Birth Doula services in Essex, Cambs, Herts and Suffolk
What is a Doula?
I like to describe a doula as “a guardian of normal birth”. A doula is a non- medically qualified woman who has herself experienced the ease and joys of natural childbirth, she views childbirth as normal, not a disease or sickness or something that a woman needs artificial help to achieve. A doula believes in a woman’s own innate ability to birth her own baby, she doesn’t so much support the birthing mother (as that would indicate that a woman needs more than her own wonderful body to birth her baby) rather she ensures that the woman can feel as at ease and undisturbed as possible so that the amazing act of childbirth can be, free from outside influences and therefore as easy and as safe as possible.
So what exactly does a doula do?
As I mentioned above a doula’s primary role is to guard the environment of the birthing mother. We make sure that the mother feels comfortable (this might involve keeping her cooler or warmer, it might involve helping her into a relaxing bath and massaging her if she likes to be touched), that she feels as unobserved as possible (so we may help to keep the dad calm and occupied and make sure that medical staff aren’t staring at her!) and that she feels as free of fear as possible (which is where our own wonderful experiences of normal birth come in, we are confident in the amazing ability a birthing mother’s body has to birth her baby easily and safely). You may want your doula to hold your hand every step of the way or you may prefer your doula to sit quietly in the corner reading a book – her mere presence being a comfort to you, the key is we work with you to provide the exact environment that suits you best.
So why is the environment so vital?
The major hormone released during labour, oxytocin, is incredibly fragile with regards to external stimulus. If a woman is too cold, if she feels scared, feels observed, if the light is too bright and so on she will release catecholamines, the most well known of these being adrenaline. The release of adrenaline during labour causes two things to happen, firstly it inhibits the release of oxytocin, this causes the uterus to stop contracting effectively and can cause the labour to become erratic and slow, secondly when we release adrenaline we cannot release beta endorphins, nature’s own natural anaesthesia. The contracting uterus also becomes starved of oxygenated blood which leads to a build up of lactic acid and thus pain and combined with the lack of release of our own natural pain killers labour becomes harder, longer and more painful. By ensuring that the birthing mother releases as little adrenaline as possible we can help the birth to progress easily, safely and comfortably.
So why can’t the dad do all of that then?
Some might say that the role of the baby’s father and a doula are quite similar, but the differences are crucial. The father or partner may be able to provide continuous support, but typically has little actual experience in dealing with the often-subtle forces of the labour process and like a doula has, he hasn’t experienced being in labour himself. Even more importantly, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation. Studies have shown that fathers usually participate more actively during labour with the presence of a doula than without one.
Is there any evidence to show having a doula helps?
Yes absolutely!
According to recent studies, women supported by doulas benefit by experiencing shorter labours and lower rates of epidural anesthesia and caesarean section deliveries. Also, a smaller percentage of their newborns experience foetal distress and/or are admitted to neonatal intensive care units. A small selection is presented below:
1) The obstetrical and postpartum benefits of continuous support during childbirth.
Scott KD, Klaus PH, Klaus MH. J Womens Health Gend Based Med 1999 Dec;8(10):1257-64 Division of Public Health, County of Sonoma Department of Health Services, Santa Rosa, California 95404, USA.
The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the twelve trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these twelve trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.
2) Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers' wellbeing in a Mexican public hospital: a randomised clinical trial.
Langer A, Campero L, Garcia C, Reynoso S. Br J Obstet Gynaecol 1998 Oct;105(10):1056-63 The Population Council, Regional Office for Latin America and the Caribbean, Colonia Coyoacan, Mexico DF, Mexico.
OBJECT: To evaluate the effects of psychosocial support during labour, delivery and the immediate postpartum period provided by a female companion (doula). DESIGN: The effects of the intervention were assessed by means of a randomised clinical trial. Social support by a doula was provided to women in the intervention group, while women in the control arm received routine care. SETTING: A large social security hospital in Mexico City. PARTICIPANTS: Seven hundred and twenty-four women with a single fetus, no previous vaginal delivery, < 6 cm of cervical dilatation, and no indications for an elective caesarean section were randomly assigned to be accompanied by a doula, or to receive routine care. OUTCOME MEASURES: Breastfeeding practices, duration of labour, medical interventions, mother's emotional conditions, and newborn's health. METHODS: Blinded interviewers obtained data from the clinical records, during encounters with women in the immediate postpartum period, and at their homes 40 days after birth. Relative risks and confidence intervals were estimated for all relevant outcomes. RESULTS: The frequency of exclusive breastfeeding one month after birth was significantly higher in the intervention group (RR 1.64; I-C: 1.01-2.64), as were the behaviours that promote breastfeeding. However, the programme did not achieve a significant effect on full breastfeeding. More women in the intervention group perceived a high degree of control over the delivery experience, and the duration of labour was shorter than in the control group (4.56 hours vs 5.58 hours; RR 1.07 CI (95%) = 1.52 to -0.51). There were no effects either on medical interventions, mothers' anxiety, self-esteem, perception of pain and satisfaction, or in newborns' conditions. CONCLUSIONS: Psychosocial support by doulas had a positive effect on breastfeeding and duration of labour. It had a more limited impact on medical interventions, perhaps because of the strict routine in hospital procedures, the cultural background of the women, the short duration of the intervention, and the profile of the doulas. It is important to include psychosocial support as a component of breastfeeding promotion strategies.
3) Continuous emotional support during labor in a US hospital. A randomized controlled trial.
Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. JAMA 1991 May 1;265(17):2197-201 Department of Pediatrics, Case Western Reserve University, Cleveland, OH.
The continuous presence of a supportive companion (doula) during labour and delivery in two studies in Guatemala shortened labor and reduced the need for cesarean section and other interventions. In a US hospital with modern obstetric practices, 412 healthy nulliparous women in labor were randomly assigned to a supported group (n = 212) that received the continuous support of a doula or an observed group (n = 200) that was monitored by an inconspicuous observer. Two hundred four women were assigned to a control group after delivery. Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; and control group, 18%) and forceps deliveries. Epidural anesthesia for spontaneous vaginal deliveries varied across the three groups (supported group, 7.8%; observed group, 22.6%; and control group, 55.3%). Oxytocin use, duration of labor, prolonged infant hospitalization, and maternal fever followed a similar pattern. The beneficial effects of labor support underscore the need for a review of current obstetric practices.
How much do you charge?
For a limited time only, whilst reaching full recognized doula status with Doula UK, my fees are a minimal £150 to include attending your birth, one antenatal visit, one postnatal visit and a written record of your birth to keep. I will also prescribe as a registered Homeopath during your labour if you so wish.
What training have you had?
Apart from being a mum to four easily born children myself, I have been trained by Michel Odent and Liliana Lammers of Paramanadoula, London, and am also a trainee member of Doula UK. As well as this I am an experienced women and children’s Homeopath, HypnoBirthing Instructor, Homebirth Supporter and Happiest Baby Educator.
Which areas do you cover?
I work within a 15 mile radius of Saffron Walden, North Essex. This includes Bishops Stortford, Cambridge, Dunmow, Haverhill, Royston, Stansted and Saffron Walden.