Your doula questions answered
Whats the difference between a midwife and a doula?
As a doula I do not interfere in any way with the care provided by midwife or doctor. As birth is a dynamic process, parents may be faced with an change in their care or a medical intervention. In these situations, I remain as always non-biased and assist with gathering information on the options available to my clients. My highest concern is that the labouring person is listened to and can make a choice they are happy with.
I often find midwives are cautious when meeting a doula in labour but once they see the positive effect it is having on the women, they are appreciative of the doulas role. Its also interesting to look at the evidence around doulas. Numerous studies have shown an added benefit to continuous support in labour. These include shorter labours, less requests for pain medication and less likely to have a caesarean or a instrumental birth (Hodnett et al. 2013). This was most effective when the continuous support was provided by someone, such as a doula, who was neither part of the hospital staff nor the woman's social network.
What should I expect from a doula service? How much does it cost?
Initially, I offer a complementary 1 hour meet to discuss my service and your needs.
Once we are both happy to proceed the doula package consists of:
2 - 3 antenatal visits in the third trimester
on-call from 37 weeks for labour support day or night
1 postnatal visit
The fee for this package is €1,050
How does my hospital's one birth partner policy affect me?
Waterford University Hospital, Wexford General Hospital and St. Lukes in Kilkenny have a policy of one birth partner in the delivery ward. For women choosing a doula as her main birth support there is no action needed. For women who want to hire a doula alongside her nominated birth partner, in most instances, this needs to be communicated with the hospital in advance of labour. Like all birth preferences, a pregnant person has the right to make an informed choice on birth partners.
I recommended writing to the Director of Midwifery (DOM) in your hospital with your birth preference to have a doula as your second birth partner. The DOM will then get in touch with you. I advise clients to ask for a written response outlining your birth preference and the hospitals agreement so it can be added to your file. While not always required to have this written agreement it may clear up any confusion arriving in labour with your partner and your hired doula.
In fact, only one hospital in Ireland, the Coombe, has a position statement on doulas, acknowledging their role to provide for women's continuous support needs in labour. Outside of Covid-19 restriction or an emergency event in labour, all Irish hospitals facilitate a woman’s request to have both her partner and her doula present during her labour and birth whilst on delivery suite.
How does a doula work alongside my partner?
In my experience partners are much more relaxed with a doula present at the birth. I am someone they have come to know during antenatal visits. This is a bonus as frequently your midwife or doctor at the birth would not be known to them. I am very aware of taking time to build a rapport between myself, the partner and the care providers in labour.
Healthcare or infant-care is typically not an area of expertise for partners and that can feel scary. Some dad's worry they wont be able speak up, or if they do, they will sound confrontational. I can help with those difficult conversations and offer partners tools so they can be hands-on if they wish.
I can never replace a partners/ dads special role in bonding with the birth-giver and newborn. What I do offer is support at times when it feels overwhelming and give some ideas of ways to manage the normal anticipated moments of labour. Knowing that the mother will not be alone if partners need to step out for breaks is very welcome too!
How long will my doula spend with me in labour?
Can a doula help me if I'm planning an epidural or caesarean?
Whether a caesarean birth is planned or unplanned, doula support can help the birthing parent stay calm, centred and prepared. Hospitals are becoming more accustomed to requests for delayed (optimal) cord clamping, measures to ensure breastfeeding is supported if desired. I cannot speak for a client, however I help clients find their voice and let them know their options surrounding a caesarean birth. It may be possible for me to be in the operating room or step in as soon as possible in my role as continuous support. I am passionate about reuniting mom and baby post caesarean and I am an advocate for bringing as many elements of the wonderful golden hour post-birth to mothers and baby's after a caesarean.