With national birth rates rising and widespread cuts to the NHS our midwives are struggling to give the one to one, continuity of care that women need during labour and birth.
Doula (doo-la) is a Greek word that has come to mean a woman experienced in childbirth who provides continuous physical and emotional support to the labouring woman and her partner. The term translates as ‘trusted servant’ and was coined in America to give a name to the rising movement in the use of trained birth companions.
In the majority of cultures throughout the world there is a tradition of women helping other women during this time. In our modern society where birth has migrated from home to hospital this tradition has become almost extinct.
Doulas are growing in numbers around the country. Hiring a private doula in the UK can cost from £300 to £1000 usually dependant on experience. Most doulas will offer an obligation free initial meeting so that you can ask questions, see if you get on and check her experience and training and what she offers. Commonly a doula will offer two pre natal visits, two post natal visits, presence at your labour and birth (for however long it takes) and 24/7 availability for two weeks either side of your due date. Some doulas will offer additional services such as natural therapies, book and DVD loan, birth pool hire.
So what can a doula offer that a midwife, family member, partner or doctor can’t?
1) The doula is concerned with only one patient for the entire labour and delivery where as a midwife may be shuttling between many other women and have paperwork, handovers and other tasks to perform.
2) The doula focuses on the emotional and physical needs of women, not medical issues. A doctor is trained to see and deal with medical problems and emergencies. A doula supports the woman to stay present with her body, her breath, her experience so that the process of labour and birth can unfold in its own unique way.
3) The doula remains calm and objective, which can be difficult for a family member or friend. Having dad’s to be in the labour room is a wonderful advancement. However, I am sure many of them would be the first to admit that being in the role of husband, birth coach, advocate and remaining objective and level headed whilst their loved one is having possibly the most intense physically and emotionally challenging time in her life, is a big ask. The doula also has recourse to natural pain relief methods.
One of the leading proponents and researchers in this field is Dr. John H. Kennel, a paediatric doctor in the US, famously said “If a doula was a drug it would be unethical not to use it.” Studies by Dr. John H. Kennel and other researchers have shown dramatic improvements in perinatal outcomes when the woman and partner have a doula present. One randomized control trial showed a reduction in caesarean section rates by 50%, use of forceps by 40%, requests for epidural analgesia by 60% and a 25% decrease in labour length. With these results the NHS should put doulas on the payroll and they would make a huge saving!
Other outcomes include better mother and child bonding, higher breast feeding rates, reduced instances of post natal depression and more active involvement from the birth partner.
Sheffield City council have had the great foresight to launch the Sheffield Volunteer Doula project. In conjunction with the city wide Breast Feeding Friendly initiative, this project is aiming to provide better outcomes for vulnerable women, babies and families in the short and long term.
I foresee a time when ‘doula’ will be a household name and when you go for your pre natal check-ups at the hospital you will be asked, would you like a doula with that? But for now, their popularity generally lies with more liberal, educated women and couples who want to go down the ‘more natural route’. So, spread the word DOULA for happier mums, babies and families.
By Sarah Oldfield
Doula and Shiatsu Therapist
References: ‘Benefits of a Doula Present at the Birth of a Child’ PEDIATRICS Vol. 114 No. Supplement 6 November 1, 2004 pp. 1488 -149