Issue 95 is out now
Melissa Corkhill

By Melissa Corkhill

28th June 2013

National interest in childbirth has recently become a major phenomenon, with more than 9 million weekly viewings of “Call the Midwife” and 5 million watching “One born every minute”. The national birth rate has reached its highest level since 1971, at 688,120 births in England in 2011 and a further rise in 2012.

Melissa Corkhill

By Melissa Corkhill

28th June 2013

Melissa Corkhill

By Melissa Corkhill

28th June 2013

In some parts of England, the birth rate has jumped more than 50% in recent years. Official data suggests that immigration may be another factor behind rising birth rates – with foreign-born mothers make up nearly a 25 % of the total. The Royal College of Midwives say that although more midwives are being employed in England, and the number of places for midwives in training is on the rise, there are still too few staff to cope with the rising demand for services increasing the demand for Doulas. “England remains around 5,000 midwives short of the number required with Maternity units are under intense strain. We are reaching a crucial tip- ping point for maternity services in England,’ explains RCM chief executive Cathy Warwick.

What does a Doula do?
Doulas are female birthing companions whose principle role is to provide non–medical personal, emotional and practical support to the mother and her family in the run up to, during and immediately after giving birth. She can explain birthing options, pain relief and help to empower the parents in their decision making during a time of anxiety when clarity of thought is not at its greatest. Women rarely have continuous support from one carer throughout her labour, fema- le relatives often live too far away to provide practical help, and the community midwife service is under pressure due to lack of resources. In contrast, a Doula provides continuous support, for up to a month before, and after the birth.

?Nowadays many women feel that they have to be in hospital to give birth. In this environment it is much more likely that a birth will be medically managed and intervention methods, such as induction, forceps, and even caesarean section may be used. Research has shown that having a Doula present at a birth can:
• Shorten first-time labour by an average of 2 hours
• Decrease the chance of caesarean section by 50 %
• Decrease the need for pain medication
• Helps fathers participate with confidence
• Increase success in breastfeeding

Childbirth can be a lonely event, but the presence of a Doula helps to create a better bonding between mother and child. Research in the US has also demonstrated that continuous, rather than intermittent support during labour is strongly as- sociated with improved outcomes for both mothers and children – in terms of both medical and psychological benefits, as well as an easier transition into breast feeding. One of the roles of a Doula is of “being” and not “doing”, while helping to maintain a calm, quiet, comfortable surrounding for childbirth. This may sound like alternative medicine but there is scientific evidence to support the beneficial effect of reducing parental anxiety. The mother’s natural response to anxiety is to produce adrenalin; this counteracts the production of Oxytocin and endorphins, the body’s natural pain relief which is produced during childbirth.

More support equals better Mums
“We all know about the 3 trimesters of pregnancy, but there is a fourth, the first three months of the baby’s life,” explains Lucy Shutes, of Doulababes, who visits mothers across an area covering Guildford, Woking, Haslemere, Dorking and adjacent areas. “It is a really intense time, when parents and babies need maximum support.”

?Breast feeding can be an issue for first time mothers, but results of a survey amongst 105 Doulas world-wide showed that of 1,106 babies supported by a Doula, 93 % attempted to breast feed of which 70 % were still feeding exclusively after six weeks. Figures from the UK Dept. of Health show that of just over 74 % of new mothers att- empting to breast feed, but just 47 % were still exclusively feeding at the same stage. The survey also showed that only 12 % of Doula assisted births required medical intervention such as ventouse, forceps or caesarean compared to the national average of 37.3 %. “Although Doulas support any kind of birth and are not there to change outcomes it is startling that the women who have experienced continuous support during labour are much less likely to require serious intervention,” according to Bridget Baker, Board Member, Doula UK.

Doulas can be really helpful in protecting the mother’s space, as a facilitator, as a communication connection between the parents and medical staff and helping to support difficult decisions when the parents are often very tired and anxious. “Even though the midwives and doctors explain what is happening, the parents can’t always absorb the information in the first instance. Doulas can help explain options 2 or 3 times if necessary, we actively assist parents in their decision making,” explains Shutes. “There is an increasing demand for Doulas from parents expecting twins or more, the success of IVF has made this a more common occurrence,” she adds. Doulas can help discuss diet, exercise and lifestyle before and after the birth. They can provide post natal support too – with many going on to have longstanding relationships with the mother and child. Doulas can help parents navigate the bewildering landscape of pregnancy and child care at their own pace. “We offer unconditional support for the parents” she concluded.

How do you find a Doula?
Doula training courses are run by Nurturing Birth, Doula UK and DONA (Doula In- ternational). Many Doulas have their own websites, local community health centres may have details or visit Doula UK (www.Doula.org.uk). Doula UK is a voluntary, non-profit organisation offering support and training to Doulas and their clients. They offer training and accreditation schemes, they also have a Code of Conduct. Their website offers a lot of practical information to women considering employing a Doula. An initial informal interview between the prospective Doula and mother/ parents is the first stage of “getting to know you”. During this session discussions are typically based around the Doula’s background, number of children she has, her experiences and training and questions such as about views on pain relief, birthing and support. Assessing the father’s contribution is also part of this initial meeting. Partners need to be involved and the Doula can help to develop their self – confidence too, so that they can feel reassured and make a positive contribution to the birthing process. If you feel tongue tied Doula UK has a comprehensive list of questions you may want to download from their website. The website is packed with useful information.

?There are now 450 Doula’s working the in the UK. Lucy Shutes is also a trained nurse (SRN) and hypnobirthing advisor, she has three children of her own, having experienced a caesarean delivery and two natural births. She is passionate about women’s wellbeing and keeping people well and has been a Doula for 5 years in both Dubai and the UK. She has lived in many parts of the world during which time she helped run various clinics and assisted women to understand the benefits of getting fit after various medical treatments. For further information see Doulababes.com

How much does a Doula cost?
The cost varies depending upon where you are in the UK but on average, ranges between £ 450 – 750 plus travel for up to 3 antenatal visits and 1 postnatal visit. Your Doula is on call 24 hours per day for the two weeks before your due date, during the delivery and 2 weeks after the birth. On an hourly basis this is not a lot, it is a vocation which is why women who train as Doulas do it for the love of childbirth.
Doula UK also offers an access fund for mother’s on state support. The organisation has a budget to cover expenses incur- red by Doula’s who work for their clients in the local community and who would not otherwise have the financial support.

According to recent feedback, the majority of pregnant women using a Doula felt more empowered during the birth and better able to make decisions for their child, this feeling of empowerment continues after childbirth and can be incredibly helpful in developing a mother’s self-confidence during her child’s life. “The best thing that can happen after a birthing is when the mother says “I did it!”, she explains, “then I know I have done a good job in being there but not doing.”

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