Adopting a holistic image of birth, a doula sees the mother as the centre of the birthing experience, with her chosen birthing team there to support and guide her. A doula supports the labouring woman through assisted positioning and mental relaxation techniques. She is there for the woman and her partner as they prepare to welcome their baby into the world; providing one-on-one care in pregnancy, throughout the entirety of labour (no matter how long), and into early parenting. A doula’s aim is to respect this vision of birth as well as the birth plan set out by the mother and her partner. Studies have shown that women who choose to have a doula present during labour:

• tend to have shorter labours with fewer complications and interventions;

• request pain medication less often;

• have lower incidence of operative deliveries including caesareans;

• and have more positive opinions of their birthing experiences and greater success in breastfeeding.

So you’re a midwife, right?

No, doulas are not midwives. Where midwives as primary care providers are exceptionally qualified to make medical decisions, assess clinical tests and make recommendations, and can ‘catch’ the baby, doulas provide non-clinical care in the form of experience, information, physical, and emotional support. Doulas follow what is called the ‘midwifery model of care’, which means that doulas see birth as a normal part of a woman's life, not a medical event, wherein the mother, partner, and family need emotional and physical support throughout the entire process of pregnancy, birth, and parenting. Doulas don’t catch babies – they catch the mothers!

Why should I hire a doula?

A birth doula’s purpose is to help mothers come as close as they can to having the kind of birth they desire, leaving them and their birth partner with the best possible feelings about themselves and their capabilities. They work to educate mothers and their partners about childbirth, to help mediate the stress and discomfort that can be associated with pregnancy and labour, and to provide physical and emotional support throughout the entire childbirth process. The doula offers suggestions on comfort measures, pain relief, positions, movement, breathing and relaxation. They provide constant, nurturing, helpful and objective support as well as first-hand knowledge and understanding of what you, the labouring mother, are going through.

While the outcome of birth can be unpredictable, the care you receive during your labour never should be. A doula is YOUR assistant. They do not work for the hospital or nurses. They're employed by you, and therefore have your desires, hopes, and best interest in mind.

The heart of doula care is the understanding that continuous emotional support and reassurance during labour and birth improves and enhances maternal satisfaction. Doulas specialise in non-medical skills and do not perform clinical tasks. In addition to the support, doulas are trained in non-pharmacological pain relief. This means anything non-medical such as massage, aromatherapy, visualisation, situation-appropriate application of heat or cold, breathing patterns, body positioning, focal points, and relaxation techniques. Doulas do not diagnose medical conditions, offer second opinions, or give medical advice. The doula’s goal is to help the woman have a safe and satisfying childbirth, as defined by each individual woman.

Do doulas do anything a partner couldn't do?

Yes. Doulas play a different role from a woman's partner because they bring with them a wisdom that comes from experience. They have seen and witnessed the normal process of birth and therefore, when things get intense in labour, they are there to reassure the mother and partner that things are progressing normally. Also, partners are often more emotionally involved in the birth, and at times it can be hard for them to see their partner in pain, but doulas offer a connected yet more objective presence. You’ll often find the doulas clapping when a woman throws up in labour, and smiling when she says “I can’t”, because we know she can, and because we know enough to understand that these are signs of great progress! Partners and doulas give a labouring woman the best of both worlds – the comfort and love of her partner and the skills, knowledge and experience of a doula.

Isn’t my partner’s support enough?

The partner has his own unique challenges in birth: witnessing the woman that he loves work through the birth process, staying awake and alert for long hours, experiencing the emotions of becoming a parent, and acting as gate keeper and facilitator as new caregivers come and go with new questions and recommendations. Labour may require long hours of demanding massage, sometimes too much for one person.

And you won't judge me or treat me like I've failed if I have medical assistance?

NO WAY! Labours are unpredictable and sometimes mums or babies need some extra help along the way. Caesareans can be life-saving procedures and are necessary in some cases. Educated decisions to receive an epidural, pitocin, and other interventions can be a huge help in having a healthy mum and a healthy baby; for example in a very long labour when the mother may really need a break in order for labour to progress. A woman shouldn't feel pressured to please anyone in childbirth, including her doula. I believe that each woman will make the best decisions for herself and her baby and I will support her in whatever those decisions may be.

If I decide to have an epidural, will I not need a doula?

Women who have epidurals can greatly benefit from having a doula there to assist them. Women don’t just disappear when it is administered; so they should continue to be given emotional and physical support through the entirety of labour. Likewise, if you had planned on having an unmedicated birth and choose to have an epidural or any other medicated assistance, our work doesn't suddenly become irrelevant. We can offer many of the same physical and emotional supports after the epidural is administered or through a caesarean operation. A doula’s support is not just through labour, but begins in pregnancy and lasts through early parenting – something all women can benefit from, regardless of their decisions for pain relief.

Won’t the hospital provide this type of support?

During a traditional hospital birth, most physicians don’t stay in the room with you continuously during labour, and midwives often must split their time between several patients, not to mention coming and going according to their shifts. Hiring a doula may be the only way to assure that an experienced coach will be with you continuously throughout the labour and delivery process.

When should I hire a doula?

Generally, the earlier in your pregnancy that you contact a doula the better, since most doulas will meet with you three or four times before your birth to help you prepare yourself for labour. These antenatal appointments offer opportunities to get to know each other and discuss the type of support you prefer, your birthing options, and much more.

What does a postnatal doula do?

A postnatal doula provides in-home support in the first few weeks with your new baby, helping you and your family adjust to the sometimes overwhelming emotional and practical demands of parenthood. A postnatal doula specialises in guiding the new parent and baby through these early experiences by offering help and is there to empower you to be the mother that you want to be.

Belinda Kelly-Mandalis is a certified birth and postpartum doula and is the founder of Beautiful Beginnings – Sunshine Coast Doula Service.