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We shared our recent blog about the challenges of being a doula over on the Nurturing Birth Directory, but we reckon it merits a share here too!

The challenges of being a doula – a video blog

Do get in touch if you have any questions about becoming a doula – the good, the bad and the ugly! info@nurturingbirth.co.uk

Dear Natasha

I read your Times article, now reproduced in the online Mail, with a mixture of emotions – primarily sadness that someone felt so unsupported and uncared for during her birth.  Rage too that our maternity services is able to let women down on what seems like a regular basis and that your story does not stand alone.  And a sense of despair that those of us who work so hard to try and improve the situation aren’t reaching enough people, or having enough of an impact to make the necessary changes.  It is those people who have traumatic or terrible experiences in birth whose voices are heard loudest, and with reason.  No one should have to experience what you went through – no one should feel unheard and unsupported.  No one should feel like their birth experience is still affecting them negatively on a day to day basis years afterwards.

Trauma, for it does seem as if your birth experience has been traumatic for you, is a bitch.  And it can play out in so many ways.  The interesting thing is that someone can have what would be interpreted by many as a traumatic experience and not feel any of the symptoms of trauma at all, and someone could have a relatively “easy” time in other people’s eyes and be left with horrible, recurring feelings.  What matters is the feelings.  And so many of the debriefing and reflecting options available can actually be more negative than positive, helping to retrigger and retraumatise the person involved, allowing the amygdala (the monkey brain) to head off in to fight or flight yet again, stirring up the crazy heartbeat, sweaty palms, bowel-evacuating, dizzy panic feelings once more.  So it is important to find the right option for you in helping to recover from your experience.  Ultimately no one wants to stay in trauma long-term – it affects relationships, self-esteem, life choices.

Birth is a really sticky topic.  It’s emotive.  There are those who fall in to the pro-natural camps and those who are resolutely anti.  As a doula it is often assumed that I wholeheartedly and exclusively support those mothers who want to breathe their babies out in water at home.  And, believe me, those births can be magical to watch.  However, I am not naïve – I realise that that experience is not available to everyone, for many reasons.  I have also supported magical caesarean sections.  Many women choose to work with a doula having had a negative first experience of birth.  Knowing that you have continuous care and attention from someone who has built up a relationship with you, understands your previous experience and the potential trigger points can be invaluable and has been proven statistically.  A doula will help you to negotiate your options with your care-providers, without foisting her personal opinion or judgement on the situation.  She will listen, empower, help to move you to a place of readiness for a subsequent labour.

Antenatal preparation is key and I am really interested to hear people’s experiences of classes and courses.  How to achieve the right balance … how to keep it real without terrifying …  how to show the possible magic without setting up unrealistic expectations … how to help women and couples take responsibility for their unique situation … how to pitch something that suits the women with huge medical complications AND the women who have a low risk, straightforward pregnancy?  It is complicated and I don’t envy the teachers.  I do, in one-to-one situations, always want to look at different potential scenarios so that women are empowered and know their choices – we never know how birth is going to go and sadly I haven’t managed to create a crystal ball or magic wand yet!  But I am passionate about physiology and so shocked and surprised how little emphasis is placed on physiology in antenatal prep.  Understanding how the body works, what causes the mechanical changes – the dilation, the contractions, the pushing etc is invaluable.  But so is discussing comfort measures and that includes pharmacological pain relief.

So, what do I wish for?  More than anything I hope you find a place of acceptance of what happened for you in your birth, a release of the feelings that are affecting you personally and in your closest relationships.  Separate to that I have a much bigger wish, and one that seems challenging given the current state of our NHS.  I hope that we can magic a significantly larger number of midwives in to our birth units, midwives who are properly supported in delivering quality, compassionate care, midwives who are able to be “with woman” as their name suggests, not run ragged, exhausted, unable to eat, sleep or even go to the bathroom during a ridiculously long shift.  I pray for communication and respect between health professionals, a recognition that the job each of us does is valuable.  I pray that anyone who experiences trauma in the birthing room, from mothers to partners to health professionals is able to find an effective way to recover and not carry the trauma forward with them into the rest of their lives.  Perhaps if we get those things there will be more positive stories coming out in the press, rather than distressing ones.  Given that half of the population might choose to have a baby at some point in their life wouldn’t it be great if the majority of what they heard was affirming?

