Do I need a doula?
Although most of us expect to have our partners at the birth of our child, there is much research that suggests the presence of another support person can greatly enhance the experience for everyone. Some partners are reluctant to “share” the birth with an outsider, and worry they will be made redundant in the birthing room if there is someone else there in a support role. But talking to couples after the baby is born, most describe the actual experience of having extra support as a blessing, and a part of their positive view of their birth.
Benefits of continuous care
Research indicates that continuous caregiver support during childbirth has a number of benefits, including a reduction of the need for medical intervention such as forceps, vacuum or caesarean, a tendency for shorter labours, and a reduction of negative feelings about one’s childbirth experience. Catherine, a mother of two young children, wishes she knew about this before her first child was born. “I didn’t think I would need any support, as I knew exactly how things were planned to go. I so wish I had someone to advocate for me, and explain my options in more details, and offer me the continuous care I know I needed. I could see the birth just getting away from me, and I didn’t know where to turn.”
Who will be there for me?
So who is going to provide this continuous presence throughout the labour if it is so beneficial? Usually not the obstetrician…they are generally only called in towards the end of the labour or intermittently to review any concerns. Traditionally this support has been provided by midwives, but currently our health care system places many limitations on our health carers. And this is especially true of midwives. In our hospitals, it is generally difficult for midwives to really get to know women prior to their birth, as often they don’t meet the woman until she arrives in labour. So it is hard for midwives to know your particular needs, and the “flow” of birth you are looking for*. Plus, midwives are often unable, due to hospital policies, to remain with a woman for her entire labour.
Doula definition .
The word ‘doula’ (pronounced ‘doo-la’) is a Greek word meaning ‘woman servant or caregiver’. According to the Aus Doula College, A doula, or birth attendant, ‘is a woman offering non medical support and information to parents in pregnancy, childbirth and the post natal period.’[i] Kelly Winder, a doula and creator of BellyBelly.com.au, describes doulas as being “trained and experienced in childbirth and are usually mothers themselves. They have a good knowledge and awareness of female physiology, but a doula does not support the mother in a medical role – that is the job of the midwife or doctor… she will not make the decisions for those she supports, but she assists them through the decision making process and provides balanced information so the couple can make their own choices.”[ii]
Support for both of us?
A doula might come to your house when you are in the earlier stages of labour, or meet you at the place of birth. She sees her job as supporting both partners as they enter this new phase of life.. A doula can stay with the woman at all times, offering physical and emotional support. Her presence can be freeing for the woman’s partner, enabling him to ‘be there’ even more for her, as practical tasks (such as getting hot towels, or responding to siblings’ needs, or getting the car ready for the trip to hospital) can be spread across both support people. She can act as a resource for the partner as well, if needed, providing reassurance and guidance, if needed, as the birth unfolds. A doula can also act as an advocate to help couples get more information to be able to more fully explore their options, enabling them to make informed decisions from a place of knowledge rather than fear. She can , work with the woman, her partner and the midwife to ensure that, as much as possible, the birth is a positive event. Debby Gould, co-founder of Birthtalk.org, has been passionately involved in couples’ birthing journeys as a doula for the last 9 years. She says, “My desire is that all couples come through this life experience feeling strong, confident and capable and having had the best birth possible. We do not have to be powerless in how we experience our birth, and it is important that we feel safe and cared for. Every couple should be able to come through their birth experience feeling uplifted and with a strong foundation for their futures.”
Midwives and doulas together
If you choose to employ a doula, it is important also that the midwife attending you is a key member of your birthing team. Not only for the safety of you and your baby, as the midwife is the health professional responsible for your care, but also so that you FEEL safe, and have your labour supported from all sides. Your doula can then support you and your midwife by sharing information and providing continuity of support.
First time mum
Melinda, a first-time mum, had doula support for her birth. Her doula attended sessions of Birthtalk’s Antenatal Course with Melinda and her husband. Melinda says, “[During the birth] I was acutely aware of voices around me and the nurturing, supportive energy of my doula, my husband, and a new gentle midwife. When I had a couple of moments of saying out loud ‘I don’t know if I can do this’ they each reassured me that I was already doing it and things were progressing beautifully. Strong, reassuring words that encouraged me to keep going. All the while my husband and my doula kept scooping the warm bath water onto my lower back until their arms would ache and they’d switch over. Melinda experienced a gentle drug-free birth, from which she emerged confident and strong. She says, “The birth of Tion is probably the most empowering experience I’ve had in my life. I feel content about the way events unfolded and so grateful for the two amazing support people I had present. I think that this birth experience has given me a sense of calmness in the way I mother.”
