Why Do You Need a Doula?

This is a question that many people ask when someone suggests hiring a birth or postnatal doula.

Rightly so- you may have gotten this far without support from a complete stranger, right?! A common misconception of a doula is that they replace the role of the birth partner when actually, the main aim is to make the birthing team even stronger by empowering with knowledge, advocating and providing guidance if needed.

To give you a brief background, doulas have been around for years, but are becoming a popular addition to parents’ birth teams in our modern day world. Traditionally, mothers, aunts, sisters, even neighbours would be around to support a new family during and after baby’s birth. But in recent years that community dynamic has changed dramatically. Our health system is more stretched than ever and doulas are providing more families with emotional and practical support everyday.

It was in 1973 that the term “doula” became an official ‘job’ description- it’s a shame they didn’t pick a name that was a bit more self explanatory!! The word doula comes from ancient Greece and means female slave (hmmm). In this context, it’s someone who supports before, during and after childbirth.

A 2013 Cochrane study found that the presence of a doula during pregnancy and childbirth resulted in a wide range of positive outcomes, including reduced chance of unplanned caesarean or assisted birth, reduced need for ­medicalised pain relief or epidural during birth, shorter labour, increased parental satisfaction with the birth experience and increased likelihood of initiating breastfeeding.

So what can you, the birth partner, expect from a doula?

During pregnancy,  before the birth:

• In the lead up to the birth, doulas spend a good amount of time getting to know you and teaching you about the how’s, what’s and what-if’s about birth. Informed parents are confident parents, and doulas love to see parents take control of their decisions knowing they are doing the best for their newly formed families. This would normally be over 2-3 antenatal sessions in the comfort of your own home in the months before birth.
• Doulas help you to write your birth preferences (what you can control) and think through navigating unexpected turns (what you can’t control).

During birth:

• Doulas make themselves available to come to you from around 38 weeks up to 42 weeks (depending on the agreed time with the doula), at any time of day or night, so you can rely on them to be there when you need them. Even if you aren’t sure on whether it’s the ‘real thing’, doulas will speak to you by phone at anytime in this period, and come to support you in-person when you ask them to.
• You could think of doulas as a walking library… even if they don’t have all of the answers on the spot, they’ll be completely comfortable with speaking to your care providers to get them for you.
• Doulas do not offer medical advice. They share a balanced and totally unbiased view of the situation (risks and benefits), but it will always be down to you to make the decisions on the day. This is why the antenatal sessions are so important, as it’s then that you will learn all about the pros and considerations of most options and scenarios you could be faced with in the lead up to and on the day. The doula then reminds you and helps you to navigate the situation in real time.
• Doulas are a constant, reassuring presence in the room. Someone who won’t change shift or go home – and that can have a huge effect on the birth (see the Cochrane review 2013).
• The hours spent getting to know you during your antenatal sessions will pay off during a straight forward birth or a birth that experiences unexpected turns. This is because they understand your birth hopes and support you by putting them into place. Birth centres and labour wards can be very busy places, so having someone who is comfortable to request dim lighting, music, important birth support tools can really take the pressure off of the birth partner when you just want to be together.
• Doulas will be your advocate when on new, unfamiliar ground with new people, which can all feel very daunting at what can be a vulnerable time.
• At a home birth, doulas can agree roles and responsibilities so that you’ll feel completely comfortable that everything is going to be taken care of on the day. This could be making sure the midwives are kept going with tea and biscuits, making sure the candles are lit or helping to fill up the pool if you’re having one. Doulas can be as hands on or as hands off as you’d like them to be.
• If birth slows down they have a fair few tricks up their sleeves to get things moving again… no weird magic involved (!) just calming and comforting techniques that help you to feel relaxed and safe in your environment in order to help things to pick up again.
• If an unexpected turn were to arise, having someone that you trust with you can be hugely helpful too. A lot of parents say that they worry about the birth partners in a situation where they need to be taken away for treatment, so knowing someone familiar is on hand to support you too can help your peace of mind in any unexpected medical situations.
• If birth is taking a longer time (it’s completely normal if it does), then doulas can tag team with birth partners so they can get some rest or restock on supplies. Or the doula can restock the supplies- whichever works best for you.

After birth:

• The hour after birth is known as ‘the golden hour’, and so a doula’s role here is to make sure you can be with your baby to spend that uninterrupted time with them.
• Taking photos and videos of this precious time can be something that you ask them to do, midwives generally won’t have time to do the extra bits, as much as they might love to.
• At a home birth, doulas might be making the parents some food (they will be ravenous after labour!), making the round of tea, or helping to clear away the pool and popping the towels in the washing machine.
• At hospital it might be making sure the harsh lights are switched off, dim fairy lights are set out and calming music is switched on to make baby’s transition to their new world more cosy. This can also help with supporting bonding and breastfeeding too as it will be more helpful for parent and baby to produce all of the feel-good hormones that are needed.
• If baby has been born abdominally (via caesarean), your doula can stay with you whilst your birth partner goes with the baby for their checks (sometimes these can take a little longer after an unplanned caesarean).

Postnatally

• Some birth doulas also offer postnatal doula support. You can opt for just postnatal doula support and not birth support.
• Practical support to allow you to just ‘be’ with baby can mean everything to some parents. Whether it be bringing in the food shopping, taking older children to school/picking them up, light cleaning- different doulas will offer different services so just talk through what your expectations might be when you are enquiring. Some families opt for a postnatal doula to come once the partner has returned to work, or perhaps you are a solo parent looking for a doula to be on hand most of the time. Help with baby whilst you shower, their first outings with just them and (these can be very daunting for the first time without a partner) and general help with confidence building can all be part of the care ‘package’.
• Emotional support is a big part of the postnatal doula service. Whether a parent has chosen to breastfeed, combination or bottle feed, doulas can guide them around this hugely emotive stage and get them further support if needed.
• Having someone booked in to come and see them who isn’t expecting to be hosted can also be a relief too. The early stages of parenthood can be very lonely for many people.
• Every family will have different needs, so it’s important to talk through your expectations and hopes with your doula before you hire them.

• The Mindful Birth Group® course and Parent Hub subscription includes a one hour virtual postnatal doula session post-birth. This is so you have the opportunity to talk to someone you trust about your birth, how it went and how you feel. Your doula can signpost you to information or practitioners that may be helpful to you. You may have questions about baby- feeding them, settling them, dressing them! This is your time to get impartial support, so you can ask whatever you need to. You can book more sessions if you would like to, these can be booked and paid for directly with the doula.
• Find out more about postnatal doulas here.

You see the benefits, now how do you choose a doula?

Head to this article to help you choose the right doula for you.