A doulas role is:
- to provide a knowledgeable and experienced guide through your pregnancy, labour birth, and post-partum period ( think more oxytocin)
- signpost to additional information to help navigate the medical system
- to listen and be a sounding board for you to think through any decisions you might need to make about your care (induction or not, place of birth, types of pain relief)
- to provide comfort measures during labour and birth – these are non medical techniques that support physiology and maternal well-being/maternal satisfaction (like massage, movement, breath work, visualisation)
- to support your partner to support you so they can really provide the safety and loving presence that is needed during optimal labour and birth
- to help you connect to your baby and each other in pregnancy, and labour and birth and postpartum so you feel confident, surrounded by love and supported
- for you to explore what it is to become a parent, and what you might need in the postpartum period (4th trimester)
- be emotional support for the biggest transition your life could ever go through
- to never give advice but always point you back to your own power, instincts and connection to your inner wisdom as parents
Podcasts talking about the role of doulas
Megan Rossiter – Birth Ed
Megan and doula Natalie Meddings talk about the role of doulas and how doulas support birth. Also Natalie speaks beautifully on the nature of pregnancy and birth.
Jessie Ware – ‘Is It Normal ?
This is Jessie and me chatting through the role of a doula.
How do doulas make a difference?
Midwifery and doula-philosophy understands that birth is not a medical event, it’s a physiologically normal one. Just like eating, sleeping and sex. Most of the time we don’t need medical help with these other normal functions, but sometimes our bodies become unwell and then we do.
Same with birth, obstetrics is for the rare occasion when a person becomes unwell in pregnancy labour and birth.
In our modern culture this view has got reversed; we now believe that labour and birth is a medical emergency that very occasionally goes well. There is a lot of cultural fear around birth. (this is a big topic which is the subject for another post)
So how do doulas make a difference so that women and birthing people have better birth experiences, and feel more confident entering this important phase of life?
Loving Power & Self Belief
Doulas and good midwives help women and birthing people reclaim their power in their bodies, but upholding the strong belief that birth works. That women and birthing people are actually able to give birth to their babies and feed their babies from their bodies; because it’s part of our reproductive design and nature. If this wasn’t the case our species wouldn’t exist, as modern medicine is very new in the history of humans.
The doula & the midwife both embody this belief in their bones, and hold it present when the woman reaches her limit or her edge during labour and birth, the doula reminds her she can do it. This belief is an anchor for the birthing person to hold onto through the challenge of labour and birth.
Transformation
Pregnancy labour & birth and the fourth trimester is a huge time of change, having one person who you know and trust walk with you through this time of change is a game changer. Every aspect of you and your life changes, physically, mentally, emotionally, the woman’s whole identity changes. Sociologists have coined this term as matrescence. https://www.nytimes.com/2017/05/08/well/family/the-birth-of-a-mother.html
Good midwifery care ideally looks like continuity of care with the same midwife and there is plenty of high quality of evidence to show what massive improvements it makes in clinical outcomes. https://pre.rcm.org.uk/media/2265/continuity-of-care.pdf
One study looked at the role of doulas providing care for women in favelas in Brazil and having a trusted knowledgeable experienced woman to support mothers. The study showed that this simple and cheap intervention significantly decreased infant mortality in deprived areas.
There are also plenty of studies looking at the benefits of doula support in reducing intervention, birth trauma and improving breastfeeding rates and maternal experience.
Relationships are a key factor in good health care, because people are not just averages in statistics and so doulas can help pregnant people navigate this huge change from a place of deeper connection and deeper relationship. Modern maternity care is often fragmented and women don’t see the same midwife in labour as they have seen in pregnancy or postpartum and the doula can bring the benefit of continuity to their clients.
Connection
But the big answer to why doulas make a difference is because doulas are like oxytocin factories. And oxytocin is the hormone that makes birth work. Oxytocin is high when feelings of trust and safety are high. And so the connection and bond that doulas create with their clients through the ‘soft skills’ and the ‘comfort measures’ are actually what help the woman give birth! Doulas really get to know their clients and really love them. This isn’t fluffy and woo woo, it’s the science of birth physiology that helps the woman feel safe for her to produce the oxytocin to make the uterus contract and for her body to soften and open for the baby to safely and easily be born.