The benefits of hiring a doula as part of your birth team.
What does Doula mean?
The word doula comes from the Greek word doulē, the meaning of which translates to female helper or maidservant.
What does a doula do during pregnancy?
Doulas do not provide clinical care during pregnancy, they do not have any medical training, this is the role of your Dr / and or midwife if you choose to have one.
They do not monitor your vital signs, take or interpret blood tests or measure your bump, they are not part of your standard health care.
During pregnancy, a doula can work with you and your birth partner to help you thrive in pregnancy and prepare for your birth.
Some traditional doulas may offer traditional remedies or knowledge, like massage or herbs/supplements to help relieve pregnancy symptoms or complaints.
Other doulas (like me!) will offer evidence-based support, signposting you to appropriate services or information to enable you to find the solutions that work for you!
Doulas can offer information on diet, exercise, and mindset work to support you to enjoy your pregnancy!
We can provide information and education about the process of labor which compliments any antenatal courses you choose to do, some doulas offer their hypnobirthing classes to support you in getting educated and informed about pregnancy and birth.
Doulas support you before, during, and after midwife or OB / Dr appointments to ensure you feel supported and informed, and to provide continuity of care which you may not be getting within the traditional healthcare model.
We provide you with the information you need to help you make informed decisions about your place of birth, some doulas only support certain types of birth (like unmedicated birth, homebirth or freebirth) but I support all types of birth with my Doula in your pocket package, (Hospital birth, caesarean, homebirth, freebirth and birth centre!).
A doula works with the pregnant mama and any birth partners to make sure they are on the same page!
We can help you create your birth plan, providing templates and information to enable you to prepare for most scenarios you could come across in birth.
Doulas have experience in what are the most helpful items to have available during your labour, and can help you pack your hospital bags or prepare your space for a home birth.
What do doulas do during birth?
Doulas do provide labor support but it might not be in the way you are thinking!
Doula’s do not provide clinical care, such as listening to your baby’s heart, taking your vital signs, or doing vaginal exams. They do not make clinical recommendations, or ensure you are medically reviewed. For that you need a certified nurse or midwife.
During birth doula’s can provide emotional, and physical support as well as help advocate for your wishes.
Doulas can work with the team you have chosen to support you during your birth, including working alongside midwives, independent or private midwives, Drs and your partner. (or none of the above!)
Physical support
A Doula may bring with them items which may find useful during birth, these are not clinical or medical items but coping tools such as a TENS machine or a birth comb, snacks, massage oils and aromatherapy oils, what each doula brings is individual to them.
Doulas can support you physically by using massage techniques, providing counter pressure or helping you to find comfortable positions, some doula’s may be trained in biomechanical techniques to help your baby move into your pelvis and find an optimal position (should you want it).
Doulas may prepare and provide you and your birth team with food and drink, helping you and them keep fuelled and hydrated.
They can instruct or assist your birth partner in carrying out some of these techniques, and work with your midwife to provide any non clinical physical support you may request.
Emotional Support
Having a doula in your birth space can feel like having a calming presence, doula are very good at holding space for women during birth helping to keep the environment relaxed by gently guiding you to use your coping techniques if required.
A Doula will be experienced in the physiology of birth, helping you to trust in your body and your baby.
Some doulas will provide spiritual or religious support in the form of ritual or ceremony.
Advocacy
As you will have worked with your Doula to create your birth plan they will have a good understanding of your wishes, for example helping to remind anyone that enters the birth space to use calm voices, or keeping the room dark.
We have a deep understanding of your birth rights and if we feel they aren’t being respected we can gently remind the people in the room of your rights – if you wish us to.
If a situation should arise that requires you to make an informed decision your doula will remind you of the tools you have learned to do this, for example asking for the risks and benefits of each option.
Postpartum Doula Support
You may arrange for a doula to visit you postpartum for emotional and physical support whilst you get to know your new baby.
Postpartum doula care is variable, physical support can include cooking meals, caring for older children, preparing baths with healing herbs or holding the baby whilst you sleep.
Emotional support includes holding space for you to talk about your birth and the thoughts and feelings you are going through in your newborn bubble, helping you keep an eye on your mental health.
Are Doulas regulated?
Being a doula is not a regulated profession.
In the UK, to get onto many of the Doula registries you have to complete an accredited course, ensuring you have had a basic level of training that aligns with the professional standard of that registry.
Some registries require new Doulas to be mentored through a certain number of births and provide continuing opportunities and support for the Doulas on their system.
Being unregulated means that Doulas can truly work only for you, as they are not beholden to any other rules or regulations.
What does the research say?
Having Doula support can reduce your risk of having a caesarean by 52.9% and give you a lower risk of Post Partum Anxiety or depression (Falconi, April et al 2022)
In essence a Doula is a form of continuous support during pregnancy and birth, you may or may not be already getting this support from a trusted midwife, but in the UK it is uncommon to see the same midwife for pregnancy and birth (unless you hire a private or independent one that is!)
A Cochrane review into continuous care showed that having continuous care during labour:
- 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)
- 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)
- 10% decrease in the use of any medications for pain relief
- Shorter labors by 41 minutes on average
- 38% decrease in the baby’s risk of a low five-minute Apgar score
- 31% decrease in the risk of being dissatisfied with the birth experience; this risk was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff
How to hire the right Doula for you and your team:
We have discussed that the type of care provided by doulas is variable and this is why it is important to meet with a doula before booking them (probably meeting with a few different doulas) to find the best fit for you.
Some questions you could ask are:
1/ What type of birth do you support
2/ What type of birth preparation do you provide?
3/ What type of physical support do you provide during labor? Do you have any additional training?
4/ Are you available for my due date? Do you have back up?
5/ What type of postpartum support do you offer?
6/ What training courses have you completed? Are you on a registry?
7/ Are they happy working within a team?
You need to decide what is important to you and ask questions to find out if you are aligned, for example you may want someone to chant and bang a drum whilst you birth, but the doula you interview is more practical in the ways they like to support people for example with massage and biomechanics.
What about Virtual Doulas?
A Virtual Doula is a way to access a lot of the great benefits of having a Doula, without working with them in person.
Its perfect if you want to work with a Doula outside of your area, if you don’t have the time to meet in person, if you don’t want in-person birth support, or if you simply prefer digital communication!
If you want to find our more about adding a virtual doula to your birth team you can have a look at my website www.thesmartdoula.com
References
Doula care across the maternity care continuum and impact on maternal health: Evaluation of doula programs across three states using propensity score matching
Falconi, April M. et al.
eClinicalMedicine, Volume 50, 101531