is also that you re-center yourself and realign the energy in the space.
  6. Ask for Help.   Oftentimes a doula can overload herself by feeling obligated to do it all.  Even when this comes from the heart, it can be overwhelming.   When I’m at a birth where there are extra support persons (family members, etc), I will often give them small jobs like grabbing snacks, making tea, helping me with comfort measures, refilling the birth tub with warm water, helping to fan the laboring mama, etc.  I’ve found that people LOVE to help and that it can also dissipate any anxious energy.   At hospital births, don’t hesitate to respectfully ask the nurses for help too! I’ve experienced that the nurses are usually more than glad to be of assistance.  They can help locate extra pillows, bring in drinks, fill a bathtub with water, change out bed sheets, and help move a client that has an epidural into a more comfortable and/or productive position.
  7. Keep Your Mind Uncluttered.  Doulas have a tendacy to “take it all on”. Try to remember to only focus on things in your “circle of influence” only.  Keeping your heart and mind open to those areas in which you can make a difference – instead of those outside of your circle of control – provides everyone present with a lighter and more hopeful outlook.  It creates space, opens up possibility, and focuses in the present moment.   Practicing this will allow you to be less weighted down at births, your mind uncluttered, and your purpose clear.

Taking care of yourself sets a good example of self-care for your clients and prevents a doula from burnout.

Honor and love that body that serves others with love.


Sharing the Holy Work…

  • Share with me your best tips for Doula Self Care.
  • How do you counteract over-exhaustion at births?
  • Tell me a story about a time you regretted not taking care of yourself at a birth.

2 thoughts on “Doula Self Care

  1. One time I was bending over to do a message for a mom way too long without figuring out how to make it comfortable for me as well! I learned at that birth that I can not hurt myself to help a mom or in the end we’re both in trouble.

  2. Thank you for this article! I attended my certifying (2nd) birth last night and found your article after searching about doula self care. Labor was about 24 hours, including an epidural, and even though the outcome was wonderful the family present were emotional wrecks during the long labor! They looked to me to be calm, and it wore me out : )

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