- When in my pregnancy should I book a doula?
- What areas of Perth do you cover with your services?
- Where have you supported births?
- What about the Dad?
- Who has a doula?
- What is the difference between a midwife and a doula?
- Does a doula replace medical staff (e.g midwife)?
- What are the limitations of the doula service?
- Can I have a doula at a homebirth?
- Do I really need a doula if I have a midwife?
- Does a doula make decisions on our behalf?
- What effect does the presence of a doula have on the mother?
- What effect does the presence of a doula have on the baby?
- Where does the word ‘doula’ come from?
- What research is there on doula birth support?
1. When in my pregnancy should I book a doula?
The earlier the better! Some women have even contacted me well before they have become pregnant! Once pregnant, the number of prenatal visits we will have will be the same whether you book at 12 weeks or at 28 weeks. The difference is that you’ll have someone that you can call on or email with those “Is this normal?” or “What does this mean?” sort of questions throughout your whole pregnancy. Plus the longer we have known each other the more opportunity we have to build a relationship. Contacting and/or booking in early also gives you a greater chance of my availability. I do tend to book out months in advance.
2. What areas of Perth do you cover with your services?
Being based near Fremantle, I am most happy to support clients birthing at the following hospitals: King Edwards, Family Birth Centre, St John of God Subiaco/Mt.Lawley/Murdoch, Fiona Stanley Hospital and Armadale Hospital. If you are birthing elsewhere, please also get in touch. If you are planning a homebirth and are unsure whether your location is suitable, please just contact me.
3. Where have you supported births?
Just by chance and often location, most of my clients either birth at the Family Birth Centre or King Edward Memorial Hospital, Kaleeya Hospital, Armadale Hospital or St. John of God, Subiaco. I have supported many homebirths on the Community Midwifery Program as well as homebirths with private midwives.
4. What about the Dad?
Doulas definitely support the partners too! During the prenatal visits, the role the partner wishes to take throughout the labour and birth is discussed. It’s important also for him to feel he can change his mind when the time comes around too! My role is to respect his wishes and support him through this process as well. This is a journey for birth of you.
Some partners like to take a very active role in labour, confidently supporting their woman through every contraction with unflagging energy, encouragement and good humour. Others calmly provide massage, cool cloths and endless hours of walking and slow dancing.
Still others like to be a quiet presence, happy to be nearby but feeling somewhat overwhelmed in the ‘woman’s world’ of birthing, anxious in the medical environment, and unsure of what support is needed or wanted. Some aren’t sure how they feel and the doula can provide reassurance, encouragement, and practical advice and also facilitate communication between them, the woman, and medical staff.
Sometimes the role the partner and I take change throughout the woman’s labour. I model emotional and physical support techniques, and give them the encouragement and space to develop their own style of labour support. I then take care of practical tasks so the partner can focus on the birthing woman. Birth can be an immensely exciting time for partners, and one that can be extremely validating and confidence building as they make the transition to fatherhood. But it can also be an overwhelming and anxious time for them.
“Your support through the long labour hours was crucial, we stayed at home longer in the beginning and according to my husband, he couldn’t have supported me without you.” Leanna & Dan, 2011
Supporting a woman to labour and birth normally can be hard physical and emotional work. For a partner working by himself supporting his woman is a marathon task, as he does not have the wonderful endorphins provided to the woman by her body, relieving her pain and rendering her unaware of the passage of time. Having a doula present enables the partner or husband to participate in the birth at his comfort level.
As a doula, I can also prepare food for you both as necessary, and also provide reminders to you both to eat and drink. When your partner needs a break to attend to his own needs, he can be assured that you will be supported through every contraction by your doula.
No one can replace a woman’s partner or husband at the birth because of the incredible connection that exists between you. It is an honour to be witness to this and it fuels everyone throughout the labour. The emotional support and comfort that your husband/ partner can bring to you during labour are of a quality no other can provide. As a doula, I understand that this support is essential to you in labour and by doing the physical work of heating up the hot packs, filling the bath, applying counter pressure to your lower back or taking photos, enables your husband/partner to focus their full energy on providing you with this wonderful form of support and attention.
Seeing couples travel the labour journey to birth is both stunning and inspiring. Neither has been there before but they use their bond, their strength and their love to achieve whatever experience is important to them.
“Paul felt and acted calmer when you were around and appreciated all the support you gave during the labour. Sometimes it was a few words, a reassuring look, a smile or nod that let him know all was well.” Louisa & Paul 2011
5. Who has a doula?
Some couples have a doula with their first birth, and others with subsequent births. Some women who have been dissatisfied with a previous birth experience and wish to achieve a better outcome hire a doula for subsequent births. Women without the desired support people available also hire doulas. Doulas attend births at hospitals, birth centres and homebirths.
6. What is the difference between a midwife and a doula?
A midwife is trained to do medical procedures and evaluate the well being of both mother and child, whereas your doula’s priority is your emotional support and physical comfort.
As shifts change within the labour ward, you may see many different midwives throughout your labour, whereas your doula stays with you continuously. Your doula focuses only on you, but a midwife has other mums and babies to look after and some can only check in on you, even whilst you’re in active labour, every half hour or hour for a matter of minutes.
