Choosing to believe in myself
getting my 'Red Tent Doulas' certificate; and on being my whole self and that being exactly what was needed
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I am so hugely grateful to you for being here.
I have been supporting parents through their early postpartum for almost ten years now. Since I trained to be a babywearing peer supporter back in October 2014. I volunteered with my local sling library for many years after this (they now operate out of the women’s health hub - how magic is that?!) as well as regularly attending my local breastfeeding group. I set up Postpartum Matters CIC in 2022, following a really difficult postnatal recovery with my second baby in 2020 (you can read our full origin story here) and trained to become a postnatal doula in the autumn of that year.
I have lost count of the number of women and families I have held throughout this time. Not counting the number of people I will have unknowingly impacted and helped through my always honest depiction of the postpartum period online (and that one time I spoke about my labia on BBC Radio Two!). I see such value in having physical support during this time - someone to hold your baby when you’re feeling touched out and overwhelmed, someone to put on a load of laundry, to make you a warm, nourishing meal, perhaps to run a hoover round or to give your kitchen worktops a quick wipe down. But also, I think it is hugely beneficial to have someone to talk to. Someone who has been trained to listen and to hold space. Someone who will support your choices, provide you with evidence based resources and someone who will listen to you and reassure you that you are not crazy. Someone who will sit with you in the hard.
Many of the women I have met have had quite difficult births. A lot of my listening work is unpicking that with them. Providing them a space to see the whole picture, to see their power and their strength and to reframe their experience from the failure it has been painted as by their care providers.
However, I knew from my own births, as well as from reading and research, that labour & delivery did not have to be that way for people.
I knew there would be a benefit to holding a woman throughout the entire perinatal period. Indeed, there is now solid research to show that having doula support through pregnancy, birth and the immediate postpartum improves outcomes.
And yet, I always held off on becoming a ‘full spectrum’ doula. A doula who attends and supports births, as well as working with a person through pregnancy and postpartum.
Honestly, I was never confident that I was up to the task. Even after I decided to go for it and train to become a full spectrum doula. Even following my in depth training weekend with Red Tent Doulas, (you can read all about what that involved here ), I wondered if I could do it.
If I wasn’t ‘too autistic’.
‘Too disabled’.
I wondered how I’d manage complex hospital environments and advocating for my clients when I sometimes struggle with communication and find it quite tiring.
I wondered if someone else would be better.
I supported my first birth at the end of January and I used that experience to write my ‘final piece’ - an assignment of sorts which is meant to highlight my learning and journey as I learn to be the best doula I can be. You can read the full thing below. I think it answers some of the above questions.
I have more births booked this year and I am so grateful I chose to go for it. To believe in myself. To believe that I could do it, in my own unique and much needed way.
And I hope this story can inspire you to believe in yourself.
To do the thing you most dream to do.
You are already so capable.
I believe in you.
Doula final piece
For my final piece, I would like to explore the ways in which my autistic identity influenced my birth experiences and, in turn, intertwines with and influences my doula practice, and my space holding practice. I did not know I was autistic when I birthed both of my babies.
When you discover you’re autistic at the age of 31, you have to go backwards over your life, excavating all of your precious and hard memories to see where the not-knowing had an impact. I entered the Red Tent just seven months after my knowing and so, with this, I had already done quite a bit of the reflective work asked of me in that space. I had already gone back over my births, my postpartums, my journeys with a fine tooth comb.
To find all of the ways in which neurotypical me would have fared better.
I could tell you that nothing that bad happened. I could tell you how I’d never set foot in a proper maternity unit and how I’d never slept on a shared postnatal ward. But I could also outline to you, in detail, the meeting with the HoM and the patient liaison lady and the gynaecologist’s secretary where every other sentence started with ‘a failure in communication’. It’s relevant and important because 80% of autistic women will still be undiagnosed by age 18 and because there are no statistics or knowledge of how many autistic women die in the first 6 weeks following birth compared with their neurotypical sisters. This isn’t to minimise the struggle of our Black sisters. Of our Brown sisters and of those who find themselves living in less affluent areas. It is simply to state that things quickly become sticky when you cannot easily see the difference that creates your oppression.
It is all too easy to pretend to be the privileged white lady all the while not having a clue what is happening to you, despite the best efforts of those around you to explain.
It is all too hard to safely navigate care when no one on your care team quite speaks or understands your language.
