The role of a Doula and why a pregnant person might consider having one
(Last updated August 2020)
Birth is a whole lot more than having a baby. It's a rite of passage, a new phase of your journey, a time to enquire and evolve in new ways as a human being.
An opportunity to connect with your body, your baby, with nature and with birthing traditions and practices which feed your soul.
Birth is an everyday occurrence and utterly extraordinary all in the same breath. It can be incredibly empowering and positive, forming vastly unique and different trajectories. There is no perfect theres just you way. Birth is an everyday occurrence and utterly extraordinary all in the same breath.
Your approach, mind-set and attitude to birth will directly impact and shape your birthing experience. As Robyn Lim says;
“Birthing is the most profound initiation to spirituality a woman can have.”
Over the years these are questions I have been asked, and which often come up when the name ‘doula’ enters the conversation;
'What is a 'Doula?'
‘Why would I need one?’
‘What's the difference between a doula and a midwife?’
‘Why would I pay, when maternity care is free?’
So lets talk about what doulas do. And what place doulas hold, alongside our current system of maternity care.
Sadly birth trauma as a result of obstetric violence is on the rise. Both research and experience testifies that the support of a doula, positively impacts on a birthing persons wellbeing and experiences during pregnancy, birth and in the post partum period. Birth is utterly unique, and is why, birthing people need continuity of care to ensure needs and wishes are met. Why we need to ensure through education and support we create a positive view of birth and change the culture where fear and pain come top of the list, when talking about birth.
Continuity of care is not something our current maternity care system can offer. Research shows that continuity of care, is one of the most significant factors regarding positive outcomes and experiences of birthing people. Birthing people are the experts when it comes to their body and their baby. To increase positive experiences, they need to be loved, listened to and supported, to explore their beliefs about birth, identify their needs and wishes and process the information presented to them so they understand and make informed choices regarding the advice and procedures being offered to them. Fundamentally encouraging the birthing person to focus on their innate abilities, and to trust their intuition, on a deep, cellular level.
So here is where a doula comes in.
Birth keeper I Baby catcher I Moon mother I Doula
All the above, describe someone who offers support to a birthing person. In pregnancy, birth, post natally or at all these times. For some these names and this role, maybe unfamiliar, but in many cultures around the world, this person is a highly respected and necessary part of birthing practice.
“The way a woman gives birth can affect the whole of the rest of her life. How can that not matter? Unless the woman herself does not matter.”
Beverley Beech and Belinda Phipps.
What does the research say?
Research clearly shows that birthing people who have continual care, support and trust of an additional birth support or doula are significantly less likely to request pain relief, need medical intervention and have higher levels of satisfaction regarding their birth experiences.
Researched benefits of a doula:
Reduced risk of instrumental birth (forceps, ventouse)
Reduced need for painkillers or epidural during birth by 60%
Reduced risk of Caesarean birth by 50%
Reduction need for induction of labour by 40%
Shorter labour, with labour time reduced by 25%
Increased parental satisfaction with the birth experience
Increased likelihood of initiating breastfeeding
Increased likelihood of successfully establishing breastfeeding & to be breastfeeding at 6 weeks
Here's what I believe a doula can offer;
Continuity of Care (Doula support starts whenever you decide - some people get a doula early on in pregnancy to support right through and for some its something they come to later on - there is no perfect, just what feels right for you). Research shows that the continuous support and presence of a second birth support of choice, is beneficial for wellbeing and increases the likelihood of the birthing person reporting positive experiences.
Emotional and Mental Support in Pregnancy, Birth and Post Birth - encouragement, praise, reassurance, love, care and attention - helping to foster a positive mindset and cultivate emotional connection and security is vital to supporting the birthing person to achieve a positive experience. A doula supports you to listen to your intuition, to believe and trust in yourself, your baby and your body.
Ritual and Research - A doula can broaden the spectrum of awareness around birth, and birthing practices from around the world, encouraging inquiry around your own birthing linage, beliefs and values. Exploring these alongside current research and best practice, can help inform, empower, support, and establish respectful boundaries.
Informational Support - as a non-Medical trained professional, a doula can help you understand the system which is providing your care, your options and alternatives. This support can allow you to navigate this time, whether out-with or alongside the maternity care system. Exploring the differences between policy, procedure, and best practice to ensure you receive quality care, and positive experiences.
Informed Choice & Advocacy - Being fully aware of all your choices, having space and time to explore the relative benefits, risks, best medical evidence and importantly your own intuition and beliefs, so you can make informed choices. A doula’s role is to offer support without judgment or preference, to provide tools and preparation that helps you to work out what it is you want, effective questioning and what to do with the answers you are given. And equipping you with tools to effectively communicate your needs and wishes and ensure they are respected by medical professionals/care providers.
