Frequently asked questions about doulas
What is a Doula?
"Doula" (pronounced "doola") is a Greek word meaning "caregiver” or “woman servant". It now refers to an experienced woman who offers emotional and practical support to a woman (or couple) before, during and after childbirth. They have been around for many years but it’s only fairly recently they have been named “Doulas” and have been organised as a profession. A doula believes in “mothering the mother” - enabling a woman to have the most satisfying and empowered time that she can during pregnancy, birth and the early days as a new mum.
What does a Doula do?
The services offered by a doula vary greatly according to the needs of the mother-to-be/parents-to-be. A doulas role has to be flexible to fit in with the given situation e.g. the type of support will differ for a first time mum to that of a woman who has children already. Every birth is unique and therefore every woman's experience is also unique.
Before childbirth the doula meets the mother (and her partner) at least twice in order for the three of them to get to know each other and for the doula and parents to prepare for the birth and to go over any questions or worries. The doula will then be with the mother and her partner during labour, however long, and are able to offer help and suggestions on comfort measures such as breathing, relaxation, movement and positioning. The doula can also encourage the father to participate in the birth to a level at which he feels comfortable. The doula's most important role is to provide nurturing, continuous support and reassurance.
After childbirth the doula will usually visit the mother, partner and baby to give some support, a birth debriefing if that is what the mother wants and help with breastfeeding or any other issues.
Why is there a need for Doulas?
As childbirth has moved from home to hospital, a vital element of care has been lost from the whole process. Gone are the days where a woman would have continuous support from one carer throughout her labour. It used to be the case that the womenfolk within the immediate and extended family (mothers/sisters/grandmother etc...) would be on hand to provide the nurturing role for the new mother, to guide by experience and help with the practicalities that need to be performed before, during and after a woman gives birth to a baby.
Later the concept of the community midwife developed, but due to lack of resources, this service is steadily declining in many areas.
Nowadays many women feel that they have to be in hospital to give birth to their baby where it is much more likely that a birth will be medically managed and intervention methods, such as caesarean section or forceps, will be used. Research has shown that having a doula present at a birth;
- Shortens first-time labour by an average of 2 hours
- Decreases the chance of caesarean section by 51%
- Decreases the need for pain medication by 36%
- Reduces need for forceps delivery by 57%
- Helps fathers participate with confidence
- Increases success in breastfeeding
Findings from "Mothering the Mother"
Klaus, Kennell & Klaus, 1993
Doulas and Dad’s - Why do I need a doula if I have a partner?
Doulas do not replace fathers – we are not the ones telling mum how much we love her, that’s their job. Our job is to support and enhance the relationship between parents and not to interfere with the intimate nature of it. We are trained to know when to be hands on and when to step back and allow the couple space to be together. Sometimes this can mean guiding the father on how to emotionally and physically support the mother. Other times it can be as simple as being an extra pairs of hands to make a cup of tea, carry bags or pay the car parking meter. Labour can be long, dads need a break, a nap, to go to the loo, something to eat – wards are often busy, midwives are under pressure and may have many women to attend to. A doula provides that vital continous care.
I believe in mum dad & doula working together as a team. Dad’s need reassurance and support during a birth as much as mothers. They have a very important role to play and nobody to guide them through it. Many fathers, especially first time dads can feel quite powerless and anxious during labour... as would anyone who saw the one they loved in what is often perceived as pain and distress and were unable to help. Dads often find the long waiting process difficult and feel frustrated they cannot “fix” the problem. Doulas are there to give dad a break if and when he needs it and to reassure him that all is going well if he is feeling anxious. Doulas are good at waiting! We know it is part of the process and are very good at making fathers enjoy the birth. Remember it is a fairly recent phenomenon to have fathers in labour wards at all and now it is “the correct thing to do” but this doesn’t mean that all men (or women!) are totally comfortable with it. The combination of a doula’s knowledge and experience combined with the father’s loving touch and voice can make all the difference in the world – Less stress for the father and perfect loving support for the mother.
What’s the difference between a doula and a midwife?
A midwife is a trained medical professional. They attend to the delivery and can assess fetal heart rates, check cervical dilation watch for and treat complications of birth and give medical advice. Doulas do not perform a medical service and are not employed by a hospital or work for an NHS Trust. Their concern is purely for the wellbeing of the mother. In essence: doulas work with the mother from the waist up while the midwife primarily attends to the mother from the waist down!
Also, doulas only support a few women per year, they always promise to be available at the birth and are therefore on-call for a whole month around the due date. They will stay with the mother for as long as needed; there are no shift changes for a doula !
Doulas and Epidurals: Is a doula only interested in supporting me if I plan to give birth without medication?
There is a common myth that doulas are only for women attempting to give birth without drugs or medical intervention. Nothing could be further from the truth. Whilst we are trained to view childbirth as a natural and normal process we are not all die hard natural childbirth fans and are aware that there is a time and a place for medical intervention.
We are there to provide emotional, physical and informational support. Women who receive medication during childbirth need all of these things and in some situations even more so than a woman who chooses to avoid medication.
Doulas want every woman to have a positive and empowering experience. For some women that means giving birth with as little intervention as possible, for others it is not even a consideration for personal or practical reasons.
We do not push our opinions and philosophies onto our clients. We provide information so they can make informed decisions. Our job is to support those choices whatever they may be. We will not decide for you and should not provide biased information.
We are not interested in making martyrs out of our mothers. We want you to have the best birth experience possible with the healthiest outcome.
Who employs a Doula?
All sorts of people, you can’t really generalise. From first time mums who have heard of the concept and think this would benefit her. Women who already have one or more children and often her experience wasn’t good and she wants the support of a doula for the next time. This is particularly true for women who had a caesarean (planned or emergency) and who would like to have a vaginal birth (VBAC) this time. Single mothers and mothers who’s partner does not want to or is unable to attend the birth. Of course doulas can’t wave a magic wand but statistics and medical research have demonstrated the real benefit of having a doula.