They feel like simple things - small things. I can see how you view that. The candle who’s low batteries are causing a flicker and the drip drip of the tap and the way the hot water you place in the pool burns up my body as you work to raise the temperature ready for baby. I know you think that you are whispering. I know you think that it is important, to check my vitals and press the cold jelly hard into my tummy to hear the fast loud beating heart of my infant but is it less important than a well regulated birthing mother? I know you have never stopped to consider that - why would you? It is only a small thing. A simple thing. Every 15 minutes leaving never enough time to come back down to earth. It all easily becomes too much and that too muchness makes it hard for my ears to listen to your words as you explain and for my brain to form answers that my lips will shape into words for you to see me. I cannot advocate for myself if I cannot understand what I am advocating for -
Or against.
The big problem here, as I see it, is that there is no way to describe to you - as a practitioner - how I experience the world and what it is I need from you. As a late diagnosed autistic woman, I really have no way of fully knowing myself, what it is I will struggle with, what it is that will help.
There are no research papers. No specifically designed care pathways. No activist groups specifically fighting to make this better.
This is not an issue solely in reference to maternity care but it is true for all of the womanly transitions of life - menarche, menstruation, menopause. The entirety of the autistic female experience is piecemealed together from shared stories and personal incidences. Yet-to-be-examined, and finely explored under the gaze of male science and population statistics. I don’t have any more answers than you have.
And you meet one pregnant autistic woman and you’ve met one pregnant autistic woman.
So singular stories are not necessarily powerful. What we need is large population studies that may pick up on trends and common, shared experiences. What we need is for people to help us. To take the time to begin to understand.
I may not have the answers here, but, what I think I do have is that feeling that I may be ‘of use’. Neurodivergent folks understand each other - and neurotypicals - far better than neurotypical people understand us. And so, perhaps, my role here is less hands on heavy touch massages and more translator. For them - to understand you and your needs and for you - to understand what it is that their graphs and charts are telling them, what it is that they are wanting to demand of you.
Living your life on the outside of social interactions makes you awfully good at picking up the subtext - despite what the DSM says. The needs that aren’t being spoken or met. Being so unseen makes you awfully good at seeing others - despite what the DSM says - and these are all things I think can go a long way to me being the best kind of doula, the kind of doula I hope to be for the women I serve.
I want to finish with a poem. I find writing words regulating. They help me process difficult or challenging or complicated experiences and feelings. They help me to remain calm. Sometimes, oftentimes, the answers that were blurry will come forth to the surface.
I began to write this poem as we grappled with the latent phase in the midwife led unit. I finished it, days after, cuddling my own babies and reflecting on the sofa to a background of Bluey and Peppa Pig.
I hope it serves you to somewhat understand.
A poem for Hev
I don’t mean to always bring it back to this one specific thing but it feels important and I guess that’s why it’s Autistic mother, Autistic woman, Autistic doula and not ‘mother with autism’ or ‘doula with autism’. Because it matters. It was different to how they said. We did not touch. Not once in the seven months prior to us entering the birth portal - together - and not during. Not much. Save a wet cloth on your forehead and that one time I rubbed your back and reminded you that you could do it. There was never a need. Instead reminding you - out of sight, out of mind - instead - how you might move your body and sway and maybe pillows under head will feel good? I held you not with hands but with knowing your needs your sensory preferences and shading you as best I could from the timelines and the beeping and and the expectations There is no rush. Take all of the time you need to fully hear and fully feel and fully think to fully process and fully move and fully open. I worried before that I would not be up to the task. Of bright hospital lights and long days of little sleep. Driving in the dark. There are many reasons why I would not be the best woman for this particular job. When I can’t drive in weather - snow rain, wind and - when it becomes hard to be verbal after a few short hours of speaking. When I can’t do ‘horizontal resting’ not least in a room that is not my own and can’t remember to care for myself in the thick of your opening. Disabled. But I did it and I watched you and I held you and I reminded those harsh hands where they were not to touch and I re-dimmed the lights and I realised that, perhaps, in truth, a different kind of brain takes a different kind of space holding. That, perhaps, in truth I am the exact woman needed for this particular job. Thank you for teaching me my true value here. Outside of the social media fairy lights and deeply in the thick of your personal need.
Further reading
Addressing inequity and inequality within maternity services for autistic women
By Karen Henry Midwife and lecturer, Suffolk, UK
National Autistic Society - Supporting pregnant autistic people
If you found this post helpful, I’d love it if you could share a reflection in the comments or if you could share this post with a friend. Thank you so much x
Sending love, till next week,
This was beautiful, Zoe. It made me tear up a bit.
Ahhh this was so amazing to read… what a gift you are to all those who you will support in birth and beyond. Celebrating you for taking the leap into unknown territory. Xxx