What on earth is a Birth Doula and why would you hire one?

If I could give you a dollar for every time I have heard the question “What is a Doula?” well…….. you know the answer to that one……. But, seriously, let’s talk about what a Birth Doula is - because I sure wish I knew about them when I had my 3 children.

To understand the role of a Birth Doula first we must distinguish the role from that of others involved in the childbirth process as each has a defined role to play. Midwives and Obstetricians - are responsible for clinical and/or medical aspects in the care of the woman, it is their top priority. A Birth Doula is NOT trained to make any medical decisions, but that doesn’t automatically mean she is not medically trained. A Birth Doula can have a background as a registered nurse or midwife, but as such, is no longer practicing and has chosen to work as a Birth Doula. So, what do we focus on and what is our role to play as Birth Doula’s? Psychosocial and non-medical aspects of care. For those of us who don’t have a medical background we certainly gain a fair amount of knowledge during our training and each birth we attend this knowledge further expands.

Most Birth Doulas (but not all) have had children of their own. Having given birth before, you gain the innate sense of what the experience of childbirth is like and therefore, you hold the ability to feel and share your empathy with ease. I want to discuss for a moment the focus of the Birth Doula in relation to the mother-to-be and her birthing partner. Why would you need a Birth Doula when you have your partner? My initial thoughts too - until I thought back on my 3 childbirth experiences, trained as a Birth Doula back in 2018 and from then have attended many births.

The Greek word Doula means ‘woman caregiver.’ These days, this term describes a trained and experienced labour companion whose role is to provide the mother-to-be and the birthing partner continuous emotional and physical support, through massage techniques, use of a rebozo (a long scarf used in many different ways e.g. controlled movements for comfort during labour), helping with labour positions, breathing and relaxation skills, positive affirmations, educating and empowering women during their decision making & birth plans and may even be able to offer HypnoBirthing techniques (check their training).

This is where the beauty of a Birth Doula lies- we all have something unique to bring to our role, our life experiences, ongoing professional education (which we all do because we all get addicted to the many courses/seminars/ongoing training that is available in the birth world……!).

Here is what a Birth Doula does in a nutshell (From DONA Int What is a Doula Workshop Manual, 2017)

  • Recognises birth as a key life experience that the mother will remember all her life

  • Understands the physiology of birth and the emotional needs of a woman in labour

  • Assists the woman and her birthing partner in preparing for and carrying out their plans for their birth

  • Stays by the side of the labouring woman throughout the entire labour

  • Provides emotional support, physical comfort measures, an objective viewpoint, and assistance to the woman in getting the information she needs to make good decisions

  • Facilitates communication between the labouring woman, her partner , her clinical care providers

  • Perceives her role as one who nurtures and protects the woman’s memory of her birth experience

    I am humbled to write that the acceptance of Birth Doula’s in maternity care is slowly, but surely gaining recognition - this is of course our contribution to the improved physical outcomes and emotional well-being of mothers and their babies.

The World Health Organization recognises the benefits of continuous support during childbirth https://www.who.int/reproductivehealth/topics/maternal_perinatal/support-during-childbirth/en/ but the KEY takeaway message is this:

Women who received continuous labour support were more likely to:

  • Give birth vaginally

  • Had fewer caesarean, forceps or assisted vacuum births

  • Were less likely to use pain medications

  • Were more likely to be satisfied with their birth experience

  • Had shorter labours

Read more here: https://www.nationalpartnership.org/our-work/resources/health-care/maternity/continous-labor-suppor-cochrane-review-2017-takeaways.pdf

How Does a Birth Doula and the Birthing Partner work together to support the birthing person?

Concerns we hear from potential clients when being interviewed are that they are concerned we might interfere with the couples intimate birth experience, the partner may be pushed aside, we have taken childbirth education classes so we don’t need any more support to don’t we get in the way of the midwife or obstetrician? They are all fair questions.

Firstly, The Birth Doula allows the partner to participate at their own comfort level. The partner can’t be everything, all the time and can often feel pressured into ‘getting it all right’ and worried they won’t know what to do or may have fears around their own behaviour (particularly in first time births - it is a new experience OR if they have attended a birth that may have been traumatic in one way or another - extra support for them is vital). We are able to supplement their efforts, during a long labour the birthing partner can take a break and know their partner is being fully supported. All in all it reduces stress - and this is what we aim to avoid from the start and for the entire duration of the birth experience. Combined effort and contribution of the birthing partner, Birth Doula and medical staff only serve to give the birthing person the best outcome. Why wouldn’t you want that?

Childbirth Education. It’s fabulous and so downright beneficial in so many ways (this will be a separate blog…). So is it enough to take the classes and then hit the dance floor so to speak? Yes AND No. As a certified ChildbirthEducator myself, I am the source of information, whereas a Birth Doula is the guide in helping the mother-to-be and her birthing partner to find further support, evidence-based information and resources specific to their own needs. We encourage our clients to not only gain knowledge, but to make their own choices and understand the reasoning behind it all. So, childbirth education + Birth Doula = an extensive knowledge base + added confidence and reassurance of the Birth Doula throughout the duration of their labour and birth experience. The best of both worlds!

What is a Birth Doula is a huge topic, and I feel I have only touched on it. My next article will go through my ‘typical Birth Doula’ contract which breaks down how I work and what my support service offers from the moment we meet to a few week’s post-partum. Take a peek at one of my birth stories (shared with client’s permission) so you can get a real insight into what the support ‘looks like’.

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My Birth Doula Contract - What it is, Why we have it & What to expect