In Monday’s Independent Hannah Fearn discussed how more women are employing doulas to support them during birth due to the fear of not having support from midwives. Whilst we welcome positive reports of doulas in the mainstream press there are a few comments that need clarification. It is certainly true that the use of doulas is increasing in the UK, and internationally, as women empower themselves and take responsibility for their birth experiences. However, doulas are not a new concept – there is much evidence to show that experienced local women have supported those giving birth since time began. Research consistently shows that having a doula present at a birth decreases the length of labour, reduces the number of caesarean sections, medical interventions and/or need for pain medication. It also shows that women have better breastfeeding initiation rates with a much higher percentage continuing to breastfeed at 6 weeks plus. It is imperative though, that a doula be recognised as a non-medical support. A doula does not undergo a medical training and never replaces the role of the midwife. She is there to provide emotional and practical support and to empower a woman to make informed choices, something that has been recognised by the charity Birthrights as being key to a woman’s positive mental state after birth. It is true that the current NHS provision for the majority of women means that they are not supported by a named midwife through their antenatal, perinatal and postnatal experience. Often they meet the midwife who is going to be at the birth of the baby on the day itself. Having someone by their side who has heard their concerns, hopes and expectations in advance of the birth can certainly allay fears and promote a positive environment for birth. Doulas aim to work alongside midwives, supporting them in their challenging role and enabling everyone to be their best on the day. Many doulas work hard to establish positive relationships with their local midwife teams, becoming members of the MSLC or Maternity Forums at their local hospital trusts, and setting up mutually beneficial events.
The subject of cost came up and the implication seems to be that doulas are looking to charge exploitatively. There are doulas who charge between £1000 and £2000, but the vast majority charge less than £1000, with many new or mentored doulas charging significantly less than £500. Doula UK has an Access Fund for anyone who has financial difficulties to support their employment of a doula. The birth doula role typically involves several meetings with the client antenatally, being available on the phone or email, going on call for up to 5 weeks, attending the birth (however long that may be), then returning to visit the clients postnatally a couple times to ensure that all is well. It requires a doula to ditch her day-to-day life at a moment’s notice with no idea of when she is able to return home.
Sadly the benefits of the postnatal doula were not discussed – the invaluable support that a doula can bring to a new family, helping them to settle in to their new parenting roles, providing information, supporting feeding, taking on some of the domestic responsibilities, making food, helping to look after other children etc. This cannot be overlooked, and goes far beyond the midwifery remit.
For information about the Doula Preparation courses provided by Nurturing Birth please email us on info@nurturingbirth.co.uk or call 0121 422 2819.
