Take a look at other articles in this series:
– Part 1: What is a doula?
– Part 2: What kind of qualifications do doulas typically have?
– Part 3: When and how can a doula help me on my journey?
– Part 4: What does the research say?
The concept of an experienced woman providing support and accompaniment to a pregnant, birthing or breastfeeding woman is as old as childbirth itself, and spans many cultures.
While in the past, this was more likely to be someone from within the woman’s own social or family circle, modern living – with family and friends often scattered around the world – has left us somewhat removed from trusted elders.
Doulas have, in a way, stepped in to fill the role.
In general terms, a doula is a trained, non-medical professional who offers emotional, informational and physical support to a woman before, during and after childbirth, to facilitate the best possible birth and early parenting experience.
Some doulas specialise in offering support during a particular period, i.e. pregnancy, birth, or during the post-partum period, while others can provide support during any or all of these important periods.
The kind of support and services that doulas provide can also vary somewhat between different countries and cultures – for example, while in the United States, dedicated post-partum doulas (who may even offer live-in help to ‘mother the mother’ and carry out light housekeeping) are relatively common, this is not the case in Belgium.
A typical journey
Women typically reach out to a doula once they are already expecting a baby, but doulas can also provide support before conception, especially when the women or her partner are undergoing fertility treatment. Some doulas also offer dedicated support (usually for free) to women who suffer pregnancy loss or choose to end a pregnancy, for whatever reason.
One of the doula’s main objectives is to inform the couple about the birth process and about the importance and significance of the birth journey, both for the mother and baby. Throughout the relationship, she wants to build both trust and confidence, and her ultimate goal is that the parents-to-be decide what’s best for them — her own opinions and beliefs are secondary. She respects the woman in her choices – be those choices about prenatal testing, monitoring, the choice of home or hospital birth, whether the woman wishes to use pain relief or not.
If the doula will be present for the birth, she discusses the woman’s wishes and needs in advance, and personalises her approach on ‘the day’ according to how events unfurl. There is no fixed plan, and the doula will always strive to meet the evolving needs of the woman. During the birth, the doula helps create a peaceful environment where the mother’s powerful intuition and bond with her baby can work their magic.
She offers emotional support and advocates for the woman and her partner if needed, but in general, does not to impose on the situation. For example, in Belgium, for a woman who does not speak a local language fluently, it can be comforting to have a French- or Dutch-speaking doula who will be able to relay information and requestions between the couple and the medical staff. Having a doula as an intermediary can also help a woman protect the sacred space she needs to be able to let the cocktail of birth hormones flow as needed, e.g. to answer questions about progress.
Thanks to her training and experience, the doula has her own tools to physically relieve the mother during childbirth (such as massage techniques, suggestions for comfort positions and positions that can help the baby find the best position for birth), as well as to guiding the woman’s partner in supporting the mother during labour and delivery.
After the birth, a doula can continue to help and support the woman and her partner. She can assist the parents with their new baby, help them learn basic baby care such as bathing, dressing and soothing, and will ease the transition to their new family life.
What does a doula NOT do?
Doula support during pregnancy does not replace medical follow-ups, and it’s vital that the mother-to-be is followed by either a midwife or gynaecologist during the pregnancy. Couples can, and do, discuss medical aspects with their doula, but a doula will always focus on the emotional side to help the couple find the information they need to understand the situation, and to take informed decisions.
A doula will never tell a couple what they should or shouldn’t do, whether during pregnancy, birth or in the postpartum period.
During labour and birth, a doula doesn’t perform any clinical tasks, like vaginal exams or fetal monitoring. And she will never make a decision (medical or otherwise) for the woman during birth. Nor does she take over the role of the partner.
Doulas are not allowed to support a woman with a non-assisted birth i.e. a homebirth without the presence of a midwife or a doctor, and do not ‘catch’ babies unintentionally (though it is known to happen!).
Doulas do not usually change shifts during a birth, but if they need to (e.g. in the case of a particularly long labour), they will call in their back-up – another trained doula who the woman has already met.
Check back tomorrow for the next in the series of our Ultimate guide to having a doula in Belgium!