What is a doula?

Language

Doula

The word doula comes from an ancient Greek work for female slave. There are many reasons not to feel comfortable with that imagery. But doula as a modern western concept has developed a meaning of its own and is in common usage now as someone who provides non medical, social and emotional support through pregnancy birth and early parenting.

Gossip

In the history of our own culture here in the UK the group of women who would gather when someone in the village was birthing to provide the practical support for the birthing person, family and the midwife used to be called gossips. More info here. Of course the word gossip has also come to mean something else now, but maybe it’s time to reclaim the language?

Other terms we sometimes like to use are birth/postnatal companion, birth/postnatal supporter, birth/postnatal/parenting coach, non clinical birth worker. None of which feel like the fully cover everything a doula can be.

Vaginal Gandalf

You need a working knowledge of the story of the Lord of the Rings for this next analogy to work, please feel free to skip ahead if it’s not your thing.

Jake: Copy that. I will call the doula. Which is a thing that I definitely know what it is.
Sharon: A doula is someone who supports you emotionally and physically and coaches you through the process.
Jake: Oh, I see. So sort of like a vaginal Gandalf?
Sergeant Jeffords: Stop saying that word!
Sharon: Ooh, that’s actually a pretty good analogy.
Jake: Well, Sharon liked it, Sarge.

The TV show Brooklyn Nine-Nine gave us Vaginal Gandalf as an option for a name which while cool I’m not sure really covers it still. Mainly I think because it implies more power than we’re comfortable bringing into a situation. As doulas the power we recognise in the birth room is in the birthing person. Maybe we’re really more like Vaginal Sam Gamgees calmly by your side through the thick of it all.

Mothering the mother

It’s often said that doulas ‘mother the mother’. What I think this means is that they treat new parents with love and care in the way that a loving mother does, with a selfless attitude. However, there are cultural and personal issues that surround mothers and motherhood which make the use of this term not always helpful to everyone. Mothers can also be authority figures and doulas are not. So I prefer to think of myself as a doula in more of a sister or good friend role. Someone who cares for you on an equal footing, who it’s safe to say no thanks to if necessary and who will be there for you through good and bad times. Although having a doula is even better than having a good friend as you doing have to worry about your doula’s needs we’re doing a job not a favour.

Whatever you call us, what do we do?

You’ll get as many answers to this question as there are doulas.

For me as I choose to step into the role of doula my main priority is to leave my ideas and opinions behind and to work for you. To work for what you want from your birth or parenting. To respect and support the decisions you feel are right for you. To respect you enough to make sure you have the opportunity to make informed decisions.

I’m not there to tell you what you should or shouldn’t do I’m not there to promote my ideas of what child birth should be like or how you should deal with your contractions. I can provided you with information but I will not provide you with advice further than this: ask questions and go with your instincts.

Also as your doula I work only for you, I’m not working for myself to promote my ideas or my experience, I’m not working for the health service I don’t give out medical advice, I’m not working for your extended family to suggest you do things how others have done them before. I’m working for you and only you.

Listening

Practically what does a birth doula actually do? Well we listen a lot. We know stuff about the usual progress of birth and about many things that can happen and interventions that may be offered during the progress of your labour so we can sign post you to any information you may want. We know how to let you talk about what matters to you and to put your thoughts into a simple birth plan or preferences that are easy to reference on the day. We also support your support team. As a birth partner having someone there to ask any questions (remind you there’s no such thing as a silly question) and give you confidence to support your partner through their labour and birth can be very valuable.

On the day of your birth

During your labour and birth your doula will come when you call and will be calm and peaceful and encouraging. I will tell you how amazing you are and help you calm down if you start to panic and do the same for your birth partner if needed too. I’m there with a clear head to help remember all the tools you planned to help you manage your contractions.

Your doula helps you both remember your birth preferences and ask the questions you need to make any new decisions required on the day. Your doula continues to leave all decisions to you and all the medical involvement and advice to your midwife or doctor.

Doulas provide practical support as well as emotional support. As labour progresses you doula may remind you of and organise the practicalities for self help measures. Your doula will help with keeping lights low and voices quiet because that helps increase the oxytocin in the room. If you feel uncomfortable or want a change of position your doula may suggest ways to move or positions you could try, suggest using water having a bath or shower, physical relaxation, breathing, using hypnobirthing or other mindfulness techniques. Your doula will help you stay hydrated and nourished so you have energy when required. If you’re using a birth pool at home your doula may help set this up. If you’re transferring to hospital your doula may help keep you comfortable as you travel. Finally when baby arrives your doula says well done you did it you’re so amazing you should be so proud of yourself.

And in between all those other things and just as importantly as the practical tasks doulas sit quietly keeping an eye on what needs to be done and a calm atmosphere in the room.

Postnatal Doula Support

As a postnatal doula I also listen a lot. The emotional support of having someone who really listens to you in the early days of parenting as you process your birth and the momentous experience of having responsibility for a whole new person can be invaluable for your long term mental health.

Of course doulas support you with all the usual baby care tasks, feeding your baby, changing them, bathing them, burping them etc. They also support you to get enough rest and to stay hydrated and nourished. They can also help you keep the house in enough order that you can relax in it. They don’t do a deep clean though if that’s what you need a cleaner would be the right choice for the job.