Effort and surrender

There is a yogic principle regarding effort and surrender (the yogic terms are Tapas and Ishvara Pranidhana, and the words "effort" and "surrender" are two simple translations) that I believe applies directly to birth as well as to our larger life journeys. During pregnancy, we make an effort toward health by eating and drinking appropriately (lots of water and healthy meals and snacks), getting enough rest and exercise and preparing for the birth itself. Our effort in the preparation of birth should include reading positive birth stories, making informed choices about our health care providers and the "where" and "how" we choose to birth, and visualizing (or meditating on) our peaceful and healthy birth. By making this effort of educating ourselves of the realities of birth in this country, we are then able to feel confident in the birth itself. It leads us to the ability to surrender to the power of birth.

Surrendering to our body's innate wisdom of birth is the only way to have a peaceful birth. Of course this doesn't mean that labor and birth will necessarily be easy, but we can work peaceful from a place of trust and knowing. Labor is so instinctual, so primal, and so out of control of the rational mind that the only way we can birth is by surrendering: surrender to the body knowing how to do this work; surrender to the baby knowing how to do this work; surrender to the currents of energy that help to open the cervix and bring the baby down and into this world.

If we don't prepare for birth, if we hold fear or if we let others choose how we birth, it is impossible to surrender to that flow of energy and the wisdom of the body. There are many birth and doula books that encourage women to create a birth plan, imagining exactly how, where and when she wants to birth, and then they go on to say, "but don't get too attached to your birth plan because birth is so unpredictable." On the surface, this is an example of the effort and surrender model. However, there is one woman, Cynthia Gabriel, author of Natural Hospital Birth who disagrees. She says we should be attached to our birth plan because too often birth professionals, while their intentions are good, are not you. They don't know your body with the intuition and wisdom that you bring to the experience. They don't know how strong your resolve is for a natural birth. They don't understand the experience that you are trying to create. They don't know how strong you are. The pressure from hospital staff can be so great in trying to do something the "help" the labor, when what is often required is patience and surrender. So here comes the third piece of the yogic wisdom; we must use self-study (Svadhyaya) to discern when effort is required and when surrender is required.

We must have faith in the body's power and wisdom. When we can fully embrace the power that is inherent in birth, women will know their true power in this world.

The doula

The benefits of labor support to the mother and her family
Studies have shown that having a doula reduces the length of labor, reduces interventions and the cascade that leads to C-sections, reduces the length of hospital stay and ultimately lowers financial costs (to insurance providers). A better birth experience also leads to quicker and easier bonding and breastfeeding, and lower rates of post-partum depression.

The purpose behind providing labor support
Traditionally and for centuries women have supported other women in the process of birth. Quite often two women support the mother. They provide physical, emotional, mental and spiritual grounding. A woman in labor needs a safe, quiet, peaceful place so that she may become calm, relaxed and withdrawn. When she is able to access this place, interventions are unnecessary and birth comes sooner. Who would think to let a sick person heal themselves alone? And in the same vein, when did we come to the conclusion that women should labor alone? In a society where the bottom dollar is what drives our decisions, we can also justify women supporting one another in this sacred and intense right of passage by saying that labor support also reduces financial costs for the family and to some degree the hospital.

The doula’s role
There are a variety of roles for a variety of people during labor. One role is the physical support of birth, ensuring the safety of the mother and baby. In the majority of births in the country that looks like a computer showing the baby's heartbeat and the "strength," duration and frequency of contractions. That is, of course, important, and they should be attended to in a way that is least invasive. The other element of physical support is encouraging and physically assisting the position of the laboring woman. Hospital staff (nurses primarily) do this, but generally with the intention of making their work on monitoring, viewing and catching easier. A doula's role here is to physically assist with positioning with the intention of making the mother comfortable and creating space for the baby to do its work.

Another, equally important role for labor support is emotional and mental support. Since a doula is with the laboring woman continuously throughout the process, a sense of stability and easily flowing energy are created. The woman's partner is also an energetic player in the event of labor, and a doula can create continuity and stability for the couple. Emotionally, a doula can help calm fears, reinvigorate the process, or create a grounding energy for the laboring woman to go into herself. To some extend a doula's presence should be so calming and reassuring that she becomes invisible (so the mother doesn't feel like she is performing) or second-nature (so that a mother feels comfortable asking her anything).

The doula’s responsibilities
The most important responsibility of a doula is continuous presence. A mother or couple may give her the responsibility of physical comfort (massage, pressure to the hips or back or head, movement), or they may decide that the doula is there more for mental reassurance (calming fears, helping to communicate with care providers), and some may just ask a doula to "hold space" and be a calming presence in the midst of effort, pain, technology and other people's expectations.

Empowered birth and the future of society

When women can birth freely, without fear and in the way that they choose, birth will be peaceful, providing the framework for peace and joy in the family and in the larger world. It really is that important and that far-reaching.

For centuries men have been dictating how women use their bodies, mostly in the service of men. We have been told both that we are lustful sinners and that we are delicate, pure, sexless angels. Both are myths created to deny women their true feminine nature which is strong, compassionate and instinctual. We are wild and mysterious. And of course we are sexual.

There is a cosmological view (to use the words of Jeanne Achterberg, author of Women as Healer) in the Western world today that supports a hierarchy of man superior to woman, but that woman is more connected to the earth (as in Mother Earth or Earth Goddess). She says, "for this and other complex reasons, women, and what is typically regarded as the feminine perspective, bear the brunt of ecological stresses. The fate of woman and the fate of the earth are inseparable, perpetually linked by the metaphors of woman as nature and nature as female." Therefore it is our imperative as women to reclaim our divine feminine power, principally through our power of birth, in order to bring about the shift toward peace and the survival of our planet.

11. Write an essay (500-1000 words) on The Purpose and Value of Labor Support
The essay must be typed and double spaced.
The Purpose and Value of Labor Support Essay should include:
a. The benefits of labor support to the mother and her family
b. The purpose behind providing labor support
c. The doula’s responsibilities
d. The doula’s role

The essay will not be accepted if the doula only addresses her personal reasons for
becoming a doula.


The DONA International Birth Doula Position Paper, Standards of Practice and Code of
Ethics should be referenced when writing this essay. Please include the benefits of doula
care, as shown by current research.