What is a Doula?
The word 'Doula' (pronounced 'doo-la') is traditionally defined by Klaus, Kennell and Klaus(1993) as 'a Greek word referring to an experienced woman who helps other women. The word has now come to mean a woman experienced in child birth who provides continuous physical, emotional and informational support to the mother before, during and just after child birth'.
As an inclusive doula, I acknowledge and respect that not all doulas, or people who give birth, identify as a woman or a mother.
It is a role that is centuries old and would have been performed by a new mother's closest female supports. In modern society we have lost that strong sense of community around birth and early parenthood, and sadly it often occurs in isolation.
From this societal shift has come the need for a formalised role in which many doulas will feel a 'calling' to do, and may have completed doula training.
Doulas do not offer clinical skills and are not medically trained, and nor do we pretend to be! Our role is very different to that of a midwife or obstetrician. We bring a lay perspective where the emotional well-being of the parents are our priority. We provide continuous support for the whole whanau through pregnancy, birth and the early days of parenthood. We are there to listen, give confidence and not judge. We offer flexible, practical and emotional support and work in parent's own homes and where ever the baby is born.
A wide variety of parents (from different communities, with different needs and planning all kinds of birth) hire doulas and I believe the right doula is out there for every parent.
"The whole point of woman-centered birth is the knowledge that a woman is the birth power source. She may need, and deserve, help, but in essence, she always had, currently has, and will have the power".
Heather McCue
What does a birth doula do?
- Continuity is key. You doula will meet with you antenatally to build a warm and friendly relationship with you and your family (if appropriate), discuss your birthing preferences and provide birth preparation education.
- They will help you access inspiring resources and evidence-based information so you are aware of your choices, know what to ask, and feel able to make informed decisions. They will support your decisions.
- Once you are in labour, your birth doula will go to you and stay with you (whether you are at home, a birth unit, or hospital) offering continuous emotional, physical and practical support until your baby is in your arms. When they go to you will be agreed antenatally. How they support you depends on your needs while in labour and during the birth, and they will intuitively bend and flex to meet each of your needs as they come and go. This may include emotional (listening, advocacy, encouragement, reassurance, validation, positive affirmations), physical (massage, acupressure, breathing techniques, positions, food and drink, hot or cold flannels), or practical support (making phone calls, tidying up, adjusting the birth enviornment, getting you a snack, putting the kettle on, looking after older siblings) and everything in between! Or, if you are labouring well (feeling calm and relaxed), they may instinctively just sit with you quietly, holding your space. In this case, she may appear to be doing very little! What they are actually doing is wonderfully effective; offering a gentle presence and holding your birth space without disturbing your birthing hormones.
- Your doula will visit you postnatally to see how you and your baby are doing and help you start to process your birth story. Some doulas support women over weeks or months in the postnatal period too, these are postnatal doulas.
What DON'T birth doulas do?
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Peform any medical assessment/intervention/diagnosis. Doulas are NOT medically trained.
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Replace your husand/wife/partner. A doula will extend her support to your whanau, enable them to support you as best they can and compliment them by offering additional support. Having a Doula also means your husand/wife/partner can nap, pop out to use the toilet or make a phone call, knowing you are not left alone. It gives them room to participate in the birth at a level in which they feel comfortable.
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Replace your midwife/obstetrician. A doula is NOT a substitute for a birth professional. A good doula will be part of your birth team and ready to work cohesively. Everyone has a role to play in supporting you.
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Give advice or make decisions for you. A doula will help you to access evidence-based information to make you aware of your options, and will support your decisions.
How do I choose a doula?
Doulas are like shoes – we come in alsorts of shapes and sizes and you need to find the one that's the right fit for you! Each doula brings her own experience, values, skill-set and personality. The right doula is out there for every birthing woman, and the most important thing to consider when employing a doula is “Do I/we like this doula? Can I/we spend time with them? Can I/we trust them?” Feel free to ask around, get recommendations and interview more than one doula. If it makes you feel more comfortable, ask a doula for references from previous clients. The right doula for you will be someone who makes you feel comfortable, shows they care and is genuinely invested in supporting you. Their doula experience or ability to provide other services are secondary to the most important part of the relationship: do you ‘click’?
"If I don’t know my options, I don’t have any".
Diana Korte
How does it work?
If, after a free consultation, parents like the doula they have met, the doula will be employed upon signing a contract (that the doula provides), and is paid directly by the clients.
How much is a doula?
