As a doula – a woman who supports women in labor – Maich Gardner deals with birth on a regular basis.

On any given night – "it's always the middle of the night," she laughs – she may get a call from the Women's and Children's Health Unit (WACHU) at Cheshire Medical Center that a woman in labor needs some support.

Gardner will splash her face with cool water, arrange her hair and put on her "birth duds" – sweatpants or leggings and the purple cotton shirt with the doula logo. She will grab her bag – always packed and ready by the bedroom door -- containing a change of clothes, citrus and lavender essential oils, a satin eye bag, raisins and walnuts, a notebook, a disposable camera and more. She kisses her husband good-bye, not knowing if she will be gone a few hours or several days. Within 15 minutes, she is out the door and on her way to the hospital.

"Helping escort life into the world," she calls it.

But nearly two years ago, Gardner found herself in what would seem to be the opposite place – attending to her mother's death.

When her 94-year-old mother was dying in Kerrville, Texas, Gardner and her sister, Karen Johnson, stayed with her for the last two days of her life. They slept in her room, held her hands, stroked her face and sang hymns to her for hours from a Methodist hymnal – "those wonderful old Christian hymns," says Gardner, such as "Onward Christian Soldier" and "How Great Thou Art."

"These were songs we grew up singing and listening to," she says. "My mother would sing around the house, when she was doing dishes – she'd just sort of burst into song. I was struck with how much singing had been such a part of her and our life."

The surprise for Gardner was that this experience of attending at her mother's death was not so different from the more familiar doula experience. "It was like being a doula at the other end," she says. "I was escorting a life out instead of escorting one in."

That Gardner, 58, was able to travel this final path with her mother – a mother she had not always felt connected with – is a testament to how far she's come from her traditional, conservative Texas background and to the work she has done to know herself and allow herself the freedoms her mother never knew.

'Unequivocal support to the laboring moms'

Gardner's mother had wanted to become a nurse, but her family wouldn't let her and she "always regretted that she didn't have the courage to stand up to her parents." The irony is not lost on Gardner, who did stand up to her mother and left Texas and her traditional upbringing and, while not a nurse, works side-by-side with nurses as the coordinator of the volunteer doula program at Cheshire Medical Center. Five years ago, she left a 14-year stint as an environmental educator at Antioch New England College to take up the ancient and challenging profession of assisting women and their families through labor and childbirth.

Doula is a Greek word that means "woman servant." Unlike midwives, who deliver babies and are licensed to perform medical tasks, doulas provide emotional and physical support to the laboring parents. They work with the birthing team of nurses, doctors or midwives and family members or friends to make the experience safe, healthy and nurturing.

"We (the doulas) are there to provide unequivocal support to the laboring mom," says Gardner. "Each experience is highly individualized. We look at the mom's comfort and ease and offer things like breathing techniques or massage or help them remember what they learned in childbirth education. Or we offer emotional support and encouragement. We don't touch or give advice without asking permission. The mom and her birthing partner are always in charge."

Twenty-five percent of the births in WACHU or about 125 each year are attended by doulas. At least three of the 23 doulas are on-call at all times.

Carmen Carignan, an obstetrical nurse in WACHU for 25 years, says the doulas are "wonderful adjuncts to the laboring moms – not only for the moms but for anyone else there with her. They're sometimes there for hours on end and are like glued to the woman. It's important for the women to have that consistency, to have someone there for them the whole time. It relieves a lot of anxiety. As nurses, we do all that support as well, but when it gets busy, we can't be in two or three rooms at one time. It is comforting for us to know that the moms are being taken care of."

Carignan was a little resistant to the doulas at first, she says, but is now one of their biggest fans.

"Nurses are very nurturing people," she says, "and we love that one-on-one closeness with our moms. There was a feeling that that might be lost with the doulas, like we might be thrown aside and forgotten. But it's such a collaborative team effort, it just adds another beautiful piece to the labor process. And the doulas bring such a beautiful spirit to the process. Birth is a spiritual experience and they are all very spiritual women."

When Londa Holsinger of Brattleboro had her son Zane in 2000, Gardner was her doula. And she will perform that role again when Holsinger has her second child in April.

"I had a 40-hour labor," says Holsinger. "I went through five shifts of doctors and nurses. Maich was the consistent person the whole way through. She kind of gave up four days of her life. The last 24 hours, she was there straight."

Holsinger describes a doula as "an open book, unloaded with baggage. You can write on them what you want. You don't have to worry about their feelings or dignity or judgment. They provide unconditional support; your needs come first.

"I really respect Maich," adds Holsinger. "She's had four kids of her own, she's had many careers. She's very wise, a complete woman. And I like her age – the last thing you need when you're in labor is someone who's young and perky. You know you're not going to scare Maich. I think we both surprised each other with our capacity to do our jobs."

"I am continually amazed at how deeply women can dig in to do this very hard job," says Gardner of the birthing experience. "Again and again, whether they're 17 or 35, they rise to the occasion to birth beautifully. It is such a privilege to witness this."

Circles of women

Susan Curtin, who has been working with Gardner as a doula for three years, says that the tradition of women helping women is central to the doula program.

"There's a part of you that just thrives in a circle of women," she says. "To be in the birthing environment – it's in your blood; it's innately an environment you thrive in. We need to be with other women in a helping manner. If I weren't a doula, I would still go (to the doula meetings) for the sake of the circle.

