Doulas can be seen as a luxury, but the care provided by a doula to women and their families during pregnancy and birth is seen by many as an essential part of a positive birth experience, helping you to feel confident and in control.
A doula? What even is it?
Doula’s have been around for centuries, long before childbirth became a hospital event, supporting women in labour, as a “servant to women”. But with the move of birth being in the home and community for millenia, into the medicalised setting of hospitals and under the care of midwives and obstetricians, that place of a traditional female birth support that offers continuous love and care was largely lost.
In recent years doulas have been gaining exposure and popularity, with articles such as a recent one in The Sunday Times entitled “Get me to my DOULA!” which talks of the rise in popularity of doulas in the UK. Many modern birth books talk of the benefits of having a doula attend your birth (The Positive Birth Book by Millie Hill), along with podcasts such as “Is it Normal? The Pregnancy Podcast with Jessie Ware” (singer/songwriter).
So what is it that doula’s actually do?
Every birth is different and every birthing person is different, so as a doula supporting a birth no two experiences are exactly the same. Being a doula is a very fluid and intuitive role, working with a woman (and perhaps partner) through pregnancy and labour, responding to whatever comes up and in whatever way is needed for her client to feel as relaxed, confident and in control as possible. But what can that actually look like?
Fountains of information
A doula can help clients to learn about what is happening in pregnancy and birth, sharing information about the body and birth process, physiological changes during pregnancy and what to expect during birth (including info around natural pain-relief). A lot of this information can also come through your midwife, but there can be gaps in information and communication which doula’s can help women to bridge, giving them a deeper understanding of what’s happening to their bodies and babies, and helping them to feel more in control. Sitting with a cuppa talking about birth or pregnancy, or having them in the birth room with you to ask about what that epidural actually means for you and your baby can give you the reassurance and confidence to make choices right for you.
Hands-on practical support
Doula’s can provide great practical support during pregnancy, labour and postnatally in terms of helping you to stay watered, fed and well nourished (essential as a mama!). In labour they can recommend different positions to relieve pain or help the progression of your baby. A doula may be more hands on with some gentle massage to help with surges/contractions, or simply holding your hand through your birth journey. Sometimes it might even be having someone to fill the birth pool or answer the door to midwives if you’re having a home birth, or supporting you and your partner with the car ride to hospital (I hear many partners sigh a sigh-of-relief!). Knowing all these kinds of things will be taken care of can help you to feel a lot more relaxed, which means you can get on with the job of birthing your baby.
Your emotional rock
This is perhaps the one that is hardest to explain, but arguably the most important role of a doula. Those prenatal meetings that you have with your birth doula are so important for building a connection and sense of trust so that when it comes to being in the vulnerable and powerful birth space you feel emotionally supported and held. If a woman feels emotionally supported and safe in birth, then the beautiful birth hormones will have a much better chance of doing their job. Having someone you know and trust tell you how great you're doing in labour and that you look like a goddess can make all the difference for helping that oxytocin to dance!
They'll always be there for you
This one relates massively to the point above about emotional support, and all the areas we've talked about previously - doula’s don’t just turn up for the first time when you’re giving birth, as a stranger, and tell you once how great you’re doing. A doula will spend time with you during your pregnancy, getting to know you, getting to know what helps you to feel relaxed, what really pisses you off, and what it is you really do or do not want to happen when you are giving birth to your baby. They will then be with you throughout your whole labour experience - whether this is two days, or two hours. That same lovely person, that you feel cosy and safe with, will stay with you to help with your first baby feeding experience and will come and visit you after the birth to see how you’re all getting on. They will make you a cup of tea, ask how you are and spend as much time with you as you need because they really do care about you.
Various *studies have now been conducted around birthing experiences and evidence has shown time and time again that continuous care can lead to better outcomes for mother and baby, including:
Increased spontaneous vaginal birth
Shorter duration of labour
Decreased rates of c-section, instrumental birth, use of analgesia
Reduced negative feelings about childbirth
Being your advocate
With rates of birth interventions and cesarean-section procedures ever rising in the UK**, it is not surprising that some women may feel that they would like someone by their side to advocate for what they want to happen to their body and baby. Doulas are well informed about the risks and benefits of interventions in birth and can help women to navigate difficult decision making and support you in whatever choice you want to make. Too often I have heard women talk of feeling like “things were just done to me” in their birth experiences, and are left feeling disempowered and sometimes traumatised as their body and baby were taken out of their control. A doula can support you in the birth choices you want to make.
Having had a doula at the birth of my baby, I can advocate for all these points! My doula helped me to feel safe, to feel held and supported and like I was in control of my birth experience. She was loving, supportive and non-judgemental in her help with breastfeeding, which I was really struggling with. Mainly she helped me to feel confident in myself as a mother and in my body to do what I knew it was built to do! With her support, I had the home birth I wanted, where I was in control - and I got to flop into my own comfy bed at the end holding my baby in my arms.
All women deserve to have a positive birth experience - one where they feel like it was your choice, where you understood what was happening, and where you can look back and remember how awesome you and your body is.
Resources:
* Perceptions and experiences of labour companionship: a qualitative evidence synthesis, Meghan A Bohren and Sarah Chapman, Cochrane Review, 2019
** Caesarean section rates continue to rise, amid growing inequalities in access, World Health Organisation, 2021
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