What does a Doula actually do?
A lot of people give me a confused look when I tell them I’m a Doula. “A what?” they say, as I see them working out how to spell it so they can research it later.
Back in 2002, when I was asked by a friend to be her support person, I didn’t even know that the word ‘doula’ was a thing.
So what is it?
The word “Doula” (DOO-luh) comes from ancient Greek, meaning “Woman’s servant.” Other translations say that a Doula is a “Mother to the mother”. In many cultures, women have been supporting women through labour and birth throughout history by providing continuous physical and emotional support. Things have changed over the years and it is now more common for families to live farther apart which means less women have access to the support that women traditionally had when they were surrounded (physically or metaphorically) by mothers, aunties, sisters and neighbours. Birth has also become more medicalised and doctors or midwives can rarely be with a woman continuously.
That’s where a birth Doula can step in - we are trained and experienced in childbirth to provide continuous physical, emotional and informational support to the labouring mum before, during and just after birth. Doulas know how to help a woman in labour find her inner strength and stay focussed, confident and believe in her body’s ability to birth her baby by supporting them.
We don’t perform any medical or clinical procedures, such as monitoring blood pressure or physical examinations including vaginal examinations, foetal movements or heart monitoring.
We don’t diagnose or give medical advice or prescribe medications.
We don’t make decisions for you; however, we provide you with education and resources so that you can make an informed decision that feels right for you and your circumstances.
In practical terms, though, what does a doula actually do?
Well, here are some of the things that I do:
I help my client understand the process of birth and what is going on in their body as they prepare to go into labour.
I explain why labour is painful and I teach, with many different examples, techniques of mastering pain.
I teach breathing techniques for relaxation and labour.
I explain why a calm, quiet birthing space is important and what the mum can do to her birth space to make it more comfortable (no matter where it is).
I discuss how hormones affect birth and what the mum can do to increase oxytocin (the love hormone).
I show the mum how she can prepare her body for a natural birth to give her baby the best possible start to life outside of the womb.
I discuss the pro’s and con’s to all of the medical interventions and medications she may be offered so that she can make informed choices as to what is best for her and her baby.
We discuss all of the possibilities… Like, what will happen if the mum births in the car before she gets to the hospital? Or what happens if the home birth midwife gets caught in traffic and doesn’t get to your house in time? Or what if there is a COVID lockdown and the hospital won’t allow support people? We talk through all of the scenarios so that the mum is well prepared (and emotionally ready) for any situations that may arise.
I spend time with the mum and hear her desires for her birth. I help her write a birth plan which articulates her wishes.
I listen to her fears and I work through them with her.
After the mum has had midwife/doctors appointments, I check in with her to find out how she went. We debrief what any new information means and how it might affect her birth plan.
I send her evidence based research to help her make informed choices.
I answer all of her messages and texts when she is wondering about pregnancy symptoms like restless leg syndrome or itchy skin.
I help her find ways to get a more comfortable sleep at the end of pregnancy when rolling over takes three attempts and her bladder won’t let her sleep more than a few hours.
I take the call in the middle of the night when the mum has started to feel contractions and is unsure if it is labour or just her body warming up. I give suggestions on how she can comfortably labour while she is waiting for the contractions to get stronger, longer and closer together.
I make sure my family is ready so that when I get the call, I can be out of my home and on my way within the hour.
I talk with her when she is in early labour (but not ready for me to come just yet) and needs some reassurance that what is happening is normal.
I go to her house and labour with her, giving her the confidence to stay at home for as long as possible.
I help her to decide when to call the midwife or go to the hospital.
If she is having a home birth, I help set up the birthing pool.
I travel to the hospital if that is where the birthing mum is going, and I help her check in and get to her room (often while her partner parks the car - or I park their car for them).
I suggest position changes or a shower and I massage. And then I massage some more. And I continue to massage all the places where the mum is getting comfort and pain relief.
I do the double hip squeeze through every contraction (feels amazing for the mum).
I find the labour pressure points and use them to help with pain relief.
I keep the room dark and cozy and safe and quiet and calm.
I smile reassuringly every time the mum or the other support team look at me so that they feel comforted that the “ramp up” of contractions is a great sign that labour is progressing and that everything is normal.
I support the rest of the mums support team by being with the mum when they go to get a coffee or take a breather.
I gently run my hand over the mums back in figure eight patterns to increase endorphins.
I anticipate that the mum needs a drink or some sweetness (honey or tinned peaches or icy pole) and have them within arms reach.
I put lip balm on the mums lips to stop them from drying out.
I anticipate when the mum might vomit and have a bag ready to go.
I remind the mum of her birth plan if she decides to deviate from it and then I support her if she chooses a different path from what she planned.
I offer words of encouragement and affirmations reminding the mum that she is doing a great job, that she is progressing, that she can trust her baby and her body.
I massage the mums calf or thigh muscles when she has been standing for a long time and is feeling weary and fatigued. I massage her feet and put socks on her if they are cold.
I take photos of the mum with her other support people so she can look back later and see the powerful woman that we see.
I rock with her, pace with her, breathe with her, support her as she walks to the toilet, kneel beside her and put my cheek to hers when she is feeling fearful and whisper encouragement.
I let her cling onto me or push me away when she is in transition.
I put cold face washers on her brow or neck to keep her cool.
I take photos of her baby having skin to skin cuddles.
I help the mum with the breast crawl and/or maternal attachment breast feeding.
I do the clean up after a home birth.
As I drive away from the birth, I’m saturated in oxytocin and feeling incredibly emotional and amazed. I often cry and marvel at how incredible the female body is.
I record in my own words what the birth meant to me, how it all went, the timeline, what happened.
I check back in on the day after birth to see how she is feeling.
I cook a couple of meals for her and bake lactation biscuits.
I visit with her in her home and take her post birth treats and meals. We debrief the birth. We laugh and cry together and I fill in the blanks when there are things she can’t remember or blocks of time that she is confused by.
I check back in over the coming months to hear how the family are going.
Being part of pregnancy and birth and being invited into such an intimate and vulnerable time in the family’s life is something I am very privileged and grateful for.
If you are interested in knowing more about what I do or how I can support you as you prepare for birth, please contact me. I am based in the Byford Hills in Perth, Western Australia and I’d love to be part of your birthing journey.