What is a doula and do you need one to give birth?

Photo credit: Getty Images
Photo credit: Getty Images

If you’re expecting a baby, as your pregnancy progresses it’s only natural that your thoughts will increasingly turn towards labour and birth. It’s likely that planning your antenatal classes, writing your birth plan and figuring out what you need in your hospital bag are all on your agenda right now. But here’s something you may not have considered: should you hire the services of a doula, for the delivery room and beyond?

What is a doula?

The word ‘doula’ is derived from ancient Greek and translates as ‘a woman who serves’. Since the 1960s, the term ‘doula’ has been used to describe trained birth professionals – someone who supports women (and their partners) during pregnancy, labour and in the early weeks after baby is born.

‘We provide antenatal education and offer up-to-date, evidence-based information, to enable parents to make informed decisions on how they would like their labour and birth to be,’ explains doula Emily Marsh.

While many people associate doulas with unmedicated, ‘natural’ births, it’s important to note that anyone can opt to have the support of a doula during labour, even if you wish to have pain relief – a doula should not judge you, or push you into a birth plan that you are not comfortable with.

‘Doulas do not push their own beliefs on how to birth,’ says Marsh. ‘Rather, they support each individual woman in their choices. We aim to ensure that women go into their birth feeling confident, knowledgeable and fearless.’

A doula can take on several roles: a birth doula supports you both before and during labour, while a postnatal doula can be hired for the three months post-birth, to help you feel confident as you transition to your new role as a parent.

Photo credit: MangoStar_Studio - Getty Images
Photo credit: MangoStar_Studio - Getty Images

What’s the difference between a doula and a midwife?

But if you’re going to have a midwife with you, do you really need a doula as well? ‘Doulas are not clinical health professionals, but work alongside midwives and doctors,’ says Jordan Davis, midwife and developer of Puriskins Curate Babies Range. ‘The benefits of hiring a doula include having extra support during such an important time. During birth especially, doulas are able to help women focus on optimal positioning and breathing techniques, for example, while midwives may be tending to more clinical aspects of care.’

Ashley Dole, birth educator at Do It Like A Mother, agrees that a doula’s role uniquely differs to that of the medical staff who will be present during labour. ‘A midwife typically offers medical support throughout pregnancy and birth, whereas a doula focuses on providing bespoke emotional, informational and physical support, before, during and after birth,’ she says.

‘Their priority is the wellbeing of the woman or birthing person in their care – facilitating their best possible birth experience, and the most gentle, supported transition into parenthood,’ adds Dole.

What’s the difference between a doula and a birth partner?

If you do not have a birth partner, hiring the services of a doula can be a wonderful option, as having someone to support you as you give birth is not just a nice bonus – you may need someone to advocate for you during labour.

And even if you do have a birth partner, a doula is a professional who is used to being present during births and knows how to speak up for your right and wishes. ‘Where birthing partners might not feel comfortable enough to advocate for their partner, doulas can do so,’ explains Davis.

It’s also true that your birth partner may be feeling extremely nervous themselves, whereas a doula will be able to remain level-headed and calm throughout, helping to support both you and your birth partner.

What does a birth doula do?

A doula is skilled in active listening, does not have an agenda and gives space for you to voice what you are feeling, without judgement. They provide support for the expectant mother, as well as their partner, during labour – often suggesting and providing various comfort measures.

‘This includes reminding them to eat, drink and go to the toilet, putting cold flannels on their face and neck or warm flannels on the perineum, and suggesting positional changes during labour, in order to help their baby get into an optimal position for birth,’ says Marsh.

They will also advocate on your behalf, liaising with the medical professionals and explaining any procedures that may be necessary.

After the birth, most doulas provide one or two postnatal visits, in order to answer any questions related to baby care, debrief the birth and support feeding. ‘Generally, they will make sure the new parents are feeling confident in their new role,’ says Marsh.

What does a postnatal doula do?

While most people picture a doula’s role as being present at the birth, you can also hire a postnatal doula, who will support you and your family as you navigate the early weeks of parenthood.

‘Postnatal doulas tend to offer support in the early postnatal period, sometimes referred to as “the fourth trimester”, which is the first three months after birth,’ explains Zara de Candole, a doula and Luna Hive expert. ‘A postnatal doula “mothers the mother”, to ensure she is well rested, nourished and is gaining confidence in her role. She will undertake a range of jobs in the home so that the new mother can focus her attention on recovering and bonding with her baby.’

Benefits of hiring a doula

Not only can a doula provide a more positive birth and postnatal experience, according to de Candole research shows that having a doula present at birth comes with the following benefits:

  • A birth doula shortens first-time labour by an average of two hours.

  • A birth doula decreases the chance of needing a caesarean section by 50 per cent.

  • A birth doula decreases the need for pain medication.

  • A doula helps birth partners participate with confidence.

  • A birth doula increases success in breastfeeding.

  • A birth doula decreases the risk of postnatal depression.

‘Alongside this, a doula gets to know you,’ explains Dole. ‘Your thoughts, your opinions, your wishes for your birth experience. How you respond when stressed and what you need to feel relaxed again. Their care is completely tailored to your needs. They’re highly trained and provide a wealth of physiological birth knowledge and support – often from a more holistic standpoint than medical professionals – meaning the person in their care benefits from a full picture of their options for birth and beyond.’

How to hire a doula

If hiring a birth doula is an option you would like to explore, how do you go about it?

1. Hire an accredited doula

The decision to hire a doula is personal and entirely up to you. It’s also important to note that the profession is not regulated, so anyone can call themselves a doula, regardless of training. However, to be registered on Doula UK, doulas must have completed an accredited course and mentorship.

2. Do your research

Information is available to help you choose the right doula for you. ‘For those considering hiring a doula, Doula UK provides useful information about services provided and families can quickly search for doulas relevant to their needs, whether birth, postnatal or both,’ says Davis.

3. Time it right

Timing can also be important. ‘It's never too early or too late in pregnancy to benefit from the care of a doula,’ says Dole. ‘But as a general rule, I'd say that the second trimester is a great time to find your support. This gives you ample time to find someone you really connect with, and to feel the benefit of learning and preparing for birth with them by your side.'

4. Shop around

It's vital that you feel at ease with your chosen doula, so feel free to book multiple discovery calls and ask lots of questions on the journey to finding someone you feel aligned with, explains Dole. 'Remember, the doula you choose will be a part of the most important, intimate days of your life!’

How much does a doula cost?

A doula is not available via the NHS, but instead has to be hired privately. ‘Costs for doula services can vary greatly, depending on what is included in their care package and the level of support you would like in the run-up to giving birth and the time after it,’ says Dole.

‘Anything from £200 up to £2,000 can be normal,' she adds. 'Whether they’re a trainee or experienced, provide antenatal education sessions or not, and if postnatal support is included as standard, will all affect the total, so it’s worth doing your research to find the right person and service for you.’

Help and support planning your birth

For additional support planning your birth, you can check out the following resources:

Last updated: 25-06-2021

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