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Doulas — are they for you?

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Giving birth is about a lot more than having a baby — it's about making mothers and growing families. The right support people can help enormously in making sure that the ingredients are there for a wonderful start to life. Some women are turning to doulas for this support.

What is a doula? 

Doulas are women trained in giving other women professional birth support — they essentially mother the mother. These women have reawakened the ancient tradition of having supportive, knowledgeable women present at births. Doulas generally meet a woman and her partner during pregnancy and support her during the birth and sometimes also in the early postnatal period. Some doulas, however, just do birth care or postnatal care. These women usually attend the birth, whether that be at home, in a birth centre or hospital.
 
Doulas provide emotional and physical support for the woman and her partner during birth. Renee Adair, director of the Australian Doula College, says it means being with women and couples in labour and postnatally. "Our job is to listen to the needs and requirements of women and create a positive labour atmosphere that allows parents to feel empowered and positive so that they move into the postnatal period with a newborn well, happy and empowered," she said.

Are doulas the same as midwives?

Doulas are not midwives and therefore not trained to provide any clinical advice or examinations. Doulas cannot provide antenatal care, deliver babies or provide the clinical aspects of postnatal care. Midwives work closely with doulas but the roles are very different.

What services can a doula provide?

  • Access to resources and information about pregnancy, labour and birth.
  • Information about classes, such as preparation for parenthood, yoga, etc.
  • Assistance with writing a birth plan.
  • Care and support during pregnancy, such as massage, making sure you drink, keeping your birth environment peaceful, helping you with birth positions and use of water for pain relief, encouraging you and advocating for you.
  • Some postnatal support for you and the baby and the ability to contact lactation consultants and other professional support should you need it.

Can having a doula be helpful?

Having the right support person can help make the birth a better experience. Research indicates women who receive close support and care throughout labour are less likely to need pain relief or have major interventions such as caesarean section, forceps or a vacuum delivery. They are also more likely to be satisfied with their birth experience. Doulas have been shown to have a similar effect on women's labours and births. Check out what women say about doulas and if you know someone who has used one, chat to them about how they work.
 
Jenny said the doula she had for the birth of her first child Jack was wonderful."I knew Mark [partner] was worried about the birth and I thought I needed some other support, for both our sakes really. Our doula just made us feel relaxed. It was like she knew what we needed next and what would work best, but she never took over."

Who might benefit from a doula?

  • This service can be of value to women who do not have adequate support and/or can't access a continuity of care midwifery program, where they get to know one midwife or a couple of midwives.
  • Women who do not have many friends or family around for support at the birth can also benefit from a doula.
  • If you have a partner who is very anxious about the labour, then a doula may be calming and reassuring to both of you. Partners who really don't want to be at the birth can be traumatised and also potentially detract from the whole experience.

What is the cost of having a doula?

Doulas will charge anywhere from $400 to $1500 to support women through the birth. The cost will depend on their level of experience, the amount of time they spend with you before and after the birth, as well as any other service they might provide, such as massage, aromatherapy or hypnotherapy.

How can you choose the best support people if you don't use a doula?

Giving birth is one of life's most emotional, intimate and instinctive experiences. The people you choose to experience this with need to be respectful of this fact and be able to enhance, not detract, from the experience. Women need to feel safe in order to labour. If you become frightened and feel unsupported, you begin to secrete adrenaline. During labour this has a negative effect, as it inhibits the production of the most important hormone in labour, oxytocin. When this is inhibited, labour slows down, often leading to interventions in birth.

Hint: Look for calming people when choosing support for your birth.

Characteristics of a calming support person

Calm in a crisis
Always positive
Loves you
Makes you feel safe and comfortable
Intuitive to your feelings and needs
Nurturing
Good attitude to birth, with no personal baggage
 
Where a woman cannot find this sort of person or people in her circle of family and friends, a doula can be invaluable. It is important that if you choose to have a doula at your birth, your partner and other support people meet them and interview them about their practices and philosophies. If you have children and they will be at the birth, then make sure they become familiar with your doula as well. You want to make sure when the big day comes you are a team all going in the same direction — your direction!
 
Find a qualified doula Doulas have a variety of training. Some have very little training (a week or less) while others have a much longer training (a year or more). The following organisations have developed doula training courses and can advise you about qualified doulas near you.
 Dr Hannah Dahlen is the Associate Professor of Midwifery at the University of Western Sydney. She has been a midwife for more than 20 years. Hannah is also an executive member of the Australian College of Midwives, NSW Branch. She has researched women's birth experiences at home and in hospital and published extensively in this area. Hannah's website is www.hannahdahlen.com.au

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