Sophie Brigstocke is an award-winning birth and postnatal doula, as well as Director and Doula Course Facilitator at Nurturing Birth.  See here for more information

Click here to hear Sophie talking about the “superpowers” of doulas, particularly around listening to previous birth trauma experiences

To contact Sophie go to sophie@nurturingbirth.co.uk

Sophie Brigstocke talks about mentoring and why it is beneficial for ALL doulas, not just those at the start of their journey.  For more information about the Nurturing Birth mentoring scheme contact Michelle Every or the mentoring page of the website.

I think I am becoming more pernickety in my old age.  I really care about the language used around birth to the point that my own family tease me relentlessly – they’ve cottoned on to the fact that I hate the word “delivery” and will therefore take every chance to use it in front of me, hoping to provoke a reaction.  Most of the time I try to ignore it – sometimes I take the bait and the teasing persists!  Much has been written about the use of the words delivery and deliver when it comes to birth – how galling for a mother who has been labouring for hours to have someone come in and say “I’m going to deliver your baby now”.  What does that imply she has been doing?  Does it say that her body is somehow less than and it requires someone else to get involved for the main event?  Does it reduce birth to something akin to pizza or parcel postage?

Yesterday I was listening to a Marie Forleo video blog where she talked about research that has been done around the difference between “I don’t” and “I can’t”.  Apparently those that say “I don’t” are far more empowered and likely to stick to a resolution rather than those who say “I can’t”, so if I am trying to avoid eating more chocolate (I’m not – that would be crazy) I should say “I don’t eat chocolate” rather than “I can’t”.  The power that two different letters makes is significant.

Empowering is one of the key words we discuss on our doula courses and we talk a lot about how a doula’s behaviour and language can disempower a woman or couple.  Let’s take advice-giving for example.  If someone says to their doula “what do you advise?” that immediately puts the doula in the position of authority – raises her up on to a pedestal of sorts.  To my mind there are three possible scenarios if a doula gives advice.

• The client takes the advice, follows it through and finds it to be the answer to all her prayers.
• The client takes the advice, follows through but the results are not positive or helpful
• The client doesn’t take the advice and chooses a different path.

It’s easy to look at scenarios 2 and 3 and see how those situations might be detrimental to the doula-client relationship, but what about the first?   Some might say, “fantastic, job done, everyone’s happy”.  But is it really?  I’m not so sure.  How has the client been empowered and supported in that situation.  If clients reach out to the doula for increasingly more advice they start to lose or not trust their own instincts and abilities to come to an answer that is right for them. The doula is placed in the “expert” role and the client takes less responsibility for decisions which might have a long-term effect on their lives and relationships.

Being an expert implies that you are an authority on a subject, that you know a great deal.  As a doula I love to learn, to read, to take courses and workshops, to discuss all things pregnancy, birth and postnatal with others who share my interest.  But, over time I have come to realise that there is a vast difference between theory and practice.  Just because someone has written the ultimate book on parenting doesn’t mean that they will have the right answers for you and your baby, particularly as the baby won’t have read the book!  I have also come to a place of feeling that the more I read the less I know.  Each topic I explore opens new doors for further investigation.  So it is not with false modesty that I say “don’t ask me for advice”.  I invite conversation on a topic, I want to know what you know and what you think, what you believe and where those beliefs come from.  I want to signpost information for you to explore options and choices, and ultimately I want to support you in making the decision which feels right for you.  My feelings on a subject don’t matter – the decision is not being made for me, but for you, your family and your baby.

So, don’t call me an expert – the only person who is an expert on the baby is the parent/primary care-giver.  I may be there in a supportive capacity, but my ultimate role is to empower the true expert in the picture.

To contact Sophie, or Nurturing Birth about anything pregnancy, birth, postnatal or doula related email info@nurturingbirth.co.uk

To find out more about Nurturing Birth doula courses visit the website

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