Exploring Our Minds and Bodies.

Childbirth Educator, Birth Doula, and Lactation Educator

I recently sponsored an A LACE Labor Assistant workshop in Santa Cruz, California. Beyond affirmation of what I do and a few new tidbits, I expected that the workshop would be more of a rejuvenation for me than a learning experience because I had already been working with women in birth and breastfeeding for about 20 years. I was so wrong!

We had a great mix of women both in age and experience, from their early 20s to their 40s, and from currently practicing labor assistants/doulas to those who had never seen a birth (except on video). All the women were very open to learning and sharing, so things were going along without a hitch. The only issue for me was the upcoming vaginal examination exercise--hands on.

The vaginal exam exercise loomed in my mind all weekend. I knew it was approaching and I was nervous about how I would handle it--both giving and getting the exam. I have only felt one cervix in my lifetime, my own. Although I am very familiar with what my cervix feels like in pregnancy and at various times in my cycle, I had never had the opportunity to feel someone else's (and really couldn't imagine a situation where the opportunity would come up!).

We spent the first two days getting to know each other and talking about birth and situations, and ways of helping women during labor. On Sunday morning, as we prepared for the exam, the nervous tension in the room was almost palpable! Lots of deep breaths and nervous jokes. Then it was time! The room was secured, and the half of us getting the exam lay down forming a wheel with our legs as the spokes and our heads together at the center of the circle. The women about to perform the exam sat at our left or right sides and donned gloves, using sterile technique (many for the first time) and when ready, we began.

Getting the exam felt very safe. I couldn't imagine ahead of time that I would feel so comfortable, but the way that Ilana Stein, the ALACE instructor, facilitated the exam, talking us through each step, was just perfect. Seeing the look of wonder and discovery on the face of the woman examining me was unexpected. I felt honored to be giving her this experience as she explored and compared what she was feeling to what she knew about her own body.

Then it was my turn to give the exam. It was so incredible to have someone in such a vulnerable position put her trust in me and open her most private self to me. I can't explain how empowering this was. Then to try to identify what I was feeling inside her, without benefit of the reactive touch that I have with my own body, was a real challenge. Feeling the birth passages of a woman who had never been pregnant reinforced the knowledge that our bodies have the miraculous ability to embrace and accommodate a birthing baby.

Imagining that each woman must feel the same and yet uniquely different inside gave me more respect for the nurses and doctors that I have worked with as they have tried to determine what was going on inside a laboring woman. I also had a new respect for sterile technique and how to not interfere with sterile fields (and the challenge of not scratching your nose when wearing a sterile glove).

To me the whole experience of the vaginal exam was very similar to how I felt after doing a ropes course. The same nervous anticipation that I would not be able to do it, doing it in a totally safe way, and then feeling the welling of empowerment that I had done this scary new thing when I could have just as easily opted out (since there is always a choice not to do the exam).

Even though I haven't in the past done (and don't anticipate doing) blood pressure checks, vaginal exams, palpations, etc., in my doula practice, this hands-on experience has given me a new knowledge and respect for the parameters of these skills. I feel more in touch with a woman's body and its vulnerabilities and capabilities. For a woman who wants to be a labor assistant or doula and has not yet given birth, the vaginal exam exercise gives her a small sense of the vulnerability one feels in labor and the trust that the mother must put in her doula. This experience will remind me to create and maintain the same safe atmosphere for a laboring woman.

The vaginal exam experience at the ALACE workshop is comparable to taking a ride in an airplane and holding the controls for a moment. It's not about learning and perfecting a skill. It's about exploring our minds and bodies. The vaginal exam at an ALACE workshop may easily be a once in a lifetime opportunity. It can have a great impact on your work with women; if you have the opportunity to participate in an ALACE Labor Assistant Training Workshop, I encourage you to go for it.

Publisher's Note: The ALACE Labor Assistant training workshop includes a series of experiential exercises to provide a hands-on learning experience. One of these exercises, the vaginal examination, is an optional activity. It is designed to help participants provide educated, comprehensive support to laboring women and their families through understanding the procedures that midwives, doctors, and nurses use to assess the health of mothers and babies during labor. For more information on the ALACE Labor Assistant Certification Program please call the central office at 617-441-2500.