Frequently asked questions about doulas

Why is there a need for doulas?

As childbirth has moved from home to hospital, a vital element of care has been lost from the whole process. Gone are the days where a woman would have continuous support from one carer throughout her labour. It used to be the case that the womenfolk within the immediate and extended family (mothers / sisters / grandmother etc...) would be on hand to provide the nurturing role for the new mother, to guide by experience and help with the practicalities that need to be performed before, during and after a woman gives birth to a baby.
Later the concept of the community midwife developed, but due to lack of resources, this service is steadily declining in many areas. Nowadays many women feel that they have to be in hospital to give birth to their baby where it is much more likely that a birth will be medically managed and intervention methods, such as caesarean section or forceps, will be used. The likelyhood of knowing your "labour" midwife is extremely small. She may also need to look after more than one mother and be in and out of your room. A doula is dedicated to a couple and will support the throughout, she works for them.

Who can benefit from having a doula?

Anyone can (men and women)... certainly first time couples (when the birth process is a new experience and may feel daunting), those who have had challenging births previously can also benefit from having another woman present who has experience of labour and supporting couples through births. Sometimes women who have complicated obstetric/pregnancy history benefit from having someone more experienced to talk things through and get emotional support.
Men often rave about thier doulas too!
Doulas are also ideal as support for mothers who want to look after their babies themselves and will welcome the help and advice traditionally offered by their own mothers or experienced sisters in the days when extended families lived close enough to be constantly on hand.

What is the difference between a doula and a midwife or a health visitor?

Doulas are not medical professionals but they are usually mothers themselves. They do not offer medical diagnosis, treatment or advice but, just as importantly, they can offer reassurance when parents are worrying needlessly about a baby that will not settle or sleep or is displaying a harmless rash. They are not part of a medical team, but if they are supporting a woman in labour, in the hospital or in the home, they can act as her advocate and constant companion. However, they cannot challenge medical or midwifery advice given to the woman or persuade her against a course of action or treatment suggested by the medical team. A doula will stay with a mother throughout labour as midwives are not always able to do (due to shortage of midwives available) and as she is not affiliated with a hospital she will focus on the mother's needs and best interests.

Are doulas of any practical benefit in the birthing room or do they just make the mother feel happier?

A recent report in the United States (Mothering the Mother by Kennel, Klaus and Kennel) showed that caesarean births could be cut by half, labour duration could be reduced by 25 per cent and the odds of a forceps delivery reduced by 40 per cent if more women have the support of a doula during labour.

Is a doula only for a hospital birth ?

No, a doula can help you for a home birth or in hospital. Where a woman gives birth is her choice and doulas support parents choices.

What is the difference between a doula and a maternity nurse?

Maternity nurses are baby-centred while doulas are mother and family-centred. A maternity nurse will give you 24-hour care for six days a week and will get up at night with the baby and set a routine for him or her. A doula will help the mother to do the mothering. She will help with breastfeeding, help with housework, and encourage the mother to care for herself as well as the baby. She will also be quite flexible in the hours she can work for you.