Friday, 23 May 2014

Supervision for doulas?




As a qualified practising counsellor, it is a requirement that I undertake ongoing supervision to the tune of approximately 1:12 hours of clinical practice. The recommendation is set in place by the professional bodies with which I am affiliated, the British Association forCounselling and Psychotherapy (BACP) and Counselling in Scotland (COSCA), to support safe and ethical practice. 
Quite right too. I have no doubt that my ability to work as an effective practitioner would be fundamentally lacking without the regular thinking time, insight and emotional and practical support that supervision affords me. How would I manage to keep myself emotionally well while holding space for the pain and suffering of people I support, without a space to download? How could I stay with the unknown-ness of another person's process in a boundaried way, without experienced support?
Not only has this has made me think about others who work in a supportive role, where perhaps there is no provision in place for supervision, or at least, supervision that is meaningful and therefore useful, but it has also made me reflect on what it means to 'be supervised'. How is being supervised different from being mentored? And would mandatory supervision be useful to the doula role for example?

As a midwife starting out on my career as a birth worker, my experience of supervision was mixed. From a call to extend my skills and push the boundaries of my clinicial practice to simply getting to the end of a box ticking exercise. "The world's your oyster go out and grab it" versus "Whatever you do, tow the line and don't get ahead of yourself." Either way, and bearing in mind that my supervisors were my superiors in the workplace, the space did not really feel anywhere near safe or potentially creative enough for me to begin to process any issues I might have brought. This said, that was all a long time ago, and maybe there is something to note about my youth and the limitations of my professional experience at that time, that might have affected my ability to utilise supervision to its maximum benefit.     

As a doula, I joined DoulaUK at the beginning, before the role of doula mentors had been developed. We relied completely on peer support, and as the network grew, those of us who were inspired to, organically assumed the role of the first course leaders and mentors. The now ongoing Doula UK mentoring process was set in place in 2004 and continues as an invaluable internal supportive network for new and developing doulas. I have, however, and to the best of my knowledge like many others who have been there from the outset, been obliged to continue to use peer support. To the great credit of my doula peers, this has nonetheless felt useful and safe enough to help me reflect, process and maintain integrity when dealing with difficult situations. But it has raised my awareness that for experienced doulas in particular, it can be a challenge to find a safe space to emotionally download. Someone to mentor The Mentor as it were. 
Traditionally, I always have been vocal in the case against the professionalisation of the doula role, but when it comes to accountable supervision, I tend to agree with others in the field who have been highlighting a need for this service among the doula community for some time. I suppose though, that engendering a culture where anyone who assumes as supportive role in their job is required to access emotional and practical support for their practice, makes sense towards limiting the risk of stigmatisation. And then perhaps supervision becomes more about appreciating and maximising the benefits of a supportive relationship, highlighting the act of taking care of yourself, and less about a sense that you are being watched or feeling ashamed for seeking help because you are struggling to cope. 

And taking care of yourself IS essential to being able to work effectively as a doula. So if supervision is required, it seems important that it works in a way that is useful to you. A place to think about a critical incident for example, or to explore how you are managing your business perhaps ? Or just generally time to reflect on how things are going, how well you are resourced and where you might be heading with your practice? Bearing in mind that sessions can be undertaken with anyone who has enough knowledge, skill and experience to be able to respond to the issues you bring in a respectful, thoughtful and progressive way, whether in-house, independently or as peer group members, so long as you feel you are engaged in a trusting relationship.
A mentor with whom you have a good working relationship can be invaluable, yet there may still be times when talking things through with someone who is not party to the internal politics of your workplace could be useful. And this perhaps becomes more relevant and crucial the more experienced you are in your field. Ultimately, if the reflective space does not feel safe and available enough for a degree of processing and certainly, for integration, how useful can it be for the worker? 

I do believe that supervision which is led in a vibrant, dynamic way can be an empowering, creative and essentially useful route to supporting best practice, whether as a doula, a midwife, a counsellor or anyone else working 'in relationship' with others. Although without my recent experience of counselling supervision, I perhaps might not have felt so sure.

To find out more about supervision sessions for doulas and other birth workers on an independent basis, face to face or online, see http://adelastockton.co.uk/supervision/
 

Sunday, 9 February 2014

Re- Direction?

This blog is an archive of my birth related, doula related posts to date and these will continue to an extent.

I will be moving the focus more towards reflections on psychodynamic and psychoanalytic thinking however. I am interested in the therapeutic dynamic of human relations outside the counselling room explored through working with horses, in the garden and via visual and performing arts.

Join me on Twitter @psychodynamix

For counselling services information see here.


Wednesday, 13 February 2013

Gentle Birth Companions - Debra Pascali Bonaro review

"I love Adela's book. Gentle Birth Companions captures the heart, passion and sacred path that doulas hold in supporting women and their families through out time. The perfect blend of her-story with science, showing the doulas role and importance today as she helps us  re-discover the value of female companionship during childbirth. 

If you are pregnant, thinking of hiring a doula, becoming a doula or are involved in maternity care today, Adela's book is essential to help you reconnect the circle of support in childbirth that provides an essential ingredient for a safe, fulfilling birth experience."

