Doula (pronounced doola) is a Greek word meaning ‘woman servant or caregiver’. It now refers to someone very knowledgeable about, and usually experienced in, childbirth, who offers emotional and practical support to families before, during and after childbirth.
Doulas believe in enabling their clients to have the most satisfying and empowered time they can during pregnancy, birth and the early days as a new parent by ‘mothering the mother’. This type of support also helps the whole family to relax and enjoy the experience.
Doulas who work with families antenatally and during labour and birth are called birth doulas. Doulas who work with families in the weeks after the birth and are called postnatal doulas. Some doulas offer only one type of doula service, while others offer both
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Birth Doulas
Birth doulas provide continuous support and reassurance throughout labour, helping their clients have the birth they want. In an NHS hospital it is unlikely that a midwife will be able to remain with a birthing parent throughout their entire labour. However a doula can be with them from before they even go to hospital, and remain with them until after the baby is born. If attending a homebirth, a doula can arrive before a midwife would consider it necessary to be there and can remain as long as the family want.
A doula is not a doctor, a midwife or a nurse. Their job is not to make medical decisions. However, they are very knowledgeable of the natural birth process as well as medical procedures, enabling them to explain them to parents.
Doulas do not replace partners, although they are often employed by single parents or those who would otherwise be birthing alone for any reason. Doulas can help partners to participate more fully in the birthing process by offering reassurance and suggesting ways in which they can help. The presence of a doula also allows supporting partners to take short breaks, from what can be a physically and emotionally draining task, knowing that their labouring partner will not be left alone. Doulas can also take on the practical tasks, such as preparing refreshments, taking photographs or video, adjusting heating, looking after older siblings or making phone calls, that would normally take the supporting partner away from the labouring partner.
"Improved obstetric outcomes are associated with continuous support, especially the support of a doula. A 'doula' labour support companion has the strongest impact on health and safety during labour and birth, compared with women who have no support in labour, or support from a member of the hospital staff, friend or family member.
Women with continuous support from a doula or other independent person were:
• 28% less likely to have a caesarean section
• 31% less likely to use synthetic oxytocin to speed labour
• 9% less likely to use any pain medication
• 34% less likely to rate their childbirth experience negatively
Continuous support from a person who is present solely to provide support, is not a member of the woman's social network, is experienced in providing labour support, and has at least a modest amount of training, appears to be most beneficial."
'Continuous support for women during childbirth (Review) - The Cochrane Collaboration' Hodnett, Gates, Hofmeyr, Sakala and Weston (2011)
Postnatal Doulas
Postnatal doulas work flexible hours to suit the family, offering practical and emotional support to parents following the birth of their baby. Doulas usually work for around 3 or 4 hours per day, anywhere from a couple of weeks to several months after the birth. This may be as frequently as every day or just once or twice a week.
Doulas can provide emotional and practical support. They may help with light household duties and with looking after older siblings, allowing the family to spend time bonding with their new baby. Doulas offer support and information on many aspects of caring for a newborn, including feeding, as well as allowing parents to rest by looking after the baby.
Too often nowadays, new parents are rushed back into normal day-to-day activities. In many cultures women are confined to bed and rest for a period of up to 40 days. This may be impossible in our society but with the help of a postnatal doula, parents can enjoy some of the benefits of a prolonged 'babymoon'.