“We found you to be the one person during our whole pregnancy that provided the most guidance and continuity of care. We were so impressed with the way you carried yourself, explained the process and also how you associated with the medical staff during the labour.” Kate & James, 2014
7. Does a doula replace medical staff (e.g midwife)?
No. Doulas do not replace midwives or other medical staff. Doulas do not perform clinical or medical tasks such as taking blood pressure or temperature, monitoring fetal heart rate, doing vaginal examinations or providing postnatal care clinical care. They are there to comfort and support the mother and to enhance communication between the mother and medical staff.
8. What are the limitations of the doula service?
Doulas are not midwives, nurses or doctors, and as such they do not give medical advice or perform clinical tasks during labour such as monitoring baby’s heart rate, performing vaginal exams, assessing baby’s position, taking blood pressure etc. Doulas do not make decisions or speak on behalf of the couple, yet they can help the couple make informed decisions by ensuring all information is obtained from the medical staff and understood. The doula agreement outlines the role and limitations of the doula.
9. Can I have a doula at a homebirth?
Doulas are very helpful at homebirths, often arriving to support the couple before the midwife. They provide an extra pair of hands for the midwife, whose primary responsibility is the wellbeing of the mother and baby. At a homebirth, doulas provide the physical and emotional support for the woman and her partner. Practical aspects often are the doulas responsibility; keeping birth pool warm enough, drinks, snacks, taking photos, helping the midwife, taking care of any siblings, helping with mother and baby soon after birth, with the clean-up, or whipping up a post-baby meal. Ideally, doulas and midwives work hand-in-hand at every birth.
10. Do I need really a doula, if I will have a midwife?
Most couples will answer ‘yes’ to this question. Although there is some crossover between the roles of doulas and midwives, there are many important distinctions. Primarily, the midwife’s responsibility peaks at the time of the birth, which is when she must be at her most alert to perform her job effectively. This means that she must conserve her energy throughout your labour to perform her job as best as she can. This does not mean that midwives do not provide labour support – they do- just that they have many other responsibilities that must take precedence.
In contrast, a doula’s responsibility peaks during active labour and transition, when you need the most help coping with your contractions. By the time the birth rolls around, the doula has already accomplished most of her work–she has helped you through your labour to the point of birth. As a result, a doula can afford to spend most of her energy in the labour stage.
As the midwives are busy setting up for the birth, taking fetal heart tones, charting, and many other important tasks related to monitoring the health of mother and baby, your doula is there with you, coaching you through each contraction, heating up your hot packs, adding fresh water to your bath, and fetching a glass of juice for you, and a cup of coffee for your partner. Doulas are also very helpful at homebirths, where an extra pair of hands to help with the clean-up, or whip up a post-baby meal can come in very handy. Ideally, doulas and midwives work hand-in-hand at every birth.
11. Does a doula make decisions on our behalf?
A doula does not make decisions for clients or intervene in their clinical care. She provides informational, physical and emotional support, whilst respecting a couple’s decisions. She cannot speak on their behalf, but will often facilitate more effective communication between the couple and the caregivers. This enhances the decision making processes and informed consent.
“I thought of you as our ‘guide,’ you helped us ask the questions we needed to in order to make our own decisions.” Leanna & Dan
12. What effect does the presence of a doula have on the mother?
When a doula is present during and after childbirth, women report greater satisfaction with their birth experience, make more positive assessments of their babies, reduced chance of maternal fever and infection, have fewer caesareans and requests for medical intervention, and less postnatal depression. Mothers also feel more secure, more in control, have reduced levels of anxiety, reduced maternal bleeding following birth and have a higher regard and increased sensitivity towards their babies.
13. What effect does the presence of a doula have on the baby?
Babies have shorter hospital stays and fewer admissions to special care nurseries. Mothers are more affectionate to their babies in postnatal period and there is an increased chance of successful breastfeeding.
14. Where does the word ‘doula’ come from?
The word ‘doula’ comes from ancient Greek, meaning ‘woman’s servant’. Another translation is ‘to mother the mother’. Throughout history and in much of the world today, a cadre of women support a woman through labour and birth, giving back rubs and providing continuous emotional support. Like their historical counterparts, doulas know how to help a woman in labour feel better. However, today’s doulas are much more diverse than their predecessors.
15. What research is there on doulas/birth support?
A review by Cochrane (a prestigious international organization that prepares and keeps up-to-date systematic reviews in many areas of health and medicine) on the effect of “Continuous Support for Women During Childbirth*” has drawn astonishing conclusions. The primary objective of this review was to assess the effects, on mothers and their babies, of continuous, one-to-one intrapartum support as compared to usual care.
Fifteen trials involving 12,791 women were included. After review and analysis of the data, the researchers offered the following synopsis: Continuous labour support reduces a woman’s likelihood of having pain medications, increases her satisfaction and chances for ‘spontaneous ‘ birth, and has no known risks. Supportive care during labour may involve emotional support, information and comfort measures. Such care may enhance normal labour processes and thus reduce need for obstetric intervention. The reviewer’s offered the following conclusion: All women should have support throughout labour and birth.
* Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.