Embrace the transition to motherhood with confidence

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.

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.

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!