The reasons why the doula should be part of the maternity care team!

​Controlled trials from around the world show that the presence of a doula improves obstetric outcomes and patient satisfaction, compared with the usual hospital care without a doula.

The vast majority of midwives are caring and competent and therefore, the best model for supporting women and couples during childbirth. However, midwives can be busy with important medical checks, or simply because they are splitting their time between multiple women. In this case, the labouring mother (and her partner) may find they have a need for emotional support and stability which is not being met. The doula is able to provide this stability. 

Historically, doulas have always played a role in childbirth, before hospital births became the norm. They were the wise women, the aunties, grannies, sisters and mothers who assisted the midwife at home and made sure that the labouring and new mother always felt emotionally supported and never alone.

In which ways can a doula enhance already established services?

• Unless the woman is cared for by an independent midwife (who are currently not allowed to support births in the UK), she is likely to see different midwives during her pregnancy, but the doula stays the same.

• Unless she has booked domino care with her midwife, which is no longer available in most NHS trusts, she is likely to labour at home on her own or with her partner before transferring to hospital, but the doula would come and stay with her as soon as the woman wanted her to, making everyone feel more relaxed. (Domino care is when the midwife attends the woman at home when she goes into labour until it's time to go to the hospital. The midwife goes with the woman to hospital to support her during the birth of her baby, and then returns to their home with them after the baby has been born.)

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• By the time they go to hospital, the doula has established a working relationship with the labouring mother, which is of immense value for continued progress and minimal emotional upheaval.

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• If the woman has booked a home birth, the doula will be very familiar with the surroundings, will find things quickly and will stay until the woman is emotionally settled. If her midwife feels that she needs to transfer into hospital, the doula is with her during those crucial times, whilst the midwife is busy making arrangements. The doula is with her while she gets examined and her contractions measured - during all these changes her doula provides emotional stability.

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• Soon after birth and the initial checks have been done, the midwives will be busy cleaning up and writing notes, however, the doula will still be by the woman's side, offering support.

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• In the time following birth, the woman will normally see several different midwives and a health visitor; however, her doula will be there consistently, to listen to her and to help debrief her birth experience.

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• Since the doula is not bound by guidelines and policies, she can offer evidence based information and often bring information in an objective way, offering choice instead of advice.

There is so much that doulas bring to maternity services that it is surprising that doctors surgeries, hospitals and antenatal classes don’t inform pregnant women about this option in childbirth.  It really is frustrating to think that the majority of the population in the UK still don’t know what a doula is and that we’ve been portrayed in TV and films as knit-your-own-yogurt type of women, dressed in long skirts and chanting as we go.

In my experience, the majority of women who become doulas are passionate about supporting women to have positive birth and parenting experiences - and what these experiences look like will differ from family to family.  They come from all walks of life, all different ages and with different life experiences.

My wish is that everyone who is pregnant or who has just had a baby would find out that doulas exist - we have so much to offer!