So what is a doula anyway?
Updated: Apr 15, 2020
“A dona? A doona? Dolla? Duller?”
“No, I want to become a doula”
“Doula? What is that?”
This is basically how every conversation went with my family and friends about my choice in a new career path. Unless you have some relation to or experience with the birth industry, then you probably haven’t heard of this word. In fact, my mum, who has been a theatre nurse for countless caesarean births, had never heard of what a doula was. So even in some birth work circles, the word of doula is foreign. You might not even fully know what it means or the history behind this ancient career. I didn’t even know the extent to which doulas should be an integral part of birth and postpartum support.
Ever since becoming pregnant with my daughter in 2018, birth has fascinated me. I became infatuated with the strength, power and indescribable ability of women to birth their babies. Being a secondary teacher, meant that I placed a high value on gaining knowledge to inform yourself about certain things. Birth was no exception, and I realised that the more I informed myself, the more I grew a passion for it. Fast forward to birthing my daughter and the many wonders and challenges of birth came to my own fruition. Despite my learning and research of birth, I realised that there was a missing link in my experience. You can learn and practice all the different tools and techniques to achieve a calm and confident birth, but in the end you have no idea how you and your birth partner are going to react when the time actually comes. This is especially true for new or first time mamas. And this is what happened to me and my husband. My husband in particular, reacted in a way that was foreign to us, going inside himself with the shock of how I looked and sounded in birth. As a sports strength coach, he figured he was born to encourage and cheer me on during birth. Instead, when the day arrived, he the lost the confidence to use the tools we had learnt to help me through the challenging times, and I was too far gone in “birth land” to direct him in the type of support I craved. My birth had beautiful and empowering moments, but (like many women before me) I was also hit with extremely challenging ones and I believe that my experience suffered due to not having the right support network.
The experience of birth matters. And all women have the right to a positive birth experience. Birth is never, and should never just solely be about a healthy baby. Without a healthy mother, and by healthy, I mean in mind, spirit and body, a healthy baby cannot thrive. Months after my birth, with this concept fuelling my mind, I came across the idea of a doula. Researching further, I found that a doula was the missing link to my experience. A doula is an integral part to the support network of a birthing woman. Derived from the ancient Greek word of “servant”, a doula’s primary role is to support the birthing woman, surrounding her with protection, comfort and confidence. In the modern world, the word doula was first introduced by American medical anthropologist Dana Raphael in 1973, used in the relation to support of breastfeeding new mothers. She wrote about the success of some communities who appeared to depend on support by other women who often came from outside of the mother’s family. Over time the word of doula came to also refer to people who helped in childbirth. In the 1980’s American neonatologist Marshall H. Klaus and pediatrician John H. Kennell discovered the benefits of continuous emotional and physical support from another woman in labour through various controlled trials. By 1992 Klaus and Kennell joined with Phyllis Klaus, Penny Simkin and Annie Kennedy to found the first ever doula organisation DONA (Doulas of North America). The popularity of doulas rose from there on in, with DONA becoming an internationally recognised organisation.
“One of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.”
Safe Prevention of the Primary Caesarean (evidence based journal) 2014
Doulas act as continual, non-medical, emotional and physical support for the mother and birth partner during birth (but also during the pre and post-natal phases as well). They build a strong bond and rapport with the couple whilst still employing a professional approach to the birth experience. They can offer evidence based research on ways to emotionally and physically support a woman during labour and utilise and remind the couple of the various tools and techniques to maximise their birth day.
“…to encourage her to release and let go, breathe, move and focus.”
Vicki Hobbs (Doula) 2020
Birthing my daughter was such a pivotal moment in my life. It challenged me to my core and proved to me how strong women really can be. But most women don’t recognise their own strength and power. Most mamas go into birth, fearing what will happen and without adequate support. Fear and lack of support have such an impact on how you birth, as well as shaping what type of mother you become. Since becoming a mother myself, one thing has stood out to me. Support is the number one thing necessary to “survive” birth and motherhood. Unfortunately, support is also the number one thing lacking in our society. Mothers, in fact women, are amazingly powerful and resilient people. We are bombarded with the concept of “figuring it out on our own” and pregnancy, birth and the postpartum period is riddled with societal pressures. This should not be the situation. Mothers need villages. Women need villages. As much as we try, we cannot do this on our own. And we shouldn’t have to. And this is where a doula can help. You are not alone, if you have a doula by your side.
