Ever heard of a doula?

It’s like having that mother to take care of you and nurture you when you are giving birth or in the days afterwards, with all the education and training behind it.”

That’s how Amber Liebner, a mother and doula herself, sums up the work. While doulas have no medical training and are not the voice for a mother in labour, their aim is to work with the midwife and hospital staff to make the mother’s birth experience a positive one. They also aim to support the woman’s husband or partner in doing what will help the birthing mother during the labour process.

“The word doula is a Greek word and signifies a servant or a caregiver attending a woman giving birth or in the postpartum period,” Amber says.

“Nowadays, it’s for an emotional and physical companion, whether it be birthing at home or in the early stages of labour, or in the hospital or at home afterwards.

“It can be a great help to have a doula with you at home in the very early stages of labour, for example, when it may be too early to go into hospital. In some cases, it can be ideal where the woman does all the hard work in the peaceful environment of her own home then in an ideal scenario is in transition (ready to start pushing) by the time she gets to hospital. The doula makes no decision about anything, like when to go to the hospital – that’s absolutely up to the couple. We’re just supporting the woman in labour and her husband.”

Doulas go to the house and meet the family well ahead of the birth, she says.

“We’ll go over different relaxation techniques, different massage techniques that your partner can be doing. In an ideal scenario, the partner is actually their doula and we are just supporting them to be a doula. A lot of times, the partner is saying: ‘I don’t know what to do.’ So, you’re talking over things that can help, like rubbing the woman’s back if she has pain there. The physical support means talking about things like comfort measures, massage, relaxation and positioning.”

Amber, an American who came to Ireland because of her husband’s job, is impressed with the reaction of Irish hospitals to doulas.

“Hopsital systems in Ireland are actually really great. I have had babies in other countries and was wondering what it was going to be like here, but this week I was in a hospital here and they were fantastic. Midwives were giving the mother doula-type care already, but sometimes it can depend on how busy the hospital is. When you’ve met the doula beforehand and worked through the early stages of labour with them, you have that continuity of care and familiarity then when you go into hospital.”

The Doula Association celebrated its 10th anniversary in April this year.

“It started with a handful but now doula numbers have doubled. It’s becoming so popular and accepted in hospitals – it’s fantastic.”

APPLYING FOR HOSPITALS FOR PERMISSION

Some hospitals have an open-door policy so you don’t have to get written permission to have a doula with you when giving birth.

“With some hospitals, the fact that you’re planning to have a doula with you is just written down in your birth plan and they come with you and your partner when you go in. With other hospitals, the mother-to-be has to write to the hospital a few weeks before their due date, saying: ‘I have a doula and I’d love her to be at my birth’ – and they get approval because the hospital will want the woman to have a positive birth. If the extra support and continuity of care of having the doula is there, they’d be for it.”

When do women book a doula?

“Some women get in touch straight away, as soon as they know they’re pregnant they’ll ring to see if you’re available,” Amber says.

“While some doulas work individually, most of us work with a partner. You are on call for five weeks because we don’t know when babies are going to arrive and we don’t want births to overlap, so we only do a handful of births a year.”

Some women seek support at the birth because their husband or partner may be away.

“So many different situations arise. One mother’s partner couldn’t be there at the time, for example. We have emergency situations like that, too. Doulas usually offer that service as well.”

Many doulas are mothers but have professions also.

“They know that they are on call and often work in a flexible work environment where they can get time off when they need to. The rule is that you can’t be more than an hour away from a labouring woman or a birthing mother.”

Fathers often need support

A lot of fathers are often unsure what to do in a labour situation, she says.

“They know they want to make their wife comfortable and for everything to be fine and they tend to be more at ease when a doula is there who can make suggestions about what they do and give guidance. Birth should be a bonding experience for the family. They are bringing a life into the world and expanding their family and it should be a positive experience for them. We help by giving them the tools and empowering them to do it on their own and helping in any way we can.”

Training

But is every doula a mother herself?

“No. It’s more of a passion for the work that any woman can develop. Some go to another country to do volunteer work in hospitals, for example, and they fall in love with this kind of work and want to train and do it when they come home.”

Amber came to Ireland 18 months ago when her husband was relocated here by his company.

“I had one baby in England, a home birth, and I had a home birth in Switzerland too and those were great experiences for me. Because I had such a positive experience, I started getting involved in the positive birth movement.

“We tell mothers that you don’t have to be afraid. We help them go into the situation and be really positive. Through that I found out what a doula is and found out that they have them in Ireland.”

A lot of companies in Ireland offer the training courses, she says.

“I trained with Dona International because I’m American and might be moving to different countries with my husband because of his work and that training would be welcomed in every country.”

Amber calls doulas “an amazing group of women”.

“Some of them have trained all over world, they bring all their knowledge back. The more births you attend, the more you learn and the more you can share with the association. Some of the women have been breastfeeding for years, for example, so they’d have a wealth of knowledge about that. We meet and pick each other’s brains and pass on tips. It’s a great community to learn from.”

There are doulas who specialise in labour and antenatal support and post-partum doulas who can step in after the birth, if required.

“They can come in during the hard weeks in the beginning and help with breastfeeding or with your other children or help fill the freezer with nourishing meals. Some mothers might want help for a couple of nights so that they could get more sleep. It’s different for everyone.”

The Doula Association of Ireland (DAI) has a code of ethics, Amber states.

“We have a code of ethics in our association and with that we state that we are not going to give medical information because we are not trained to do that.

“I think doulas are becoming more common here because they (hospitals) know that we are not going to push those boundaries. We are not advocates for the parents, we don’t answer for them at all. Doulas are very popular in the US and in the UK. They are slightly new here but great to see the numbers increasing.”

See www.doula.ie

Suggestions if you’re thinking of employing a doula

If you’re thinking of hiring a doula, check with the hospital that you’ve registered to have your baby in that you will be allowed to bring in a doula as well as your birthing partner.

There are several websites where you can contact doulas. See www.irishdouladirectory.com for a full listing of doulas available in your area.

Check online profiles and meet up with a couple until you find the one most suited to your needs. Ask for references from previous clients. If you want to proceed, agree on the services you need, the fee and draw up a contract with your doula.

Note: The Coombe Women And Infants University Hospital issued a position statement on doulas in August 2014, acknowledging that continuous support from a person known to the mother can benefit her during childbirth.

See www.coombe.ie/doulastatement for further information.

Want to train as a doula?

Get more details on how to train also on www.irishdouladirectory.com

Dona International’s code of ethics for doulas can be seen on www.dona.org Certification is generally a two-year staged process.