Before I had my kids I didn’t really know what a doula was. I thought they were hippies that rubbed you with patchouli, whispered “you ARE mother earth” and jingled when you trampled them to get to an anesthesiologist.
The truth is doulas are awesome. The best way I would describe them is like a birthing diplomat. They are there to make your birth better. They “get” what the medical pros are talking about and they “get” what you are talking about because they’ve been with you throughout your entire pregnancy, so they are able to bridge any gaps between the two.
Which is why I asked Antonia if I could share her doula story because does a wonderful job of illustrating how it can work. I recognize that not all of the information will translate to a North America birth but it gives you the general idea.
It helps if you read it in an English accent….eating scones….while sitting on Benedict Cumberbatch’s lap.
“A birth doula recognizes birth as one of the most important experiences a mother will ever have in her life. She understands the physiology of birth and the emotional needs of a woman in labor. She provides objective emotional and physical support and helps the woman get the information she needs to make informed decisions. She can facilitate communication between the laboring woman, her partner and her midwives and doctors. She will stay with the woman through the labor however long it may be.”
Childbirth hurts. It really hurts. The pain is caused by intense muscle fatigue. The womb, or uterus, is a massive muscle. During the first stage of labor, it works overtime. The opening has to get from being not-even-a-smidgy-bit-open, to open-enough-for-a-person-to-squeeze-through-please. This asks a lot of the uterus and requires a great deal of effort, and the effort hurts. So much that women can become hugely overwhelmed and very frightened by it, which causes their bodies to fill up with adrenalin. This is a real bummer because it makes the pain so much worse.
To be fair to adrenalin, it can be super useful. Imagine a woman giving birth in a jungle a few thousand years ago. Should she see a woman-eating tiger up ahead, her adrenalin-filled body would do one of two things; either clamp up so that she could keep the baby inside her and run away to safety, or quickly push it out so that she could scoop it up and scrabble away (imagine). Nowadays the birth environment is generally tiger free, but adrenalin still plays an enormous part in the birth process. During the second stage of labor when the baby is being pushed out, this adrenalin is tremendously handy. Its generally makes the ‘holy shit there is a PERSON coming out of me!’ dramatic bit at the end, much quicker and easier. But if the woman becomes frightened in the first stage of labor, (the opening up bit), the adrenalin is a massive hindrance. It makes her clamp up. It tenses and hardens up all her muscles, most annoyingly the uterus, which of course makes it much harder for it to open. Oxytocin, the ‘hormone of love’ which facilities the entire birth process, gets trampled on by all the furious adrenalin charging about, which is most unfortunate.
A doula has many jobs. Managing the woman’s fear is just one of them. By helping her to stay calm, she increases the levels of oxytocin and keeps the adrenalin at bay which makes everything easier. But sadly quite often nowadays, for many different reasons, birth is not remotely easy or straightforward. There can be all the calmness of a monastery and oceans of oxytocin but if a baby is in a funny position, or if the mother becomes exhausted, things can change. Any number of things can happen. Impossibly unpredictable, birth is full of the unknown. All you can be sure of is that a doula will make whatever happens, easier to cope with.
In the UK, unless you live in 1952 or in a tiny rural village, it is most likely that you will have quite random antenatal care from any number of sources. Our birth rate is booming, and maternity services are stretched beyond their limits. Gone are the days where your midwife knew your name and shoe size – nowadays you are lucky to see the same one twice throughout your pregnancy. Unless you are planning a home birth (and today only 2% of British women do), when it comes to d-day you will have no idea who will be delivering your baby. And even when you are busy giving birth, the midwife helping you (lovely though she may be), will not be able to spend much time with you as there will be so many other women for her to look after. Many couples are astounded to find that they are left alone in the delivery room for hours. With a doula you are never on your own. With a doula you have your own personal birth assistant, a trusted birth companion on whom you can rely totally, for anything.
My second son, my darling Toby, was a HUGE baby. Giving birth to him was tricky. (Imagine a baby elephant trying to burrow out of a plughole.) Antenatal teacher or not, giving birth to something the size of a small car left some bad memories in my brain. I know how important calm is, I never stop banging on about it in my classes, so when I found out we were expecting baby number three I knew that I needed a doula.
Doula and mother-to-be form a relationship with each other throughout the pregnancy. The doula meets with the expectant mother, talks to her, and earns her trust and affection (or in my case, a full on girl crush). Whether the mother hopes to give birth hanging from a tree by her armpit hair or is planning an elective caesarean, the doula is there. Whether she wants an epidural from the onset or plans on going utterly drug free, the doula is there. Completely without judgment, she only serves to support the mother in the birth that she desires.
When I told Mr G that I was thinking about getting myself a doula his face went a funny kind of shape. (Turns out he thought I said ‘doodler’ and was confused about why we’d need someone scribbling with a biro in the delivery room.) So I explained what a doula is and what doulas do but his face remained funny looking. He felt sad – gutted to think that he wasn’t going to be enough for me in terms of support. I didn’t really notice; when I said I was ‘thinking about finding a doula’, what I of course actually meant was that I had found, met, fallen in love with and hired one. I was really excited about it. When the poor man managed to find his words he explained that he was feeling hugely redundant. A wonderful doula friend of mine, Mariana, once told me that approximately 98.9% of her client’s partners feel unenthusiastic about her at first. (I happen to know that as soon as their babies are safely in their arms they are begging her to be the godmother/live with them forever/accept their kidneys etc). I adore Mariana. A fellow antenatal teacher as well as a birth doula, she’s incredibly knowledgeable about labour and birth, she’s warm and tactile, (lucky – as I can’t seem to stop stroking her), and truly one of the funniest people I know. Also she smells delicious as all good doulas do. Having helped me find my doula, Katy, online, Mariana reassured me that as soon as Mr G met her, all would be well.
