How to survive a long birth as a doula

When I started working as a doula, one of my biggest fears was: how will I survive the sleep deprivation of a long birth?

The universe was kind to me, because my first birth was a text book, 12h long easy birth centre water birth, I came back elated and full of joy!

And overall, during my first year as a doula, I never had a marathon birth.

True I supported a birth that lasted 2 nights, but as the labour ebbed and flowed and we were at home for the longest part of the labour, I managed to have naps and even went home for a couple of hours, so I wasn’t beyond exhaustion.

My first marathon birth happened about a year into my doulaing. My client waters broke with no contractions, she declined induction. So before labour started, there were a couple of interrupted nights with phone calls etc, until I eventually joined her at home 2 days later. This was followed by 40h of labour-spanning a whole week-end and 2 sleepless nights.

I had no idea that I needed to pace myself. I had no idea inductions could last this long (I know now!), so the first night I didn’t sleep at all, and the second day I didn’t function very well at all.

I had no idea until then how lack of sleep affects your mood for the worse. When after about 24h (it was in the middle of night) the midwife announced that she was only 4cm dilated, I had to go into another room to cry, and I beat myself up for it.

I had no idea moods ebbed and flowed and that after the dark night of the soul (usually around 3/4 in the morning when your body temperature is at its lowest), my mood and energy would lift again.

I had no idea I should make sure I ate and drank at regular intervals.

I was pretty crap at looking after myself.

By the second day I was falling asleep on the chair I was sitting on without even meaning to. And whilst I waited for them in recovery, I fell asleep on a trolley.

When I got home after the birth, and had slept for 12h, I still felt very crap and also very weepy and again didn’t understand this was just caused by the tiredness (I felt OK about the birth).

Since then I have attended many long births (though none were I was present for quite as long as this one). One year pretty much all the births I attended were between 24h and 37h long-which is pretty standards for first time mothers.

So what I have learnt, and how do you look after yourself during a marathon birth as a doula? (I wrote this for my doula colleagues, but if you’re a birth partner, much of it applies too!)

First, talk to the parents about it antenatally, so you don’t feel guilty worrying they’ll think you’re a crap doula when you take a nap. I explain (especially with first time parents) that first time births can take anything between 24h and 48h and that’s normal, and I talk about how to manage the early stages (basically try to ignore it until you can’t). I also explain that I will take naps in order to be at my best to support them, and I’ll also encourage dad to sleep too (we can tag-team). If you can’t sleep, doing some relaxation/meditation/deep breathing/ being quiet in the corner for a while will help as well.  This is well worth practising ahead of time as you get better at it the more you do it. And if you’re trained in energy work, like Reiki, a self treatment can really help.

Second-pace yourself. I might go to reassure the parents in early labour, then go home, or sleep on their sofa/their spare room, during the early stages of labour. I’m also more relaxed and much better as waiting than I was in the early days-but I guess some of that just comes with experience. The good thing is, I’ve learnt to doze and sleep pretty much anywhere. It’s much easier in someone’s home by the way, where there is soft furnishing. If in the hospital, I might ask for a mat and curl up and sleep on it for a while. I fold my rebozo and use that as a pillow, and I have a nice warm shawl to use as a blanket in my bag to cover myself with. I never turn down the opportunity for a little sleep, because it can be difficult to guess how long I am likely to be there for, so I would rather prepare for the long run just in case (and mentally it’s easier to be prepared for this and then be pleasantly surprised than the other way round). Even a 20 min catnap can make a huge difference!

Third-stay hydrated/fed. Make sure you have good nutritious snacks in your bag. Junk food won’t cut it. I have a collapsible water bottle which I fill as soon as I arrive in hospital (hospitals are very dehydrating) and I chuck a rehydration tablet in there too (I like the brand Nuun). I have some good quality nuts/dried fruit and energy bars. And some dark chocolate, and good quality instant coffee (instant coffee in hospital is vile)! Oh and when I get really tired I drink some Guronsan (a French effervescent tablet made from caffeine, sugar and vitamin C-you can buy it in the UK too. I guess it’s a bit like red bull but in a much more portable format). I also have a couple of energising rollon essential oil bottles and sprays-made by 2 doulas I love, when I use them it feels like they are kind of with me in the room giving me a hug (you can get them here). If you get the chance to go grab any kind of proper food (for me, getting something hot like soup etc hits the spot) during the birth-do that!