Physical Support for the whole family. Offering support to the birthing person, the birth partner and the baby, in pregnancy, birth and as parents. Offering techniques and practices which support comfort, ease, and health, positions, movements, breathing to facilitate active birth, tools for calming, relaxing and aiding sleep and recovery. Even down to the practicalities during birth, an extra person you trust and know, to support you physically with massage, allow a partner to rest, attend to other children, go to the loo, get food etc.
Maximising Positive Mindset and Wellbeing - the support of a doula as you transition to life as parents or as you grow your family has been shown to significantly impact on healing and wellbeing throughout. A doula can help reduce the chances of perinatal mental health issues and post natal depression. Evidence shows that being left alone in birth and receiving poor post natal care, increases the risk of post natal depression. Having a trusted, continual support, can help with bonding and successfully establishing breastfeeding.
WHAT DOES A DOULA ACTUALLY DO?
Offers continual support from whenever the birthing person decides - this can be early on in pregnancy, the whole way through or to offer support for a specific and chosen stage such as antenatal, birth preparation, post partum care.
The Doula’s role is to honour and support the birthing person, so they respect and love themselves, deepening their connection and trust in their innate knowledge and power of how to grow, birth and nurture their baby.
Often, much of the work, is done in the lead up to birth. A doula offers contact throughout via phone/email/face to face. Listening, offering practical tools and strategies, supporting questions, doubts, fears, excitement, anticipation, discomfort.
On call support - usually offered two weeks prior and two weeks after the estimated due date. This can provide such peace of mind, having someone to check in with, asking all the little or big things as and when they arise.
Continual support throughout labour, from as early as you choose.
Post birth care, often with food preparation and herbs to promote wellbeing and healing.
Its important to state what a Doula IS NOT;
A medical professional or clinical support.
Does not preform medical tasks - blood pressure, CTG, delivery, cord cutting, new born checks.
How my Doula supported me
A life changing journey, which began when Nicola Mahdiyyah Goodall, showed up at my door, and I forever thank the stars that she did. I can honestly say my doula has been there every step of the way. She was my doula, instantly became a friend, then a soul sister, an educator, a mentor, a sage who i turn to both for professional and personal advice on all things birth, babes and parenting, big babes. Nicola supported me through both our home births (read my birth story here).
For me personally, the decision to get a doula was best I made after becoming pregnant the first time. Having a doula helped me feel supported in pregnancy, she encouraged me to believe in and connect with my intuition and instinct. Most importantly, having my doula at my birth gave me the courage to follow my heart, to listen to my body and my baby and to trust in all the preparation I had done. For me having a doula enabled me to navigate my way through birth and through the care system, calmly and consciously. Having a doula is not a golden ticket to a perfect birth (what ever that actually is??). A doula provides the love, wisdom and connection every birthing person deserves as they journey through growing, nurturing, birthing and then mothering another human being.
PHOTO BY IGOR-OVSYANNYKOV ON UNSPLASH
How we approach our whole birthing journey is crucial. There are positive steps you can take, regardless of whether you choose to have a doula or not. When I asked my Doula, if she could say one thing to pregnant women the world over what it would be, she said;
'You have to own it!'
These simple five words speak volumes. You have to take charge of your birth.
This is not the status quo. Not necessarily the easy option, yet can be powerful, positive and transformative. Birthing people need the space to inquire, to consider all the options without feeling pressure to conform because of policy or procedure.
For both me and my partner, our doula enabled us to be fully present throughout our whole birth journey. The support, amazing wealth and diversity of knowledge, commitment and unconditional love is what anchored us and enabled us to own both our birthing experiences, to achieve positive, euphoric and empowering experiences. It also enlightened us and made us fully respect the post partum period, recognising the need to go slowly, to know what to ask for and to welcome support with respected boundaries. To not worry about shutting off from the outside world (that will all still be there when you decide you are ready), and enjoy getting to know each other as a family.
Interested or want to know more?
Get in touch for a totally FREE consultation/chat.
More reading in the links below. You may also want to check out these blog posts;
Researched benefits of a Doula - Evidence based Birth
Reframing Birth Ted Talk, Nicola Goodall , 2015.
Birth Doula for every Mother - Midwiferytoday - (In essence, the grey box a few paragraphs down gives a nice synopsis of a doulas role in the birthing journey;)
Ina May Gaskin - 'Spiritual Midwifery'.
Michel Odent - 'Reborn: what childbirth should be'.
Sarah Buckley - 'Gentle Birth, Gentle Mothering'.