Doulas are not a new phenomenon, women have always supported women during the childbearing year. Doulas offer emotional, practical and informational support to women, birthing people and their partners, before, during and after childbirth. Doulas are not medically trained, do not carry out any medical tasks and do not give advice.
In maternity services today, we often see doulas being misunderstood and other health professionals often don’t know that much about doulas or what their roles are. We want to change that and ensure that midwives, obstetricians, anaesthetists, paediatricians, maternity care assistants and everyone who comes in contact with doulas understand our role. We must all work together as a team - putting the woman in the centre of our care!
Doulas are impartial supporters of birthing people. No matter their own personal beliefs, a doula's role is to support their client's wishes, not impose their own. They do this by helping their client to understand evidence based information and choices for their birth and care of their baby, so families are able to and supported in advocating for themselves.
Doulas do not impose their own views upon anyone, they provide evidence for families to make the choices that are right for them and then they support families in having their voices and feelings heard during their birthing journey by helping to create a safe space and the self-confidence for them to do so. A doula's practice should be reflective and supportive.
The Doula Association endeavour to educate society about doulas and challenge the status-quo within many hospitals. We feel that the current 'guidelines' and practice within many institutions and trusts are not women/person centred, when there is overwhelming evidence to show that this is the best standard of practice and care. Currently 80% (or whatever the figure is) of guidelines in maternity settings are not evidence based. Individualised care for women and birthing people should be the priority, not blanket rules and guidelines, that do not support wellbeing and positive birth experiences, as can be seen by recent research... Best practice is for evidence based, individualised care.
#1. Women should be able to take their doula with them during emergency caesareans and/or assisted deliveries that take place in theatre if they want to. A doula has been hired specifically to provide emotional and practical support to the mother and her partner and has been trained to do so. The doula is someone who is part of the ‘care team’ and more than just a birthing partner. Making the mother choose between her partner and the doula is not fair and removing the doulas continuous support, during a time in labour which has the potential to be particularly stressful and traumatic, is not offering woman centred care. We know that student midwives, medical students, even representatives of pharmaceutical companies and representatives of companies that sell medical equipment are allowed in theatre whilst doulas are often told they can’t support their clients in theatre as there is not enough room.
We would like to see these institutional rules changed so that the woman can have the continuity of support that she deserves.
#2. There is plenty of research that shows that doula support improves outcomes and birthing experiences for women. The Cochrane review explicitly states:
“Continuous support from a person who is present solely to provide support, is not a member of the woman's own network, is experienced in providing labour support, and has at least a modest amount of training (such as a doula), appears beneficial.”
Doula support leads to extended breastfeeding and happier families, yet, few maternity professionals inform women about doulas and the work we do. Complementary therapies, such as reflexology, hypnobirthing, acupuncture and other body work is often suggested but for some reasons, doulas are not.
We would like to see maternity workers support doulas and that information about doulas is given to all pregnant and postpartum women.