Awéé’: the Navajo word for “baby”

I met Karen on Monday morning in Room 11 on the labor and delivery floor at the University of Utah hospital. I introduced myself and told her I was volunteering as a doula. “What’s a doula?” she asked. I replied that doula translated to “servant” in greek. I volunteered at the hospital supporting women in labor. I explained that I offered physical and emotional care, but not medical advice. I breathe. I massage. I bring in my positive energy and knowledge to the room. I witness birth.

“Would you like to me stay?” I asked. She nodded. “Yes. I’d like you stay.”

Her husband, Dan, sat on the couch and smiled. He didn’t say much. They were both very quiet. But not their seven year-old daughter, Teagan. She and her cousin filled the room with all the conversation needed. Excited for some fresh energy, Teagan peppered me with questions like, “What is your favorite animal ?”

“Polar bear” I replied with a smile. She reminded me of Sadie, my eleven year old daughter.

My conversation with Teagan was quick because her mom was contracting. I watched Karen take a deep inhale and close her eyes. She handled early labor calmly and with focus. I walked over to the side of the bed near her head. Quietly, I reminded her to relax her shoulders, jaw and fingers. After the contraction, I complimented her and offered her a sip of water. I noticed that throughout the entire contraction, her husband didn’t look at her. Preoccupied by the TV and his phone, he did not comfort Karen. She was basically alone.

I noticed that the word “unmedicated” written on the white board in her room. Intention set. Before the next contraction, I asked how labor started. Her water broke the night before and she didn’t contract much until arriving at the hospital at about 8 a.m. She was happy that her body naturally went into labor as the doctors were planning on inducing her the following day. Her due date wasn’t until the first week in November.

I asked myself: WHY?! Why all the indications at 39 weeks? Not knowing any of her medical background, I don’t know the reason. However, I am confident that were she induced, an unmedicated birth would be much more difficult. Not impossible, but likely more intense, and likely to lead to a cascade of interventions.

Karen was dilated to three centimeters when she was “checked” by her nurse at 11am. Agreeing that she was not progressing quickly enough, the nurse administered pitocin. Pitocin is a synthetic drug that acts like oxytocin, the hormone needed to contrast a woman’s uterus. With pitocin in her system, Karen’s labor intensified. She continued to handle each contraction methodically with breath and focus and my reminders to relax.

Around noon, Dan talked his brother on the phone. He was on his way to pick up the the little girls. I didn’t recognize the language Dan spoke. I asked Karen what it was. She told me that they were speaking in Navajo. “Are you Navajo?” I asked. She replied “Yes".

Cool, I thought. I am supporting a Navajo family. This is a first.

When Dan’s brother arrived, he didn’t say anything. He stood at the door and the girls scurried out of the room. Neither Karen nor her daughter said goodbye. Wow, maybe she is not like my daughter? Sadie would be ALL over me. A couple of hours later, Karen’s sister arrived and she walked in the room without acknowledging Karen. It was twenty minutes before they spoke. I think I was the only one who found this unusual.

Was their behavior cultural? I have nothing to compare it to. I can only imagine how the attention I gave Karen must have been over the top compared to what she was used to. Every contraction that she experienced, I reminded her to breathe and relax and I told her she was amazing. I know as a doula what kind of support is effective for a laboring woman: consistent and positive.

Karen’s labor was tough! She vomited, shook, and cried - all normal. I wrapped her in warm blankets and reminded her that her body knew what to do. Her transition from Stage 1 to Stage 2 of Labor - dilation to pushing - was textbook. She wanted to give up. She said she couldn’t do it. At one point she said that she begged for pain relief. The nurse told Karen that she could have whatever she wanted. However, by the time the anesthesiologist arrived, the baby might be here. Karen was close to the end. I appreciated how the nurse left all the decisions up to Karen. She decided to just keep going.

At 4 p.m., she said she felt like she needed to push. Dr. Clark, the OB on call was down the hall at the clinic and came into her room right away. She checked Karen’s cervix one more time and announced that she was “complete” meaning she was 10 centimeters. We arranged ourselves around Karen. Dan stood on her right side holding her hand. He was so sweet, whispering in her ear. Her sister stood next to him and I was next to her. A medical assistant and I held her legs back as Karen pushed. It was hard for me to hold on to Karen’s leg. She’s a strong woman. Holding the leg of a pushing mama who is not medicated is so different than a mama with an epidural. It’s like comparing the force of a gorilla to a monkey.

With every push, the baby moved down the birth canal. Karen only pushed for 10 minutes and her daughter was born.

I witnessed another miracle. Karen delivered her placenta without issue. The doctors told her that she did not need any stitches. She would be sore, but would heal fast. I have noticed in the past seven months of supporting births that women who chose an epidural generally need stitches. I have been thinking how the intensity of the pain of birth might be delayed by choosing an epidural. With an epidural, a laboring mama skips the intense pain during the labor, but the intervention of an epidural might lead to a more difficult birth. With a good epidural, a mom doesn’t feel much when the baby is delivered so there may be more intervention at birth which could lead to stitches in the vagina causing longer-lasting damage. I haven’t seen data, but this scenerio is on my mind.

When I said good-bye to Karen, she looked me at me intently. “Thank you.” she quietly said with her baby on her chest. “I couldn’t have done it without you.”

I told Karen that it was an honor to witness such strength. Her sister hugged me. With tears in her eyes, she too thanked me. I felt so much love in Room 11. A new awéé’ in the world!