What is a doula and what do they do for you during pregnancy and labour? I can’t remember when I first heard about doulas (it was most probably from my mum), but I do know I would have hugely benefitted from having one throughout my first pregnancy and birth.
A doula is a companion who supports you (and your partner!) throughout pregnancy and labour. They’re not necessarily medically trained, like a midwife is, but they do train and can register under a professional body. Your doula is there to inform you of your choices, help you with your birth plan, emotionally and physically support you throughout pregnancy and birth, and can advocate on your behalf during labour if you so wish. Unlike midwives, who you may see many of throughout your pregnancy, a doula provides continuous support throughout pregnancy and birth and beyond, and their primary focus is you and your baby. A doula can not perform medical tasks, make decisions for you, should not try to influence your decisions in one direction or pressure you to make particular choices.
Particularly first time round, both you and your partner may be going in to birth and pregnancy blind. Having a doula can be key in presenting all your options, flag choices you should be making, provide balanced research to aide your decisions, and provide support throughout pregnancy. An unfortunate side effect of an over stretched NHS is that midwives don’t always have the time to go through these options with most women in detail. You may see a midwife a handful of times, quite often someone different each appointment, and only briefly. A doula can fill this gap in care.
Nearing to birth a doula may offer other services such as pregnancy massage, rebozo, mindfulness, hypnobirthing, reflexology, aromatherapy etc if they’re trained in it. During labour, they may provide support both to your partner (who may be going through this experience for the first time too!) as well as you. They may provide aide in terms of reassurance, protecting your birth space and ensuring your birth plan is followed, you are not unnecessarily disturbed and so on. Expecting your partner, who may never have attended a birth before, to advocate on your behalf and remind you of your choices is a tough ask. Having someone experienced who is clued up on your birth plan but is also familiar can be hugely reassuring for both of you. Some doulas focus on post birth, providing breast feeding support, ensuring the mother is cared for, fed, emotionally and physically supported. They may bring nourishing food, run errands, help with the baby and generally ensure the mother is resting and recovering.
Research is not extensive, but the Cochrane report in 2017, which studied 15,000 women, showed that having continuous support can mean more chance of a vaginal birth and less medical interventions, less need for pain relief, shorter births, less complications, and reduced risk of post partum depression. I know from experience that my first birth was extremely medical, ended up with several interventions and PND. Second time round I was adamant I wanted a more positive birth, and the information and support I received from my doula Hannah was instrumental. She went through all my options, gave me balanced researched information and advice, and reminded me if my rights when I needed it. I strongly believe if it weren’t for her calming presence and knowledge, I’d have caved in to strong-arming from over zealous doctors and ended up in the induction/intervention cycle again. Third time round Hannah wasn’t available so I had the equally wonderful Laura, who at the time was a newly qualified doula. Again her passion and extensive knowledge armed me with the information I needed to make smart balanced decisions and gave me the confidence to have the home birth I wanted. She made my lounge an oasis of calm, protected my birth space, soothed me through surges and even took some photos of the birth (which we’d not have otherwise as we were all otherwise occupied!). Birth can be a scary prospect, and there’s a lot to be said by having someone who’s sole focus is you and your baby, providing you balanced information without agenda.
With all the money we spend on pregnancy, pregnancy clothes, classes, baby clothes, cots, fancy bouncers, toys, bottles and more, the one thing I can’t advocate to spend money on enough is a doula! One piece of advice that’s stuck with me when I was weighing my options and deciding whether to have a doula or not, is this: you will never ever regret spending the money on a doula, but you may regret not spending it on one. They really can affect and improve your birthing experience in a wonderful wonderful way.