What is a doula?
Posted: Wednesday 14 October 2009
What does a doula do?
A doula is a professional birth companion. Her role is to provide emotional and practical support to couples during labour, birth and immediately after the baby is born.
She is also there to build women's confidence in their body's natural ability to give birth. For most of their lives women are bombarded with images of birth that present a medical event or even trauma of some kind. Births in East Enders or Casualty invariably show someone flat on their back, screaming and everyone around them in a mild state of panic. But this isn't how birth is meant to be. Women who have confidence in their ability to give birth and understand how to influence their birthing hormones can have very different experiences, where their births are calm, gentle and even empowering and extatic.
The word doula is an ancient Greek word meaning 'woman helper or slave'. Throughout history women have helped women prepare for labour and give birth.
During the antenatal period, at about 8 months, the doula spends several hours, one to one with the couple she is supporting. She aims to understand the type of birth the couple is hoping for and then highlights options available to them that may give them the best chance of achieving their dream birth. For example, the doula will explain the importance of allowing the natural birthing hormones of oxytocin and endorphins which, if allowed to develop and flow naturally, can help you towards a calm and less painful birth. She will show the couple how best to encourage these hormone levels to rise, for example dimming the lights, reducing talking and feelings of being observed and a number of other natural aids to labour. She will highlight possible implications of medical interventions and pain relief and the choices available to the couple during before, during and after labour. She will never ‘advise' or make decisions for you but she will highlight the latest research around each topic and give couples the option of making an informed choice.
The doula will also help prepare the woman for breastfeeding and explain that what happens to the baby during the first two hours after birth can hold the key to successful breastfeeding.
Then when the time comes she will join the couple during their labour. If the plan is for a hospital birth, couples who labour at home with the doula by their side often have the confidence to stay at home for several hours more than they would have if labouring on their own. This can help extend the time during which labour can progress calmly and encourage quicker dilation. During labour some doulas are able to provide alternative therapies such as head massage, aromatherapy or homeopathy.
The doula is not in anyway instead of the partner, but helps shows the partner how he can be of calm, practical support rather than being anxious and not quite sure how to help.
What's the difference between a doula and a midwife?
A doula provides emotional and practical support on a one to one basis and is well known to the couple when labour starts. A doula is not medical.
A midwife is a skilled medical person who usually works within the NHS under the guidance of a Registrar or Consultant although there are independent midwives who work outside the NHS.
Why is there a need for doulas?
Information that is provided by doulas in terms of choices available to couples during labour and birth is not easily accessible elsewhere. It's often about getting a woman's head around the labour process, reframing the experience for her so she enters her labour in the best possible frame of mind. Ensuring the woman is well informed and empowered, with confidence in her body's innate ability to birth her baby.
Research shows that having the support of a doula during birth reduces the incidence of caesarean section, the numbers of epidurals requested, the incidence of instrumental delivery, increases the rate of breastfeeding and reduces post natal depression:
- Up to 50% shorter labours
- 50% less pain medication requested (including 6 x less epidurals)
- Up to 51% reduction in caesarean births
- 3rd less use of forceps
- Less postnatal depression
- Newborns breastfeed more easily
Source: Klaus, Kennell, Klaus 2002
Why did you become a doula?
Because I wanted to help women have a better birth experience and do something very different to the hard nosed commercial world in which I have spent most of my career.
What do you love about your work?
Knowing that what I do really matters and can make a huge difference to couples' experience of birth. I love getting to know couples during the antenatal period and opening their eyes to a new way of approaching labour and birth. I love being part of the doula community. We are all very supportive of one another and I have made some really special friends.
Is there anything you dislike about your work?
The on-call period can be a bit stressful sometimes. Doulas are on call 24 x 7 for 2 weeks either side of a couple's due date. That's a whole month of being welded to your mobile phone, never going more than an hour and a half out of range of your couple and sleeping with one ear listening out for that phone to ring.
How do you become a doula?
There is a short period of training followed by at least four assessed births. Doulas tend to have given birth themselves at least once.
What sort of training do you have?
I trained with Nurturing Birth in 2006. Since then I have taken a number of additional courses including advanced breastfeeding, foot massage for labouring woman, homeopathy for birth and first aid for babies to name but a few. But I learn so much more during each and every birth. You research so many different things on behalf of your clients over the time and your experience just grows and grows. You never stop learning.
What personal qualities do you need to become a doula?
There are as many different types of doulas as there are people. There is no one set of qualities that you need as one doula will be perfect for one couple but not for another. I would say that qualities we all seem to have are an ability to get on with people and build rapport quickly. Diplomacy. A certain amount of confidence. Willingness to learn from others. Flexibility. Caring nature.
What advice would you give to someone considering engaging a doula?
Go to www.doula.org.uk website and click on the find a doula page to search for a doula near you (alternatively go to www.douladirectory.co.uk). Have a nose around the doulas' personal pages or websites and perhaps give your favourites a call for a chat. Make sure they're available around your due date and ask how much they charge. Then invite those you like to an interview. This is really for you to find the doula you just ‘click' with, who you and your partner would be happy to share 24 hours or more with. This isn't always the most experienced doula or the one nearest to you - you'll just know when you find her. Then book her before she gets booked up. Be honest with her about your hopes and fears. Be flexible in your approach and to her suggestions. And don't expect your doula to waive a magic wand - your birth is in your hands. The doula just helps you realise that you can do it all on your own!
Many thanks to Belinda for telling us about the doula experience.
To find out more visit the UK doula association & Belinda's own doula website - both sites are packed with useful information, and check out this You Tube videa - What is a Doula.
