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What is a doula and why have one?
Whenever I tell my birth story and mention Natalie my doula I’m often greeted with quizzical looks or comments like what the hell is a doula? I always respond with the same line, “a doula is a mother for the mother”. At which point eyes are rolled or people want to know more. “She’s a knowledgeable lady that helps you at the time around childbirth. They can either be a prenatal doula, someone that is with you during labour or postnatal or all three”. I recently read a fantastic quote that sums it up perfectly, A doula isn't a superhero that flys in to save the day, they come and tie your cape so that you can do it yourself. It is recognised by the NICE guidelines that continuity of care increases positive birth outcomes, though a Doula is not medically trained and would never replace a midwife, studies have shown that by having a birth doula the likelihood of a positive birth experience is increased.
Personally I had my doula mainly for child birth and to support me through labour. The first time it was because after deciding on a home birth we knew my parents wouldn’t approve and try to discourage us, so having my mum there was out of the question. Secondly (as mean as it sounds) I didn’t have complete confidence in my husband not to freak out. Though he doesn’t like to admit it, she was partly there as support and guidance for him as well as me.
The dictionary definition of a doula is: A woman, typically without formal obstetric training, who is employed to provide guidance and support to a pregnant woman during labour.
My God that underplays their role enormously. I look at them as a replacement for the lady in the village that knew everything, or for some it’s like having a sister or mother with you. Many doulas have seen and participated in loads of births, they know so many tips and tricks, they can do anything from rub your back, to making sure you are eating and drinking, helping you into positions, timing contractions, calling the midwife to driving you to hospital. But most of all to be honest just having someone next to you saying don’t worry this is all normal is so wonderfully reassuring and sadly in many circumstances a midwife isn’t able to do this and be with you throughout labour via the NHS. This can be possible with an independent midwife, but that is a separate post. The knowledge inside a doula's head astounds me, and every time I chat to one I learn something new. Who wouldn't want a person like that by their side?
Another thing you have with a doula is an advocate, you’ll have one or two meetings before hand to discuss your birth wishes and any worries then they become someone who not only supports you, but can help to empower your partner to ask questions and push for your wishes to be adhered to. They are not just for home births, or water births or even natural births. In fact I know a few who have attended c-sections, but they are your guide, your supporting arm and your rock.
Having Natalie with us was one of the best decisions we made, as she kept us both so calm, with her and Ross by my side I felt like I could cope with anything. To the extent that Ross’s version of Everley’s birth always makes people laugh as he popped to the shops and even went to get a haircut while I was in the early stages of labour (not many Dads get to say they did that). So, this is pretty different to most of our friends experiences of baby number one. We knew from our hypnobirthing and all my reading that it was key to carry on life as normal for as long as possible when labour started, but whether we would of been able to actually do that without Natalie pushing us to I’m not so sure.
Why did I choose to have Natalie with me, the second time though? You might be thinking, I’m a trained birth professional myself, I had a positive and complication free birth first time around and we were very open that we’d be aiming for another home birth. Well I knew I didn’t want the midwives with me too early on in my labour and for them to disturb/ observe me, also it wasn’t guaranteed that I would of met them before (It turned out I hadn’t). But I would need someone to support me and as much as I love my husband he’s a bit of a man about it all . I know he would either a) panic b) give me a pat on the back and just say good job Jem (taking on the role of football coach) or c) make himself scarce and leave me to it (he did c). Although I know I like to remove myself when in labour I didn’t want to be labouring alone the whole time and I wanted reassurance and comfort from someone. To be honest just having her lying next to me on the bed with her hands on my back, 'catching' my contractions was wonderful. At one point she turned to me and just said 'Jemma relax, stop trying to control this. Your baby boy is doing an amazing job. Trust in him and just let your body go with it.' I knew this to be true but having someone to remind me in that moment made such a difference.
What can you expect from a Doula?
Where do I start... firstly you need to think about what level of support you would like as there is a prenatal doula, a birth doula and a postnatal doula, by all means you can have one lady that does all three for you. And choosing the right doula for you is such a personal thing, it's like many things in life sometimes you just meet someone and you know.
Doulas come in all shapes and size, ages and ethnic origins.
I had full confidence in Natalie, she inspired me (and still does daily), she was a mother figure to me and she educated me. She was the right person for what my needs were which was very much a supportive mother figure who knew the birth scene inside out, understood what birth I wanted and why, and could educate me on my birth rights. It's important that you choose the right person for you, though like any professional they all have many strings to their bows and can tailor the support and style depending on the couple. I'm sure Natalie is very different with some other women than she was with me, in fact I know she is.
Doulas & Midwives
Many doulas and Midwives had fantastic relationships, they respect each others role in the birth and work brilliantly alongside one another. Lots of Midwives would love to be there to support mothers as Doulas do, but sadly don't have the capacity. There is very rarely any stepping on toes territory so it's not a one or the other decision.
How much does a doula cost?
This very much depends on the type of doula you would be looking to hire, a birth doula is normally from £750-£1,500 as they are on call the whole time you are considered full term.
A postnatal doula who will be your mothers help, either helping with the house, looking after you, or taking care of the baby while you nap... will cost between £15-£30 a hour.
What if my doula is with someone else when I go into labour?
Firstly they limit the number of women they work with at one time, so they would never over load their books so to speak. Also you will find many work in pairs, you will probably meet both ladies and if for any reason your doula couldn't make it then her partner would attend your birth.
What a Doula doesn't do Doulas are not medical professionals, so would not give medical advice, or perform clinical tasks such as vaginal exams or fetal heart monitoring. They do not pressure you have a certain type of birth and would never make decisions for you. They do not take the role of your birth partner and they very rarely catch the baby, (though when my second came while the midwife was out of the room, Natalie encouraged me to lift him from the water myself. Letting me be the very first person ever to touch my baby boys flesh)
I could talk about this topic for hours but I'll leave it there for now, if you have any other questions or would like some more information please do contact me. You can also have a look at Doula UK.