Curtin describes Gardner as the "heart of the doula program."

"Most of us who know her think of her as a mentor or big sister," says Curtin, "She exhibits a quiet kind of leadership. She has an eloquence as she speaks. You find yourself emulating her. A lot of us are more able to express our feelings and thoughts and are more thoughtful when we speak. She helps us first and foremost to be better women which allows us to be the best doulas we can be."

Circles of women are not foreign to Gardner. She says that, "at each stage of my life, there has been a critical circle of women that has reflected what's going on for me."

It was a circle of dancers in Houston, Texas, where she studied ballet seriously from ages 6 through 18; the community that developed from the childbirth education and nursing classes she taught in Texas and Boston, where her four children were born; and the circle of childcare providers when she directed a childcare program in Boston. Today, her circle includes the doulas and the women's singing group Animaterra.

"The circles of women have been profoundly sustaining to me," Gardner says. "They have brought so much joy and unbelievable support. They help me remember who and what I am."

Intentional relationships

Gardner's story would not be complete, however, without talking about the central place of family. Family is a constant theme of her life, she says, in particular the push-pull between the larger world and home and family. And she developed some creative ways to deal with it.

Raised in a Southern Methodist religious tradition, which she describes as "hard core and fundamentalist," Gardner was expected to marry, raise children and, most important, stay close to home. But she was "the spunky one"; she married folksinger Peter Gardner while still in college at the University of Houston and, by the time she was 25, they had three children. But most disturbing to her mother, they left Texas for Boston.

"She said I became a Yankee," Gardner laughs. "But I fell in love with Boston. I felt like I could breathe when I came to New England."

During her 11 years in Boston, Gardner earned a master's degree in education from Harvard and directed a child care center. She and her husband divorced and she met her current husband, Ed Tomey.

Gardner and Tomey had a son together, then moved to Keene. Gardner worked at Cheshire Health and Human Services and Home Healthcare, Hospice and Community Services for several years, then went on to earn a master's degree in human resources at Antioch. Throughout this time of many changes, the three parents – Maich and Peter Gardner and Tomey -- made a concerted effort to co-parent and created no less than a reconfiguration of the typical divorced family.

"We all determined that we would raise these children together," says Gardner. "One of my major points of pride is the good friendship I was able to have with Peter and how we enfolded our new partners into the larger family constellation. Peter and I worked as hard on our relationship divorced as we did married."

Peter Gardner also eventually remarried. The two families spent holidays and birthdays together. Gardner went to care take Peter's wife, Susie Rheault, when their son Zachary was born. And one night ten years ago, Gardner and Tomey were the first persons Rheault called when Peter died unexpectedly. When Rheault later remarried, Gardner and Tomey stood up for her and her new husband. And last Christmas, the extended families spent Christmas together in Boston.

"Living a life based on thoughtful and intentional values about relationships," is how Gardner describes it, "as opposed to falling into the traditional models we grew up with." She and Tomey have carried this value into their partnership of 27 years.

"We are deeply committed to partnership," says Gardner, "to supporting each other to be the best we can be. We are committed to being fully who we can be individually and together.

"Our issue now," she says, "is that our lives are so incredibly full that they collide in their fullness. We both love our work and we work all the time. Our lives have been filled with abundance; we've been graced with so many good things. But we struggle with how we can slow down, make more time for reflection, more time to be graceful."

'Now the Day is Over'

The last hours of their mother's life, Gardner and Johnson were with her constantly. They felt her breathing patterns change as death neared. They talked to her of letting go and "going to daddy.

"Nothing needs to hold you back," they said. "Go when you are ready."

When their mother died, the two sisters tended her; they bathed and dressed her, combed her hair, brushed her teeth, put cream on her body.

"The heaviest grieving came with the touching," says Gardner. "I became so aware of the sacredness of the body as a vessel; it was so healing. I had tears streaming down my face and I looked across the bed at my sister with tears streaming down her face. I realized this is a ritual of daughters and mothers. It was absolutely amazing, so tender and so right."

"It was a profound experience," she adds, "and such a wonderful good-bye."

The next day, the sisters went out and bought their mother a red dress -- 1940s style, tailored with slightly padded shoulders and buttons down the front. And they bought red satin underpants.

"This was another important ritual to do together," says Gardner. "My mother was a handsome woman and loved bright colors. She liked to dress up and she looked beautiful in red."

Then the sisters followed the hearse on a five-hour trip back to Houston, where their mother was buried next to their father.

At the service, as Gardner reflected on her mother, she realized she was also talking about herself. "We were not close practically," she says, "but I believe we were kindred spirits.

"Mother was a private, shy person, but regarded as very social. She was engaged in the community and with friends. She had a wonderful education but was pulled to family. Like me, she was fundamentally very introverted but trained herself to be out in the world.

"There are so many parts of me that are traditional and conservative and so many that aren't," says Gardner. "It's a constant push-pull. I used to try to be one or the other. I've finally come to terms with the fact that both are truly me. I used to work very hard to push the one side or the other into the shadows. Now I just know that, wherever I am at the moment, the other side is there walking with me. She will have her time, maybe in a few minutes, maybe in a few weeks."

At the end of the service, the sisters again joined their voices, singing one of their mother's favorite hymns, "Now the Day is Over."

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