Debra Pascali-Bonaro, Director of the documentary and Co-Author of Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience, DONA International Doula Trainer and Lamaze International Childbirth Educator www.debrapascalibonaro.com

 

Monday, 10 September 2012

Birth Stories

For many doulas, our journey begins with our own birth story. Our first experience of pregnancy, giving birth, breastfeeding, becoming a parent. Our first understanding of being part of our new family. And our first contact with the maternity care services. 

The quality of physical, emotional and social support that we have received during this time can make a huge impact on our experience of childbirth. And whether it has turned out as we hoped or expected, or whether it has confirmed our worst fears, it is nonetheless so often the trigger that starts us thinking about the idea of supporting other mothers through the same experience.

Listening to other women's birth stories is bread and butter to doulas therefore. It is the way we learn about and connect to the mothers and fathers we support. It forms the baseline upon which our relationship with our clients during this birth experience balances, it provides waymarkers and flashpoints. And allows for the unpacking of a whole heap of the grief, anger, fear, hurt and disappointment that can sometimes accompany the joys of holding our newborn.

We need to be strong, mindful and steady in order to weather the storm of some birth stories, as well as gentle and yeilding enough for the parents to know we are with them from our hearts. This can be tough, it can resonate with our own birth trauma or postnatal illness, and touch us in ways we never knew was possible. Not only can it connect us back to the circumstances surrounding the birth of our own babies, but also to our personal (unconscious) memories of our own birth.

It's useful for new doulas to be aware of the powerful and valuable impact that birth stories bring to their learning and preparation I feel. Not only does the novice hear about the physiology of natural birth and what happens when this is disturbed, but also it is an opportunity for her to begin to explore what it might mean to provide birth and postnatal support in practical and emotional terms within a safe setting.

To become humble, to begin to know a little of the amazing art of just being.






Friday, 6 July 2012

Birth Mindfulness for Parents 1

Planning a natural birth?
 
Did you know that there are three key ways that you and your partner can prepare for the arrival of your baby, whether in hospital or at home, which may make a real difference to your chances of experiencing a gentle birth? 

Place – feeling safe and unobserved in your birth environment, free to move around and take up any position you want, can help your mind and body to stay focused and keep those essential labour hormones flowing. Rearrange the furniture, hang a ‘do not disturb’ sign on your door!

People – choosing attendants you trust to uphold your wishes for labour and birth is wise. Your supporters can protect your birth space by keeping questions and noise to a minimum, by banning strangers from the room. Enlist a doula (birth companion) as your advocate, she is there for your partner too!
Pain – establishing a unified attitude to the way you choose to work with your contractions, and making sure you have plenty of positive emotional support, can mean you are less likely to feel the need to request pain medication or an epidural. Write a clear birth plan, keep everyone informed!
An ‘undisturbed’ labour means you are more likely to enjoy a gentle birth. And a positive experience helps you, your baby and your family off to a good start.
To purchase ‘Birth Space, Safe Place: emotional wellbeing through pregnancy and birth’ (Findhorn Press, 2009) see www.adelastockton.co.uk

Friday, 9 December 2011

What does 'support' in childbirth really mean?

I have been thinking about the use of the word 'support' in relation to childbirth and wondering if it is not just being paid lip-service to lately, a bit like 'natural' childbirth.

Folk say "Yes, of course support is important' but do they understand what this really means?  What kind of support we are talking about? Or why it can make a difference?

My wise doula sister BB tells me that Michel Odent is not a fan of the use of the word 'support' which perhaps suggests there is something to this discussion. Yet what term are we to use instead?

For me, this poem by Anonymous, really sums up what I mean when I talk about childbirth support, or any kind of emotional support I suppose:


What is Support? 
Support is unconditional 
It is listening
Not judging, not telling your own story

Support is not offering advice …
It is offering a handkerchief, a touch, a hug … caring. 
We are here to help women discover what they are feeling … not to make the feelings go away. 
We are here to help a woman identify her options … not to tell her which options to choose. 
We are here to discuss steps with a woman … not to take the steps for her. 
We are here to help a woman discover her own strength … not to rescue her and to leave her still vulnerable. 
We are here to help a woman discover she can help herself … not to take that responsibility for her. We are here to help a woman learn to choose … not to make it unnecessary for her to make difficult choices.
Anonymous
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Although written as if for mothers, if we replace the word 'women' for 'men', it becomes a poem for fathers too.

So let's be mindful of how we use the word 'support', let's notice when and where we use it and what we really mean by it, and if we hear it being paid lip service to, let's feel proud to quantify the true value of its existence.

Monday, 7 November 2011

'Birth Aunties'


I was fortunate to have been invited to the annual 'Gala Evening' fundraiser event for our university campus, last week.






It was a 'black tie' do and I found myself seated between a Professor (our host) and a Doctor of Education who I had not previously met, both highly intelligent, interesting and interested men.


Inevitably the moment came when I was invited (by said Dr) to define a doula.

"But surely that's the same thing as a midwife?" he responded, "What's the difference?"








So, after reiterating the emotional, social and practical - rather than the clinical - support bit, I tried something new:

"Kind of like a birth auntie!"



The conversation then changed to another subject. However, some fine wine and a good dinner later in the evening, as we paused between Raffle and Auction, the delightful Dr reflected this term back at me in perfect context.

Yay, he so got it! I was so impressed! And it made me reflect on the possibility of using 'Birth Auntie' as a way of describing the doula more often ...

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