A Guest Blog by Kicki Hansard
A doula is a person, usually a woman, who offers emotional, practical and informative support to women and couples, before, during and after childbirth. A doula does not have any medical responsibilities, is not an expert and does not give advice. Instead, they offer evidence based information so that women can make informed choices around pregnancy and childbirth, as well as in the postnatal period.
Types of Doula
A birth doula supports couples leading up to the birth of their baby and during the birth. Usually the doula will meet with the woman or family a few times before the birth to discuss birthing options and prepare a birth preference document. The doula will be on-call and support at the birth, usually starting off at the client’s home in early labour, and if transferring to hospital, go with their clients to their chosen place of birth. A birth doula will also offer a meet-up after the birth to talk about the experience, bring clarification to any aspects of the birth that are unclear and help with initial feeding challenges.
A postnatal doula will usually start after the baby has been born and support the new parents in their home. A postnatal doula is there to help and support the woman to discover the way that she wants to parent. The focus is on the mother, which means helping her with anything that needs doing around the house as well as provide feeding support and information. Postnatal doulas usually work with a family for the first six to eight weeks but some postnatal doulas stay for longer.
Who are Doulas for?
Doulas support first time mums as well as experienced mums and the majority of women who have a doula the first time around will want her there again when another baby is on the way. Doulas support their clients wherever they chose to give birth and have no agenda other than to be a beacon of hope and positivity.
So, what kind of things can a doula do?
1. Educate you on your options
Doula work really focuses on ensuring pregnant women and new parents have up-to-date and evidence based information so that they can make the right choices for themselves. Often, women have a feeling about what they want to do, but worry about the risks or whether they are allowed to do what they instinctively feel is right for them. Doulas are there so that discussions can take place around options and real risks rather than the arbitrary phrases often thrown around, such as ‘double the risk’ or ‘increased risk’. Generally speaking, if you have a healthy, straight-forward pregnancy, you and your baby are 99.4 per cent ‘safe’ when it comes to giving birth.
Doulas strive to make all the information available to their clients, are always happy to share resources and then talk through everything so that it feels right for each individual woman. There is so much confusing and even conflicting information out there and a doula will do her best to ensure their clients can make strong choices about their birth as well as raising their child.
2. Provide emotional support
During pregnancy and as a new parent, there are times when it all feels so overwhelming and confusing. A doula is there to provide emotional support by listening and validating what their clients are feeling. During childbirth, having someone there who is 100% on the side of the woman and her partner makes such a difference. Women that report having had a negative birthing experience often look back and feel like they had noone who was there purely for them, that was checking in with them and reassuring them that what was happening was normal. It can be difficult for a partner to know what to expect and who to listen to, the doctors or their loved one. Perhaps asking for more information goes out the window when things seem to spiral out of control. A doula will be a calming presence, with a number of decision making tools available to help couples make choices but also ensure that the right questions are asked.
Research shows that “Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences.”
Doulas are great listeners, non-judgemental and aim to support their clients in finding a way forward. It takes a village to raise a child and doulas provide that lost connection to a wider network of support. It’s so helpful to understand that most new mums have feelings of confusion and distress, often feeling torn between wanting to be the person they used to be and adapting to their new role as mothers. It can be tough for a new mum to think that she’s the only one that is feeling this way and having the reassurance from a doula can make such a difference.
3. Provide a safe and relaxing space
During childbirth, a doula will support their clients in ways that will encourage the release of the important birthing hormone, oxytocin. A woman needs to feel safe and relaxed for childbirth to happen spontaneously and physiological. Some women don’t like to be touched at all in labour whilst others enjoy a gentle back massage. What a doula will do is, therefore, very individual to the client as she supports her during the birth itself. Doulas will always be led by their clients so it’s important that in the meetings before-hand these things are discussed. During the birth, doulas will ensure their clients get information from their care providers about their care as well as facilitate communication. A doula usually checks-in with her clients to see that they are understanding and clear on any specific medical procedures suggested. It’s important that a woman feels part of all the decisions around her care.
Postnatally, a doula can offer suggestions and options around the care of a baby and give information on current guidelines and recommendation. Doulas can help with breastfeeding support and will know where to go for more help if needed. Postnatal doulas generally help with anything the new mum needs help with, like meal preparation, laundry, errands and practical information. This enables the new mum to be able to focus on getting to know her baby in a supportive and calm environment.
Hopefully more women and couples will start to look into the many benefits a doula can bring to their birth as well as postnatal experience. Women have always supported other women during the childbearing year and still do in many cultures. Doulas are simply providing something that has previously been there but has become lost in our busy lives, where we’ve forgotten that the presence of another human being, who cares about how someone else is feeling and experiencing, make a huge difference.
About The Author
Kicki has 17 years’ experience as a doula and has attended hundreds of births, including those of high profile clients, as well as one in Windsor Castle. She has trained over 700 doulas and continues to do so through The BirthBliss Academy. She wrote her first best-selling book on childbirth “The Secrets of Birth: What every woman should know about birth and motherhood” in 2015 and contributed to “The Roar Behind the Silence: Why kindness, compassion and respect matter in maternity care” published during the same year. She is currently working on her second book “Supporting Survivors of Sexual Abuse During Pregnancy and Childbirth – A Guide for Midwives, Doulas and Other Healthcare Professionals” which is being published by Jessica Kingsley in 2020. She has a great passion for supporting women and families during the childbearing year, in particular ensuring that they make informed decisions based on solid research as well as listening to their instinctual needs. She believes that childbirth and the postnatal period have become distorted and that women are losing out on that most empowering experience of birthing a baby. Her mission is to gently but firmly create a new culture very much based on the physiology of birth. She wants to help change the view of childbirth in the UK.