“Culture influences birth on so many levels, through beliefs we hold about our bodies, our sexuality and our innate power,” says doula Nathalie Solis Pérez. She also looks at how the language we use to talk about birth affects how we perceive and experience it – and how, with the right language, our experience can be completely transformed. For example, take the word ‘delivery’. “It’s surprising that this term is still in use as it suggests that women are not active birth-givers but someone else ‘delivers’ their baby. Babies are not delivered - mothers give birth to them!” she says...
A mother of two boys – Dei, who was 10 weeks old at the time of this photoshoot and Pablo, 6 years – Nathalie grew up all over the world. She was born in Germany before moving to Guatemala, and later Spain. When she was older, she moved to the US before settling in Australia, where she now lives in the Byron Bay hinterland with her family.
With a background in cultural anthropology, Nathalie began her journey to become a doula after the birth of her first son. “To this day I feel so grateful to my midwives for creating the safe space for me to do the work I needed to do,” she says. And if she could change one thing about the Australian maternity care model, it would be for all women to have a primary midwife who cares for them during pregnancy, birth and postpartum. “Being able to establish a relationship with your care provider is so important, and research has shown that midwifery-led continuity of care is the safest type of care for most mothers and babies. Women who receive this need less interventions at birth, less pain relief and are more satisfied with their birth experience. It’s frustrating, exhausting and carries more risk if women receive so-called fragmented care and see different clinicians at each prenatal visit and don’t know who will care for them during labour. We are not meant to give birth surrounded by strangers, but instead with a team of respectful, caring, nurturing and supportive people which we have built a relationship with.”
You were born in Lübeck, raised in Germany, Guatemala and Spain, matured in the USA and Australia, and now live between Byron Bay and Berlin. What was your childhood like?
My childhood was spent growing up in northern Germany (which is where my Mum is from). What I loved about growing up there were the mild summers we spent swimming in the Baltic Sea and going for long walks through ancient lush green forests. The city I grew up in always felt very cosy to me due to its narrow cobblestone streets, buildings dating back a thousand years and old ships along the port.
Every year we would fly to see our family in Guatemala and my time there was spent playing with wild animals and absorbing all the tropical sights and sounds of parrots and monkeys, the smells of tortillas and black beans always on the stove. I loved the social gatherings and feasts my grandmother would put on and everything seemed to have a different kind of magic over there.
I went to primary school in Barcelona and have strong memories of the hustle of that city, summers spent in swimming pools, weekend drives into the Pyrenees to collect fresh spring water and visiting little Mediterranean villages for lunch.
These places I grew up in really couldn’t have been more different from each other but as a child, I just thought that was completely normal. My childhood is an eclectic mix of places, people, languages and cultures.
Do you see lots of differences in the maternity systems here and in Europe?
I think overall the birth systems are quite similar. In Germany, you have better access to birth centres and midwifery care. Hospital midwives often also offer acupuncture, homoeopathy and naturopathy, all of which provide additional pain relief for labouring mums. In Berlin, we even have an anthroposophic labour ward where women have access to both conventional medicine and naturopathy. They even make an effort to move all technology into the background so that mother and baby are really in the centre of attention.
Germany has slightly lower intervention rates than Australia, but both birth systems suffer from similar problems. High-intervention births are financially ‘rewarded’ which makes it less likely that a wait-and-see approach is adopted where labour can unfold on its own. Labour wards are often already under-staffed and lack of funding so this system makes it difficult to support physiological birth. Care by independent midwives (in the home birth and birth centre setting) is also under threat due to rising insurance rates.
You have a background as a cultural anthropologist and you've said that in your work as a doula you "derive inspiration from many different cultures and traditions". In what ways do you think culture influences birth and the postpartum period?
Culture influences birth on so many levels, through beliefs we hold about our bodies, our sexuality and our innate power for example. The language we use to talk about birth also affects how we perceive and experience it. Take the word ‘delivery’ for example. It’s surprising that this term is still in use as it suggests that women are not active birth-givers but someone else ‘delivers’ their baby. Babies are not delivered – mothers give birth to them!
Culture also influences the way we perceive the postpartum period. In Western societies, this time is seen as a time of transition, but it does not have the same significance for the woman’s future health, strength and wellbeing as it does in countries such as China, Japan or Latin America for example. These cultures have more practices in place to honour the ‘First Forty Days’ after birth. We can learn so much from them in this regard and I think it’s important for mums to know that their need for rest, recovery, healing and nurturing after birth is so valid. It’s hard to live in a culture that does not fully acknowledge this as it makes us feel as if this adjustment should be easy, but without the support of our community and culture, it certainly is not.
Your first birth inspired your transition to becoming a doula. What was that birth like?
I gave birth to my first son Pablo at home after a beautiful and calm five-hour labour. It was beyond anything I had ever hoped for at the time and that sense of empowerment I felt after birth has stayed with me ever since. I loved how labour and birth was simply a natural part of our day together at home. This feeling of homeliness made me feel safe and enabled me to find my way of coping with the rising intensity and pain of the surges. I love thinking back of the moment where I talked to my unborn baby assuring him I was ready and would follow him wherever he’d lead me. I knew I had to give myself over completely to this process so that labour could unfold smoothly and quickly. An hour later he was born and to this day I feel so grateful to my midwives for creating the safe space for me to do the work I needed to do.
Did you choose to do anything differently for your second birth?