Fourth-Look after your body, do some stretches, go for a walk, get some fresh air. If the birth is going on for a very long time, I get cabin fever. So going to the toilet and splashing water on my face (I go to the outside toilet even if there is an ensuite for example, so I get to stretch my legs), going for a walk,  getting  a cup of coffee (I encourage the dad to do this too), can leave you feeling refreshed. Similarly, my rebozo has also come to great use to soften stiff shoulder muscles when I have been in the same position for a long time (see my video on how to do that here)

Fifth-be kind to yourself. Don’t beat yourself up, accept the low moods when they come (they will!), because berating yourself will waste precious energy. You’re only human and you are doing the best you can and making a huge deal of difference by just being there. If you need to exit to have a good cry, do (the toilet is a good place for that). If you can call a doula sister for a pep talk, do that.

And finally, sometimes I worked in a shared care team with another doula-it can be absolutely priceless to be able to tag team if the birth goes on for a really looooong time.

Remember-this isn’t selfish, because you cannot be your best at supporting parents through a long birth if you’re dehydrated, starving and exhausted. I also find it really useful to explain this to partners antenatally, because they too, tend to be crap at self care whilst supporting their partners through labour, and to worry that they are being selfish if they need a break/some food/a nap etc.  By explaining this and modelling this behaviour, we help them too.

So there you go, my guide to surviving long births. It’s quite simple really. This is what works for me so far, it doesn’t mean that it necessarily will be what works for you-do experiment and find out! I would love to hear tips from others too 🙂

If this resonates with you and you’d like to work with me-head over here 

 

PS: A comment also reminded me-although this is more likely to be the topic of the next post below, that if you are seriously sleep deprived-do try to make safe choices as to whether you are able to drive home or not.

PS: This is only half of the story-I’m planning another post called “How to recover after a long birth as a doula”

 

 

 

  1. Katie Olliffe on March 1, 2017 at 10:10 pm

    Great blog, great tips and reminders! – I love birth support but I do dread the potential of a very long birth – I have attended 3 incredibly long birth journeys – 1 of which I had you on the phone pep talking me! I remember how important that was – to have a good swear with someone else that truly understood!! Ha ha!

    • sophie on March 1, 2017 at 10:16 pm

      Thank you Katie :-). and yes it takes a doula to understand. I too have valued pep talks during long births!

  2. Linda Sharples on March 1, 2017 at 11:33 pm

    This is really really helpful. I’m new and really dreading a long birth wondering how I will ever have the stamina, especially because I am 58 so older than lots of doulas! I have evn wondered aboit never taking first births.

  3. Bridget Baker on March 2, 2017 at 9:48 am

    Good one Sophie! Just wanted to add that Sainsbury’s do a decent Colombian coffee in sachets that contain a little individual filter which you hook onto the cup. Soooooooo much better than instant. Comes in a green and purple box, taste the difference range. Perhaps I’ll bring some to the conference!

    • sophie on March 2, 2017 at 9:49 am

      good tip, Bridget, I’ll check it out!

  4. Selina Wallis on March 2, 2017 at 10:43 am

    Great tips Sophie. I would also add, if possible make use of a mentor/buddy if you are feeling low and need to debrief , or just unload during a long birth (rather than using the forum which may not be ideral due to confidentiality). Consider alternative ways to get home if you are feeling very tired after a long birth and if birth is long, consider malposition and support women in ways to resolve malposition if they feel able to https://magicalbirth.wordpress.com/2014/11/24/prolonged-latent-labour/

    • sophie on March 2, 2017 at 10:57 am

      Yes- a very important point-in fact you inspired me to write a second instalment to explain how to recover once the birth is over 🙂

  5. Renske on March 2, 2017 at 11:02 am

    So, was the woman induced anyway in the long run? Because you write that you didn’t know that inductions could take this long…

    • sophie on March 2, 2017 at 11:27 am

      yes. What I meant was at the time I didn’t know that even when a woman’s waters have broken and an infusion of intravenous syntocinon is started, it can easily be another 24h until full dilation is reached.

  6. Ann on March 2, 2017 at 1:43 pm

    Struck many chords reading this – accompanying my daughter on her labour and birth marathon was similar. My first call was on Wednesday morning and the baby finally appeared on the following Sunday evening. We had 4 days and nights at home and 18 hours in hospital. When the decision was finally made that her cervix was never going to dilate beyond 3 cm nor the baby come down into the pelvis – I went home to freshen up and get her a bag. Driving back to the hospital I wrote off the car – and almost myself – as I drifted off the road and into a signpost. I don’t think I actually went to sleep – but I was definitely in a state of altered consciousness and just didn’t follow a bend in the road. Beware doula driving when exhausted.

    • sophie on March 2, 2017 at 1:47 pm

      oh how scary, Ann! And yes it is a stark reminder-will add a line to the blog about this

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