What You Need To Know About Having A Doula

What Exactly Is A Doula?

The word doula is derived from the Greek for ‘woman caregiver’ – they’re a professional birth companion, someone who has been trained to work with you during your pregnancy, help you prepare for birth, and someone who’ll be there with you during labour as well as support you in the weeks afterwards. “Doulas are a new trend but a very old idea,” Milli Hill, doula and author of The Positive Birth Book, tells SL. “A doula is someone who ‘mothers the mother’. They will nurture you during your pregnancy, comfort you in birth and care for you in the days and weeks that follow.” Vera Dubrovina-Thompson, doula for Koala & Joe, adds that a doula is a non-medical professional who offers physical and emotional support to a birthing mother, her partner and her family through pregnancy, childbirth and postpartum. “There are two types of doula services that can be offered to families – birth doulas and postpartum doulas,” Vera says.  

How Common Are They In The UK?

Doulas are increasing in popularity and over the last few years especially, adds Emma Armstrong, The Naked Doula. “Ten years ago, there were around 50 doulas in the UK, and it’s estimated there are now around 700.”

How Are They Different From Midwives?

A midwife is qualified to deliver your baby, make assessments of your physical health and to know when and how to refer on to a doctor if your birth deviates from the expected pathway. A doula, on the other hand, is only there in the role of companion and isn’t qualified to give advice, make a diagnosis or assessment. 

“In our over-stretched maternity system, many women aren’t getting a community of care, which is where a doula can come in,” says Milli. “Doulas can advocate for you, making sure your birth plan or wishes are listened to and kept in mind, and that you are treated at all times with respect and dignity. Letting a doula take this role can be a real relief for dads and partners. Remember a doula isn’t a medical professional – she cannot administer medical procedures. Her role is to make you feel safe and empowered.” 

Doula Laura Stein agrees, saying a doula provides continuous emotional support and physical comfort, before, during and after childbirth. “Midwives used to provide what a doula can offer, but midwifery has become very medical and are most midwives in the NHS are too busy to offer this level of emotional support. In fact, many midwives appreciate the extra attention given to patients and the greater satisfaction expressed by women who are assisted by a doula,” she adds.

How Does A Doula Differ To A Maternity Nurse?

A maternity nurse is baby-centred while a doula is mother-centred, adds Doula UK. “A maternity nurse will give your baby 24-hour care for six days a week, will get up at night with the baby and will help settle them into a routine. A doula, meanwhile, will help the mother do the mothering. A postnatal doula will arrive with a listening ear ready to give emotional, informational and practical support. They may help with breastfeeding, with caring for the baby while you have a shower, or recommend networks, baby groups or health professionals to ensure there’s a circle of care around your new family. In the postnatal period, a doula’s role is to nurture and nourish the mother or parent so they can rest and feel more confident, whereas a maternity nurse is baby-focused.” Cost also comes into the equation – a maternity nurse can cost up to £300 for 24 hours, whereas a doula can be significantly less.

Does A Doula Replace A Partner's Role?

Doulas are there to support a family, and will never replace a partner’s role, says Vera. “A doula will prepare a couple antenatally for birth and help them transition into parenthood as well as provide balanced and evidence-based information. Doulas have a level of experience in birth and childcare that the partner doesn’t and together, the roles can combine to create the perfect team. Remember doulas are neutral in their views and are there to support whatever decisions you make as a couple.” Laura adds that having a doula can be helpful in a hospital setting, too. "Many partners appreciate the presence of a doula, who will often take some of the pressure off by taking on practical tasks and leaving the partner to enjoy the birth of their baby. For example, a doula can pop to the hospital café to pick up hot drinks while the partner stays with the woman in labour, or we can be the one to stay so she’s never alone. We can help with the newborn, and spend time with other children so parents can bond with their new baby.”

What Kind Of Things Can A Doula Help With Before The Birth?

