A review of 15 research trials involving nearly 13,000 women presented in the Cochrane Library shows the ongoing care of a female support person, such as a doula, radically reduces the chance of caesarean, the length of labour, forceps deliveries and requests for epidurals and oxytocin use.
Because they bypass medical and clinical tasks and work independently, a doula is there exclusively for you, offering guidance, support, reassurance and information.
Traditionally, to achieve an optimal birth outcome, other practised women guided and supported the expectant mother through her pregnancy, labour and postnatal period. Most western cultures, however, lost the philosophy of women assisting women during birth, when industrialised societies emerged. In Australia, a woman's experience of childbirth is likely to find her labouring in a bustling hospital ward with an overwhelmed partner, in the care of a rostered midwife or obstetrician.
Enter the doula. They have re-established the role of a woman as a support person during this momentous -- and sometimes daunting -- life transition. Translated from Greek, doula means "female slave for the childbearing woman". This has transformed to "one who mothers the mother" -- the modern-day meaning of what a doula offers. Because they bypass medical and clinical tasks and work independently, a doula is there exclusively for you, offering guidance, support, reassurance and information. Recent years have seen doulas flourishing in the US and the UK, and now they are gaining popularity in Australia, as word is spreading of the benefits of their holistic approach.
Townsville's Debbie Holland recruited doula Philippa Scott, co-founder of Birth Buddies, following a traumatic labour with her first baby, Cate. "It went for days -- I had every type of medical intervention and ended up having a caesarean," she explains. Pregnant again 13 months later, she instantly became apprehensive about the impending labour. "I had reached a point where I decided I would just ask for a caesarean, simply to get it over with," says Debbie.
An acquaintance who saw her distress recommended Debbie meet with Philippa. They bonded immediately and Debbie hired Philippa as her doula. "Even my husband, Andy, who is quite the macho stereotype, not at all new age, was all for the idea of having a doula after he met Philippa," Debbie says. The first childbirth experience had troubled Andy, too, but Debbie says the second time around he was relaxed and supportive, offering her massage and other pain-relief remedies. She learned afterwards that it was via Philippa's subtle coaching that Andy had garnered his confidence.
With baby Anastacia only three weeks old when she spoke, the birth was fresh in Debbie's mind and she was on cloud nine. She credits much of her bliss to Philippa's facilitation. "She was there as my advocate. She knew what I wanted as we had drawn up a birthplan. She knew I didn't want to be offered drugs and if I did want them, I would ask."
The diversity of the doula
Honey Acharya, Philippa's partner at Birth Buddies, tells of the range of their clients. "Here in Townsville we have a large defence force community. They are often stationed here without family or close friends nearby. Townsville also has many people who work in the mines, flying out for weeks at a time." Because they are often isolated, Honey says she plays an integral role in the postnatal period. "We offer help around the house or provide information or emotional support."
Doulas all seem to have a propensity for the entire birth procedure, and Honey is no exception. Her impetus to become a doula began at just five years old. "I've always been interested in pregnancy, women and babies, and planned to go into medicine and obstetrics until I realised it wasn't really what I wanted to do. Childbirth education or midwifery were more along the lines of my passion." While still pondering midwifery, Honey enjoys being there solely for the mother and not tied to the hospital's rigorous schedule. "As a doula I am not focused on routine tasks. I don't have to leave because there is another woman in labour down the hall or my shift is over," she explains.
Birth Buddies is so devoted to helping women, Honey and Philippa have made a commitment to provide support for those who may find the cost prohibitive. They usually ask for a small exchange in return. "This can be as little as some muffins or paying the cost of our taxi fare." Usually, the cost of a doula ranges from $300 to $800, depending on the type of care required.