During my pregnancy with Dei, I invested a lot more time preparing for breastfeeding and postpartum as I knew this would be challenging again for me. With my first, I had such a hard time breastfeeding and was in tears and ready to give up on day three after birth. At the time I didn’t know that lactation consultants existed which would have really helped me as I was trying to breastfeed a tongue-tied baby which caused so much pain and lead to recurring mastitis infections. I did not want to go through months of pain again with my second, so I started preparing for breastfeeding in late pregnancy by working with a lactation consultant and coming up with a plan. It was so worth it and although breastfeeding has been difficult again, I was able to push through all these challenges with the help of my support team. To prepare for the postnatal period my partner André and I had a postpartum planning session in pregnancy with one of our doulas which was amazing. Having a plan for this period is a great way to make this transition as smooth and enjoyable as possible for your family.
You've referred to the mother's partner as the 'postpartum manager'. Tell us about the importance of this role?
After birth the partner’s role is to keep something cooking on the stove, put the phones on silent, ward off or let in visitors, look after older children, put on the laundry and bring the mother water, food and snacks or whatever she might need. Keeping everything running smoothly and freeing the mother from all her usual chores is key to ensuring she can fully recover from pregnancy and birth, learn how to breastfeed and bond with her baby.
Traditionally a female relative would have moved in to provide this type of support but nowadays the partner often needs to fulfil this role whether by choice or necessity.
When it comes to birthing and postpartum, do you follow your own advice? And do you hire a doula?
Yes, absolutely. Everything I teach I also applied to my own pregnancy, birth and the postpartum period. André and I had several doulas and midwives supporting us through our journey this time around which has been wonderful.
In pregnancy and birth we are all equal and even though I am a birth doula I need as much support as any other mum going through this life transition. I realised that as birth professionals we sometimes need to work even harder to get out of our head and back to a place of trust and surrender as we embark on this journey ourselves. Because I’d been to so many births and seen so many things, I constantly needed my doula’s and midwife’s reassurance that everything was ok and would be fine, and that other people’s experiences had nothing to do with my own. It was a really beautiful experience to be on the receiving end of this type of support and just reaffirmed its value to me.
What do you think we could learn from traditional 'village' models when it comes to the postpartum period?
We could learn the importance of surrounding the newborn family with community support in the first forty days after birth. Organising a ‘meal train’ or some sort of meal delivery, or for someone to come in and cook is so helpful. Looking after the mother is looking after the baby. She is giving to her baby 24/7 so she needs to be cared for too. The newborn mother might need a shoulder to cry on, nourishing and warming foods and drinks, a massage, a chat, someone to tend to her older children, someone to hold the baby so she can rest or have a shower. No traditional culture would ever leave a mother with a newborn baby alone, but in our Western culture, this is considered normal once the partner needs to return to work (which is often after two weeks). In the ‘Fourth Trimester’ (the first three months after birth) no mother should be without the support of her community. It’s a very vulnerable and significant time for the future of this family. So we can learn a lot from traditional cultures who have always known this and put practices into place to ensure there is a circle of support around the mother and baby in the first forty and sometimes even the first hundred days after birth.
What's the number one thing you think women can do to prepare for birth?
Understanding the concept of Spinning Babies and Optimal Fetal Positioning during pregnancy. If we want an optimal birth experience we need to become proactive about ensuring our body is in an optimal state of health, balance and alignment. Gail Tully introduced this paradigm into the birth world to teach mothers how to create balance in their body to bring comfort and ease to their pregnancy and birth. Simple exercises and techniques can be applied to create more space in the pelvis and lower uterine segment so baby can settle into an optimal position for labour. Many issues in childbirth are due to fetal malposition, so this knowledge is vital to have during pregnancy but not something that is commonly shared by our care-providers. Many interventions and Caesarean births can be prevented by applying this knowledge in pregnancy. This approach is all about using balance before force and while there is no magic formula to help all women to have a physiological birth this has been helping many women. Optimal Fetal Positioning is enhanced by receiving regular osteopathic care throughout pregnancy and research has shown that this has benefits for all pregnant mums, not only the mums with posterior or breech babies.
What's been a career highlight or a favourite birth you've attended?
Every birth I attend is a highlight. I mean how could it not be? Seeing parents meet their baby for the first time always makes me cry, every single time. It’s always an absolute miracle and something so special and powerful to witness. I feel incredibly privileged to be invited into the birth room by my clients and feel honoured to serve them during this most pivotal time in their life.
My career highlight was to learn from Dr Michel Odent and Liliana Lammers, his doula friend of 20 years. They embody such a wealth of knowledge, wisdom, inspiration and their candid humour is refreshing. I have learnt more by spending time with them than I have in any other training. They instilled in me an unwavering faith in our bodies, the birth process, and our sovereignty as birthing mothers. I feel so grateful to have been able to spend time with these luminaries of the birth world.
What's the most challenging thing about your work?
Definitely the night shifts, and the unpredictable working hours. Especially while also juggling family responsibilities. I couldn’t be a doula without the full support of my partner, as I might head to my client at an hour’s notice at any time of the day or night, so both of us need to be organised. We’ve become an amazing team over time, but it’s challenging to not know whether I’ll be home in three hours, or two days.
If you could change one thing about the Australian maternity care model, what would it be?
It would be for all women to have a primary midwife who cares for them during pregnancy, birth and postpartum. Being able to establish a relationship with your care provider is so important, and research has shown that midwifery-led continuity of care is the safest type of care for most mothers and babies. Women who receive this need less interventions at birth, less pain relief and are more satisfied with their birth experience. It’s frustrating, exhausting and carries more risk if women receive so-called fragmented care and see different clinicians at each prenatal visit and don’t know who will care for them during labour. We are not meant to give birth surrounded by strangers, but instead with a team of respectful, caring, nurturing and supportive people which we have built a relationship with.