When Katy came for supper that night she proved Mariana right. The first of many incredibly sensible and clever things she did was turn up with a bottle of red wine and Mr G’s all time favourite pudding; homemade banoffee pie. During dinner she started explaining how she was planning to help us. ‘Us’ being the keyword. As well as worrying about being a gooseberry in the delivery room, Mr G was worried about how Katy would be received by the medical staff in hospital. (He is the type who never sends back cold food in restaurants for fear of being seen as rude – the thought that we were going to be turning up with what he thought was effectively our own personal midwife who may well boss all the other midwives around made his ears go hot.) Over the banoffee pie she reassured him of two important things:
1. She would not be bossing the midwives (or anyone else) about. Her role was to be entirely supportive. As it happens, most midwives are DELIGHTED if you turn up with a doula to help, and ours was no exception.
2. It would not be a ‘Katy and Antonia love in’. (I was mildly disappointed to hear this). ‘Don’t take this the wrong way Antonia’ she said, ‘but I don’t love you like he loves you. I am going to be far less emotionally involved so I’ll be able to help him to help you’.
And help him she did. When the big day arrived Mr G managed to win himself title of ‘Best Birthing Partner Ever’. Labour started on the Saturday night. All through the night and all day on Sunday things limped along at a rather unimpressive pace. Katy and I kept in touch throughout, and finally, on Sunday night after a large glass of wine and a long soak in the tub, things kicked off properly. By the early hours of Monday morning I was losing my sense of humour, and the last text I received from Katy simply said ‘I am coming.”
Soon she was with us and gently organizing things and making the atmosphere calm and lovely. Mr G was asked about breakfast. (He started to list what he fancied before Katy cut in and gently asked him to make me something to eat.) Soon he was feeding me nibbles of honey soaked bagel and giving me sips of lucozade. (Thank you God for lucozade). Unlike when the boys were being born, there were no scary decisions for Mr G to make. Katy took over timing the contractions and it was she who decided it was time to head to the hospital. The boys were safely taken away, the hospital was contacted, the bag and notes were packed into the car, and she took care of it all with absolutely no fuss or panic. Everything was sorted out with all the no nonsense efficiency of Nanny McPhee. All Mr G had to do was look after me.
When the pain was engulfing me, Katy helped him to massage my back in just right way. When I wanted to bite my own hand off, she squeezed my pelvis while whispering to him so that he knew what to say to me. She kept me moving around so I could get all the benefits of gravity, she kept me weeing (a full bladder wreaks havoc for the hard working uterus), and she subtly placed waterproof sheets underneath my posterior just in case. When I tensed my shoulders up pushed them down and I was instantly calm. In the car she sat next to me in the back while Mr G drove to the hospital, holding my hand and deep breathing alongside me, and when we arrived she let me hang onto her neck and pull her hair while he parked the car.
Once in the delivery ward it was clear that this baby of ours was keen to make an appearance sooner rather than later. Katy was dealing with the overtired and snappy midwives in Reception before Mr G and I could even work out how to string a sentence together. If there wasn’t a person coming out of my uterus I would have concentrated harder on applauding her. Soon she had me in a wheelchair and before I knew it we were settled in our own room and I was making all the appropriate animal noises that signify the light at the end of the tunnel. Katy was quick to introduce herself to the midwife and student and managed to explain the ordeal of Toby’s birth and its significance in a heartbeat. I was supported and loved from all sides. Before we knew it, our little baby girl was gently emerging, with Katy snapping pictures of the moment, just as I had asked her to do. It was all totally and utterly brilliant.
Here I am seconds after all 8 lbs and no ounces of Maisie Jane arrived.
Well chuffed with meself.
We couldn’t thank Katy enough. (I’m still obsessed with her. We became friends on Facebook minutes after the placenta was delivered and I have been stalking her ever since.) Mr G was thrilled with every bit of the experience and wonders why on earth we waited for the third baby to get a doula.
Katy assessing her handiwork
Everyone deserves a doula! First timers, fifth timers, mums, dads, babies – everyone deserves a doula! Maybe you are single and worried about support during labour. Whoever you are and whatever your situation, a doula will meet all your needs and more. Doulas range in price from around £200 (for those in training), to around £1000. Considering your doula will be constantly on call for you (and abstaining from alcohol), from 38 to possibly 42 weeks of pregnancy, you can be assured that she will be doing it for love rather than money.
Doulas need 24 hour childcare in place for their own children, and will make themselves available to you at a moments notice any time of the day or night. Sometimes doulas in training will provide their service for free exchange for the experience. Others will work out a plan with you based on your budget. Sometimes you can ‘pay’ your doula by doing something for her later on. (If your partner is good with a hammer for example, he could do some DIY jobs for her in return for her services.) There are also ways to get a doula for free if finances are really tight. A doula usually has only one client at a time although some take on more and share care with another doula in case of a birth clash.
Postnatal doulas are also available to help you at home after the birth of your baby. Payable by the hour, these doulas ‘mother the mother’, and will do anything for you from making your supper, to hanging out your washing to cuddling the baby while you sleep. If all you need is a shoulder to cry on, she will be there to provide it. Maybe you like the idea of becoming a doula yourself! A very special friend has recently completed her training and is now madly happy being a doula – I know she would not be able to recommend doulaing enough. And it goes without saying that I do too 🙂
For more information on doulas visit:
Research shows that having a doula present at the birth can lead to:
50% reduction in cesarean sections, 60% reduction in epidural requests, 20% shorter time in labor, 30% reduction in analgesia use, and 40% reduction rate of forceps and ventouse (vacuum).