How much a doula charges will vary depending on various factors for example the area they work in, their level of experience, what they include in the fee and what they feel their service is worth.
Email me if you'd like a quote.
I'd like to be a doula, where can I train?
There are a host of difference doula training options, some on line and some in person, some include certification, others accreditation, and they continue to change! If you are thinking about becoming a doula I encourage you to do your own research and choose the provider that is right for you. Good luck! Some current existing course providers include the following:
- The Doula Association
- Birth Works International
- Angela Gallo’s Dynamo Doula Training Programme
- DONA
- Childbirth International
What are the benefits of having a doula?
While doulas are not there to change outcomes, there is evidence that having a birth or postnatal doula can bring a number of benefits:
- Reduced risk of Caesarean birth † *.
- Reduced risk of instrumental birth † *.
- Reduced need for painkillers or epidural during birth † *.
- Reduced rate of induction of labour † *.
- Shorter labour †.
- Increased parental satisfaction with the birth experience. †
- Increased likelihood of initiating breastfeeding *.
- Increased likelihood of successfully establishing breastfeeding & breastfeeding at 6 weeks *.
- Lower incidence of depressive symptomatology †.
While this research is important, it’s the less tangible benefits of having a non-judgemental companion during a life-altering event that most women remember and value.
* Brigstocke S. MIDIRS Midwifery Digest, vol 24, no 2, 2014, pp 157-160
† Hodnett ED, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5 and Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub6.
What does a postnatal doula do?
Postnatal doulas typically start working with with a family in the first weeks after birth, Sometimes postnatal doulas are booked in advance antenatally, sometimes only when a family find they are struggling or feel the need for more support. The length of time a postnatal doula spends with one family varies enormously, based on their needs.
Just as when supporting birth clients, postnatally doulas provide emotional, practical and informational support.
The actual tasks in the practical support postnatal doulas provide varies enormously, and one of the big benefits of having a postnatal doula is that they are there to support the family, not carry out a specific task, so they do what is needed (within reason!). This can be things like basic tidying or cleaning, sorting laundry, looking after baby while mum (and her partner) nap, helping with older siblings, making easy meals, even sometimes, helping overnight so the parents get more sleep. Some key tasks might also include supporting the parents find a local support network, normalising early parenthood feelings and emotions, offering suggestions around caring for a newborn such as bathing, skin care, feeding or sleeping (if required) and most importantly; listening. Whatever is needed to help a family relax and have a positive experience of life with a baby.
"Positive Birth is about having freedom of choice, access to accurate information, and feeling in control, powerful, and respected"
Milli Hill
What DON'T postnatal doulas do?
While we may hold other qualifications, when we are employed as a postnatal doula, we are just that. Everything we do is around supporting the parents to enjoy life with their baby. We are not a nurse, a nanny or a maid! There are certain tasks we do not perform such taking sole responisbility for your baby or other siblings, unless you are in the house at the same time (for example taking a nap or a shower).We do not diagnose any symptoms of you or your baby, however we will talk openly with you if we feel you may benefit from talking to a professional (for example your GP, or holistic health services such as an osteopath).
"The way a woman gives birth can affect the whole of the rest of her life. How can that not matter? Unless the woman herself does not matter"
Beverley Beech and Belinda Phipps
What should I ask a doula at a consultation?
If you need some help getting discussion going when interviewing a doula, here are a list of we suggested questions to get the conversation going:
- Why are you a doula?
- How long have you been one and what made you decide to be a doula?
- Who did you train with?
- What are your views on birth?
- Do you work with a back up doula?
- How can you support my husband/partner/older children?
- Do you have any references from previous clients?
- How do you work cohesively with LMCs?
- How will you support my choices?
What if I cannot afford a doula?
I firmly believe that every parent deserve the best birth for them and wish that finances were not be a barrier. For parents where this is the case (for example those facing times of hardship, in receipt of a WINZ benefit, young, single or unemployed) please please do contact me and we can talk about payment plans or options.
Where can I go to for my own research?
For your own reading or research to help you decide if hiring a Doula is for you, I recommend the following resources:
- Why Doulas Matter by Maddie McMahon
- Doula! The Ulitmate Birth Companion DVD
- Gentle Birth Companions; doulas serving humanity by Adela Stockton
- Mothering the Mother; How a Doula can help you have a shorter, easier and healthier birth, by Marshall H Klaus, John H Kennell and Phyliss H Klaus
- The Doula UK website