VBAC (Vaginal Birth After Caesarean) support
Kay, 37, is a mum who experienced a vaginal birth after caesarean (vbac), and hired Debby from Birthtalk.org to support herself and husband Jake. We asked her some questions about the experience…
Birthtalk: Why did you choose a Doula?
Kay: Having experienced hospital policy with the birth of my first child that culminated in a possible unnecessary emergency cesarean, I could not imagine giving birth in the hospital environment without the support of a doula. To know that I was going to take a doula second time round probably gave me the confidence to proceed with falling pregnant.
Birthtalk: Did having Debby as a Doula enhance the experience for you in any way?
Kay: Birth is an extremely personal event, physically opening parts of yourself that very few people see over the course of your lifetime. I needed the support of a woman who had already done that, who had absolute confidence in a woman’s ability to birth and who had spent many years present with birth. I needed her confidence, knowledge and belief.
Birthtalk: How did you feel knowing your Doula was there for you?
Kay: I knew that my birth experience was going to be supported and validated. That if there were need for medical intervention, it would have been an intervention decision that I had participated in instead of being subjected to.
Birthtalk: Did having a Doula change the way your husband participated in the birth?
Kay: My husband did not have to be so defensive of my space and needs, and so could attend me in other ways. Having the additional person there was an assistance
Birthtalk: Would you recommend having a Doula to other women?
Kay: If I were contemplating a third baby I would take a doula again. I would sincerely recommend that any women contemplating pregnancy or pregnant to research this option. The step into motherhood following a supported birth is streets ahead of the step into motherhood following my [previously unsupported] birth where I felt a failure.
Choosing a Doula
The woman you have as your birth support needs to be someone with whom you connect, and feel safe, and who feels like ‘the right fit’ for your whole family. It can be helpful to see a few doulas, & ask them some similar questions, which may give you more of an idea about whether a certain doula is going to be right for you. The process of meeting them and talking with them can give you greater clarity about what your needs are, so it can be a worthwhile process! Most doulas will travel to support women, so even if they might not be from your immediate area, it is still worthwhile interviewing/chatting with them, just to see who seems like the right “fit” for you and your family.
Are there any drawbacks to having a doula?
Although there are many stories of women experiencing many benefits from having a doula, employing a doula is not a foolproof guarantee of a good experience. But that doesn’t have to mean closing the door on this option. It just means more investigations need to be made, to find out more about what was going on in these situations. If you know someone who had a negative doula experience, find out more, or read between the lines when hearing the story. Was it a relationship issue, where they just didn’t ‘click’? Were the role and expectations the couple had of the doula clear? Did she honour her agreed role? Was communication open and honest between mother, father and doula? Was there a situation that was not the doula’s fault for which you feel she is being blamed? These questions may help you figure out whether it was ‘having a doula’ that was the issue, or ‘people issues’, that can arise in any close working relationship.
So…do I need a Doula?
Only you can answer that question. But we encourage you to make that decision from knowledge, and explore the benefits and any drawbacks yourself. Read stories of women who have experienced doula support and talk to women you know who have followed that option. (see Lucie’s story [second VBAC, first homebirth], Kathryn’s story [second baby after previous shoulder dystocia and very unwell first baby], Romi’s story [first pregnancy, birthing twins vaginally in hospital].
Explore what is really required for a birth – any birth – to be empowering (see our tips in our article “The Pitfalls of Going with the Flow in Birth“), and ask what a doula could do to meet these requirements and promote a nurturing environment for you and your partner as you prepare to meet your little one. After taking this explorative path, no matter what you decide, you will be more informed and empowered in your understanding of your needs, which is a great step towards an empowering, positive birth experience. As Debby from Birthtalk.org says, “Birth can be wonderful, and amazing, and – yes –full-on…but birth does not have to be scary.”.
For a list of Doulas currently available in the Greater Brisbane area, plus suggested questions to ask them, please click here to contact Birthtalk
For a list of Doulas Australia-wide, we recommend the Find a Doula website
For Doulas internationally, try DONA International
For a great rundown on what to ask a prospective Doula, both in the initial phone call, and during an interview, check out this article at Belly Belly dot com dot au
And to read Melinda’s birth story click here