Doulas have lots of contacts, resources and knowledge about birth, and can help you prepare and make decisions about the kind of birth you want. “Some doulas are also antenatal teachers or hypnobirthing specialists, but even if they’re not, they’ll be able to advise you on other ways to prepare for the different births that are available in your area,” says Emma. Your doula may accompany you to appointments you have relating to your pregnancy, and they can also help in practical ways around the house.

 

How Can They Help In The First Few Weeks Post-Birth?

A doula can support you as you get to know your baby. “They’ll be able to help you as you learn the basics of dressing, feeding and changing your baby and should empower you with confidence in all of these tasks,” says Laura. “Whether it’s bodily fluids, fingernails, baby’s first birth, or caring for delicate skin, no topic is off-limits. They can also provide an extra pair of hands around the house – they can cook, do some light housework while you spend time with your newborn or watch your baby while you have a shower or bath. They can also provide evidence-based information on things such as co-sleeping and can provide breastfeeding support.” In fact, studies show that postnatally, women working with a doula have greater breastfeeding success, more confidence in their abilities as a mother, and lower rates of postnatal depression.

If You Want A Doula, At What Stage Should You Hire One?

You can look for a doula at any stage of pregnancy, but the most common time is around the second trimester. “Most doulas take on clients when they are 16-20 weeks pregnant as it gives you the chance to get to know your doula and establish a relationship. By the time of the birth, your doula should feel like part of the furniture. The majority of doulas will offer at least two antenatal meetings with you but some have a well-rounded antenatal programme that can take weeks, so check what your doula offers,” adds Vera.

How Do You Find A Good One?

There are a few different types of doulas – birth doulas, postpartum doulas and fertility doulas – although many offer all of these services. “It’s important to know that doula isn’t a protected title, and as such, doulas are unregulated,” Milli tells us. “For this reason, it’s very important to find out as much as you can about your doula’s training and experience and make sure they’re the right person to invite into your birth space.” 

A personal recommendation is always great, but the doula role is very much about relationships, so what suited your friend may not be right for you. If you have a specialist need, such as birth after baby loss, or twins or multiples, you may find a doula who has specific experience in this area. “Always choose a doula who you feel you have an instant connection with,” advises Emma. “Sites like Doula UK are a good starting point, but also look at NurturingBirthDirectory.com and TheDoulaDirectory.com.”

Do Covid-19 Restrictions Impact Having A Doula?

During the pandemic, hospitals restricted visitors, and although this is lifting, restrictions are inconsistent across the UK, so it’s always worth checking with your midwife. As Emma tells us, “Even without Covid, there can be restrictions during childbirth – especially surrounding a caesarean – so it’s always worth checking what your hospital will offer. During the pandemic, some doulas were unable to attend births while others were able to attend home births. The pandemic did, however, spawn the virtual doula. A doula’s main role is to support, leading up to and during the birth and then after, to offer words of encouragement, trust and focus. If your hospital won’t allow the presence of a doula, it’s always worth exploring something virtual.”

How Much Will It Cost?

Costs depend on where you live, what you need, what you are able to pay and what your doula is able to offer, but it can be anywhere between zero and £2k for a support package. If you have limited funds, it’s still worth talking to a doula, as many accept payment in instalments or offer a sliding scale.

Finally – Is A Doula Right For Me?

If you think you may want or need additional support and coaching in the run-up to labour, during the birth itself, or at home in the weeks post-birth, a doula could be a good choice for you. And if you have your heart set on a specific birth plan, a doula can be a good option as she’ll be your advocate if you’re struggling to voice your needs. “Anyone and everyone can benefit from a doula,” says Emma. “They can be invaluable if you’re looking for an added layer of support, whether that’s because you know the benefits of continuity of care, or because you’ve had a previous traumatic experience. Or perhaps you really want to prepare and have the best possible experience the first time around. Either way, a doula will support everyone – the person giving birth, the partner and family.”

For more information, visit MilliHill.co.uk, TheNakedDoula.com, KoalaAndJoe.com and follow @CiaoMammaDoula. For information on doulas and what they do, also visit Doula UK. The NCT also has a doula service, providing women and their partners with skilled physical and emotional assistance as well as up-to-date knowledge and information. For more information, see NCT.org.uk.