A doula (a Greek word meaning ‘woman servant or caregiver’) now refers to an experienced woman who offers emotional and practical support to a woman (or couple) before, during and after childbirth. Doulas are trained and experienced in childbirth, with a good knowledge and awareness of female physiology, but the doula is not supporting the mother in a clinical role, that is the job of the midwife/medical staff. The doula is supporting the whole family to ensure as positive a birth experience as possible. A doula believes in “mothering the mother”, enabling a woman to have the most satisfying and empowered time she can during pregnancy, birth and in the early days as a new mum. This type of support helps the whole family to relax and enjoy the experience.
Why are they needed?
As childbirth has moved from home to hospital, a vital element of care has been lost from the whole process. Gone are the days where a woman would have continuous support from one carer throughout her pregnancy and labour. It used to be the case that the womenfolk within the immediate and extended family (mothers/sisters/grandmother etc) would be on hand to provide the nurturing role for the new mother, to guide by experience and help with the practicalities that needed to be performed before, during and after a woman gives birth to a baby. This is a role the doula can fulfil.
What preparation and training do they have?
Members all complete a Doula UK Approved Course which follows the specialist Doula UK Core Curriculum. In order to move from Trainee status to Recognised Doula status, a doula has the support of an experienced Doula Mentor whilst undertaking and reflecting in depth on a minimum of her first four birth/postnatal jobs. All members are obliged to continue studying and to give proof of workshops/additional training undertaken each year.
What exactly do they do?
Services offered by a doula vary greatly according to the needs of the mother/parents-to-be. A doula's role has to be flexible to fit in with the given situation e.g. the type of support will differ for a first-time mum to that of a woman who has children already. Every birth is unique and therefore every woman's experience is also unique.
Before childbirth the doula will usually meet with the mother (or couple) at least twice to talk through birth physiology, fears, expectations, previous experiences etc. She will be able to provide an unbiased viewpoint and signpost parents to seek out ALL relevant information, to enable them to make informed decisions about the care and type of birth they desire. The doula will go on-call from the 38th week of pregnancy until the baby arrives.
During labour the doula is a calm and constant presence and is, if necessary, able to offer comfort and suggestions on coping mechanisms such as breathing, relaxation, movement and positioning. The doula can also support the father to participate in the birth to a level at which he feels comfortable. The doula's most important role is to provide reassurance, continuous support and nurturing (as this is proven to have dramatic results on the outcome of the birth and is something the NHS is often unable to provide).
After childbirth the doula may follow up with a couple of postnatal visits to help the new mum settle at home with her baby, or alternatively the mother may decide to employ a postnatal Doula.
Postnatal doulas work flexible hours to suit the family, offering practical and emotional support to the new mother/parents in the home following the birth of the baby/babies. The doula’s role is empowering a family to take care of itself with encouragement, practical suggestions for breastfeeding, baby and sibling care and can include helping with domestic tasks, cooking, laundry etc .
What does it cost?
The cost of a doula birth package varies according to location and experience, but generally falls between £350 and £900. Trainee doulas who have not yet received their Recognition from Doula UK and are undergoing mentorship from an experienced doula charge £200 for a birth. Postnatal doulas charge from upwards of £10 per hour.
Doula UK also has a Hardship Fund, which can be accessed by women who are receiving state benefits, or who have been recommended by a health professional, to enable them to have doula support. The Hardship Fund covers a doula’s expenses but the doula gives her services voluntarily.
Is there any evidence to back up claims about doulas?
A survey of over 700 births in the UK in 2008 and published (Goedkoop V MIDIRS Midwifery Digest, vol 19, no 2, June 2009) gave the following results:
45% of the women surveyed had natural births (no induction, medicated pain relief, augmentation or instrumental delivery)
15% had caesarean sections, as opposed to the 25% national average
20% had epidurals, as opposed to over 30% nationally
There was a 70% successful vaginal birth after caesarean rate
23% laboured in a birth pool
19% had a homebirth without transfer to hospital (2.3% national average)
86% breastfed at birth, as opposed to 76% nationally, and 88% of women supported by a postnatal doula were still breastfeeding at 6 weeks, as opposed to a 21% national average.
What is Doula UK?
Doula UK (www.doula.org.uk) was set up in 2001 to provide a network for doulas and is the largest organisation of Doulas in Great Britain. There are currently over 450 members all of whom adhere to a Code of Conduct and have trained through an organisation who follow the Doula UK Core Curriculum for Doula Preparation. The not-for-profit organisation has a ‘Find a Doula’ facility to enable parents to find doula support in their area.
Doula UK doulas value the mentoring and support network that is provided by the organisation and benefit from the continuous professional development opportunities that Doula UK promotes. Doula UK gives peace of mind to clients who recognise the level of professionalism of the organisation and of the doulas they are choosing to employ.
For more information about Doula UK please contact:
Sophie Brigstocke, Head of PR