When I gave birth to my son almost 19 years ago, employing a doula to support one’s birth was not as common as it is today.
My plan was to have my partner and mother attend the birth. And because I was a prenatal yoga teacher who had done a lot of research around natural and active birth, I thought that I wouldn’t need a doula.
However, I experienced a very long labour and as often happens in birth, things veered from the plan and my best friend ended up being drawn into the birthing space. It was accidental. She came to the Birth Centre to deliver my forgotten Medicare card and then never left. By the time my friend had come on the scene my partner and mother were exhausted. My pre-labour at home had already meant days of broken sleep for all and by the time I was in established labour, that had also been going on for an inordinate amount of time, they were out of juice.
My girlfriend represented a welcome breath of fresh air in the birthing room. I remember gripping on to her thin forearms as she braced to hold me. She represented a new body, a fresh body, a trusted body to help ground the intense rush of each contraction and I remember feeling so relieved that she was there, for me, for us. Her quiet, gentle energy was soothing and grounding.
In effect, my friend served as an impromptu doula helping me and my team when we were all at our greatest need. She got my mum cups of tea, took turns heating the heat packs, held my hand and was just there.
Someone in “Your Corner”
This is a large part of what a doula does: provide emotional and practical support to the birthing woman and her family. As Dr. Neel Shah, M.D., an Assistant Professor of Obstetrics, Gynaecology and Reproductive Biology at Harvard Medical School says, ‘The biggest benefit of a doula…is having someone in your corner during an emotionally intense experience’.
However, a doula is also a trained professional, which my friend was not. And even though she added so much value to what turned out to be a long, difficult labour, I sometimes wonder if things might have been enhanced further if I’d employed a professional doula.
The word ‘doula’ comes from the Greek which means ‘servant’ or a woman’s ‘handmaid’. It’s a role that has its roots throughout history before birth became as medicalised as it is today—when women would support each other during birth in a home setting; when it was normalised for sisters, mothers, friends, neighbours, the ‘wise women’ of a community to attend a birth as valued physical and emotional supports.
The Rise of Doulas
In our contemporary times, birth has become an increasingly isolated experience in which a woman will often birth in the company of her husband/ partner and the medical staff in a hospital, separate from a wider community of women.
Birth can be a marathon event stretching over many hours, which means the birthing couple may be left alone for long stretches of time with nurses, or midwives, or doctors only coming into the birthing room at intervals to carry out routine checks on the progress of labour before leaving again. It is for this reason that the profession of the doula has been revived since the 1970s as a way of recreating that traditional support and reconnecting with the feminine wisdom of the birth attendant.
Another reason for the rise of the doula is that, depending on the medical system in which a woman gives birth, she may not always have the benefits of a ‘continuity of care’ in which she experiences medical care from the same midwife or medical caregiver throughout her pregnancy, birth and postnatally. This means that the ‘continuous support’ offered by a doula can be invaluable to the birthing woman and her partner in helping reduce stress and making her feel comfortable and supported.
A doula’s support however is not medically based. Doulas provide emotional and physical support at a birth; they are not medically trained and can give no medical advice.
Specific Doula Skills
That said, a doula does have skills and know-how that a layperson does not. She has been trained to understand the stages of labour and possible interventions. She will have consulted with the birthing couple to ascertain their birth plan that outlines the kind of birth and interventions (where relevant and appropriate) that they would prefer. This means she can act as a powerful advocate on behalf of her clients, serving as a mediator between the birthing couple and medical staff.
A doula is specially trained to be non-judgemental about the birthing choices her clients make, as lead teacher of our Bliss Baby Yoga & Celebration of Birth Doula Training , Anna Watts explains:
‘As a doula I have supported many mothers birthing their babies after long, and occasionally short, physiological labours without medical intervention; and I’ve also walked alongside mothers who have received some form of medical assistance to bring their baby into the world. Witnessing the power of mothers stepping through this profound childbirth rite of passage, in all its forms, continues to be a privilege and an honour in which I now mentor doulas as they learn the art of supporting birth choices without judgement.’
Anna says that’s why it’s so important that a doula has trust in the birth-process in ‘bucket loads’: ‘In the deepest core of your being, you trust in birth. You have come to a place of inner knowing and certainty that every woman has the full potential to birth her baby in the perfect way for her own growth and transformation.’
The Benefits of a Doula-Assisted Birth
So, does the research concur that having a doula at your birth makes a positive difference? The resounding answer according to several sweeping reviews of available research—one conducted in 2014 and another in 2017—is, yes!
According to the University of Technology authors of an Integrative Review on the benefits of ‘trained or professional doulas’, the ‘four main domains’ of a doula are: ‘emotional support, empowerment, physical support and information provision.’
This kind of broad-ranging skill and support base is born out when I speak to Bliss Baby Yoga Director and Doula Nadine O’Mara and ask her what’s in her ‘doula bag’ when she attends a birth.
What’s in a Doula Bag?
Nadine explained that the ‘tools of her trade’ that she brings with her into a birth include everything from essential oils to Rebozo cloths, to birthing balls.
A well-trained doula will know how to support a birthing woman physically with pain-management and labour facilitation techniques like massage, acupressure and ‘hip-squeezing’; she (or he/they) will also be able suggest different birth positions to support optimal foetal positioning throughout the labour; can provide hands-on practical support in applying heat-packs, offering nourishment and fluids to the birthing mother, as well as anything and everything that the family might need. In my own experience as a doula, I performed the unusual task of bringing home a client’s placenta for safe keeping in our freezer!
Most importantly, a doula provides the positive energy that empowers a birthing woman with the confidence she needs at her greatest hour of need. In addition to reducing intervention rates and c-section rates and shortening labour, having a doula provides invaluable psychological support that results in greater feelings of efficacy for the birthing mother as the UTS Review confirms: ‘Women receiving trained doula support approach birth with positivity in both their view of themselves and their expectations of their birth experience’.
It’s little wonder then that more and more people, including scientists and medics are recommending doulas, declaring that ‘women should have unrestricted access to continuous emotional and physical support from a doula.’
Ana Davis is a doula (trained by Anna Watts at Celebration of Birth), yoga teacher and yoga teacher trainer specialising in women’s yoga. She is the founder of Bliss Baby Yoga.
Bliss Baby Yoga offers a comprehensive Online Doula Training with Anna Watts from Celebration of Birth as lead teacher and Bliss Baby Yoga’s Director and experienced Doula and Childbirth Educator Nadine O’Mara , and Doula & Bliss Baby Yoga Senior Teacher Rosie Matheson as co-teachers.
Tara Haelle, ‘What Is a Doula? And Do You Need One?’, The New York Times, 15 April, 2020
Papagni and Buckner, ‘Doula Support and Attitudes of Intrapartum Nurses: A Qualitative Study from the Patient’s Perspective’, NIH, National Library of Medicine
Bohren et al, ‘Continuous Support for Women During Childbirth’, the Cochrane Library, 6 July 2017 https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth
Steel et al, ‘Trained or professional doulas in the support and care of pregnant and birthing women: a critical integrative review’, 19 June, 2014, Health & Social Care in Community, Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1111/hsc.12112