“They also offer a safe and comforting presence by providing companionship and emotional support”
Curious History (website) 2016
Doulas are an integral part of the support system. But they are just one part. A successful doula is one that works together with the mother, birthing partner, family and other birth workers involved in the day. Doulas are not heroes. They are not the be all and end all of birth. The best type of doula is one that works alongside the other birth workers there on the day, whether that be a midwife, doctor or labour nurse. The most important person in the room is you, the birthing woman. The mama. You do not need saving. You do not need to lie down and be a “good little girl” and birth that baby like you have been told to. No, a doula will support a woman’s individual strength and unique ability to birth her baby in her own glorious and powerful way. A doula will stand by you every step of the way and pass no judgement on the choices you make about your body, birth and baby. Doulas are not there to coerce you.
"It is not their birth. It is yours."
Emma Goodin (Doula) 2020
Doulas are also not there to take the place of a doctor or midwife. They have their place to, and at times are absolutely essential to the safety of women and their babies. The current system is often more focused on intervention and prevention of risks, rather than honouring the physiology of birth and allowing the mother and baby to perform the most natural and instinctual tasks of humanity. It feels like society has lost its way and the system has forgotten about the benefits of a truly natural vaginal birth. Yes, there are risks. Like with anything in life. But research has shown that the more we interfere and intervene with birth, the more likely negative outcomes and experiences arise. It is often called the cascade of intervention – a domino effect that is likely to happen when birth is interrupted. One thing often leads to another. And this steady increase of intervention usually gives way to a steady decline in a woman’s power and choice to birth. This is where a doula can be an integral element to help alleviate the situation. A doula can help remind a woman of her birth plan, and encourage her to look at all the risks and benefits of each intervention offered to her. The goal here is to give the birthing woman the power to choose. In the end it is still her body and her baby. When a woman feels like she has some control over her birth, no matter what the circumstances are, she will have a more positive experience. A doula can support you in whatever decision you make, and continue to ensure you feel relaxed, calm and confident.
“All of us saw and felt the gaps and even holes in modern childbirth and parenting when it came to support. Women had traditionally been supported by women from their family and community during pregnancy, childbirth, breastfeeding and postpartum for thousands of years – but in the last 100 or so years things had changed dramatically.”
Debra Pascali-Bonaro (Doula) 2017
As well as support, doulas help women release fear and anxiety around birth. A common perception around birth is that it is painful and many women grow up fearing this pain. Instead of seeing this “pain” as purposeful and honouring a mother’s natural ability to birth, society focuses on saving women from the hell that is birth. But birth doesn’t have to be seen like this. What if we saw running as so painful that we needed medications to help numb our legs? The “pain” of running is purposeful. The muscles are working, the heart is pumping, the lunges are filling, the lactic acid is burning. The brain is sending signals to your feet to keep moving. This can be said about birth. The muscle of the uterus is working to push and squeeze your baby down and out. Your heart and lungs are pumping and filling to give your body energy and power. Your brain is sending signals to release important and helpful hormones to open, relax and soften. Everything in your body is working to help move that baby out into the world. The “pain” - the contractions, the waves or what Hypnobirthing circles like to call them as surges, is just one element to birth. But it has become an all-consuming, game changing fear. A doula can help give women the tools to release this fear. Firstly, information is the key. Research is important. Knowing what is actually happening to a woman’s body while it births is an important step to fear release. A doula will help educate you (and in turn give you the tools to educate yourself) on the physiology of birth. When you understand how powerful and clever a woman’s body is in birth, the fear and anxiety becomes just that little bit more manageable. Other fear release techniques a doula might employ is such things as massage, meditation, physical exercise and mindfulness exercises like journaling or affirmations. Sometimes just the simple task of talking about all your fears and worries about birth to someone, like a doula, who will not judge you and be there to just listen, is extremely powerful in releasing fear. Without fear, or at least having the tools to manage that fear, is a formidable step to having a positive and empowering birth experience.
"Birth is amazing. Birth is challenging. Birth is epic."
Emma Goodin (Doula) 2020
No matter what type of birth you had or will have, whether it be a vaginal, caesarean, non-medicated, medicated, emergency or home birth, women are undoubtedly strong and powerful human beings. Mama-hood is an amazing time of personal transformation for women, a time that will test you to your core and give true insight into just how “boss” you are. With a doula by your side, giving you the right type of emotional and physical support and the tools and chance to release fear and manage pain, you can have the birth that you desire. Even if the birth didn’t go exactly to plan, a mother has the chance to be heard and keep her autonomy during birth, if a she has a doula.