What does a doula actually do? And is it worth the money?

I’ve lost count of the amount of times someone has asked me what my job is, and they’ve replied ‘a jeweller?’ and then I’ve had to go on to explain what is actually is.

Most of the time it’s met with ‘that sounds like a good idea,’ So, I’ll take it!

So, let’s get back to basics, what does a doula actually do?

A doula provides non-clinical emotional, physical and informational support during pregnancy, birth and/or the postnatal period. We hold hands, catch puke, pop cool flannels on foreheads and support you through all the ups and down’s you might encounter. A doula doesn't provide any medical care.

We don’t:

• Do vaginal examinations

• Monitor your baby

• Diagnose problems

• Make clinical decisions or recommendations

• Or tell you what to do in any way

  
  

What we DO do is advocate for your needs, make sure you are always heard, support your partner and supply you with information so you can make truly confident and informed decisions.

As a doula I feel so privileged every time a new family chooses me to witness and support such an epic, life-changing moment.

What does a doula actually do during pregnancy?

Us doulas are around well before you actually go into labour. And that’s what makes our support so magical…we know birth, but we also know YOU.

Throughout your pregnancy we:

• Get to know you and your hopes/fears

• Talk through birth options and make birth plans

• Help you navigate maternity care

• Signpost relevant evidence and resources

• Help you prepare for different scenarios

• Support partners through any fears or worries

• Talk through breathing techniques and hypnobirthing tools

• Help you make postnatal plans and prepare for life with a newborn

  
  

I also work with families on some biomechanics (positioning and movements that can aid labour progress), comfort techniques and aromatherapy before labour even begins.

By the time we arrive at your birth, you’re seeing a familiar face who you trust. You can take a big sigh, knowing we’ve got you.

What does a doula actually do during labour?

The real answer is that is varies! I’ve been at some births where I have been there mostly as a quiet witness, offering snacks, taking a few photos and cleaning up afterwards. I go to others where I’m much more physically needed for hip squeezes and reassurance throughout. No two births are ever the same.

Physical support

• Positions and biomechanics

• Massage

• Counter-pressure/hip squeezes and other comfort measures

• Helping you create and maintain your environment

• Making sure you are well fed and hydrated

  
  

Emotional support

• Reassurance and encouragement

• Helping you stay grounded and relaxed

• Reminding you how strong and incredible you are

• Helping you through the difficult parts

  
  

Informational support & Advocacy

• Helping you understand your options

• Explaining what's happening

• Helping you formulate questions

• Reminding you that you can ask for time to think

• Making sure you are always heard by your care team

• Protecting your space if you need it

  
  

Doulas don’t have any overriding policies or governing bodies, we are totally independent, meaning we can offer support free from any politics or agenda.

What does a doula actually do postpartum?

The answer is going to vary doula to doula, but heres the gist:

We provide:

• A non judgmental listening ear

• Tasty food to make sure you are well nourished

• Signposting to useful local resources

• Feeding support or information

• Practical household support

• Holding the baby while you nap/bath/have a moment to yourself

• Information on postnatal recovery and what's normal

Because support doesn't just end at birth. Postpartum can be such a vulnerable and tender time, it is so valuable to have someone there to offer gentle support, a listening ear and some great comfort food.

What happens if birth doesn't go to plan?

Most of the time, when we leave birth well alone it all unfolds very well. But occasionally Mother Nature, or the maternity system, throws a spanner in works.

Having that extra support when things don’t go to plan is even more valuable. Your doula is there to keep you calm, make sure you know what’s going on and why, and support you in any way that you need. For example if you’re having a home birth, and need or want to transfer into hospital, your doula will by by your side, holding your hand, until your baby is born. It is very possible to have a birth that goes totally pear shaped on paper, but you still feel positive about it because you felt in control, informed and well supported throughout.

A doula isn’t there to protect you from birth interventions at all costs, we are not pushing our own agenda. We are there simply to support you and your partner, and wether thats declining interventions or accepting them.. we are there with a non judgmental ear and skilled hands.

Does a doula replace your partner?

No absolutely not. A doula is there to support your partner (if you have one) just as much as you. Having an extra skilled pair of hands means a partner can be truly present in the way they want to be, without worrying about any external factors.

Sometimes the partner will take on more of the physical support role and I’ll be managing logistics, advocacy and environment… sometimes the other way around.. and sometimes its a bit of both.

We can also reassure partners when things get intense, explain whats happening and give them a much needed breather so they can get some sleep or food.

Your partner can fully focus on being your partner. They know you best.

And the doula takes care of the rest.

Do doulas only support home births?

Different doulas have different specialities, and some focus more on certain types of births than others.

I can only speak for myself, but I support people to birth wherever they feel safest and most comfortable. Often, that means supporting families planning a home birth, but I also support people choosing to birth in hospital.

I’ve supported clients through home births, HBACs, VBACs, inductions, birth centre births, caesareans, and births that have started one way and ended another. I specialise in home birth, HBAC and supporting people who choose to birth outside of medical guidelines.

There’s one thing I do know: you cannot control birth. But you absolutely can influence it.

You can influence how informed you are. You can influence who is around you, how you're supported, the questions you ask and the decisions you make. And you can have someone beside you who will support you just as fiercely when things don't go according to plan as when they do.

Does having a doula improve outcomes?

No doula can guarantee a certain outcome or a certain type of birth. But there is good evidence that continuous support during labour does improve both birth experiences and some birth outcomes.

A large Cochrane review of 27 trials involving more than 15,000 women found that women who received continuous one-to-one support were more likely to have a spontaneous vaginal birth and less likely to have a caesarean or instrumental birth, use pain medication or report a negative experience of birth.

Interestingly, some of the benefits were greatest when continuous support was provided by someone in a doul role, someone whose sole focus was supporting the woman, rather than someone who also had clinical responsibilities.

You can read the review here.

What's the difference between a doula and a midwife?

Doula	Midwife
Non-clinical support	Clinical maternity care
Emotional/physical/informational support	Monitors parent and baby
Works for the family	Has clinical responsibilities/policies to uphold if working for the NHS
Can provide continuity	No continuity in NHS but can get continuity with an independent midwife
Doesn't make clinical decisions	Makes clinical assessments and provides clinical care

In an ideal world, the doula and midwife work together beautifully, each bringing something different and complementary to your birth. I've had some really wonderful experiences working alongside the midwives on the NUH Home Birth Team, but I have also had some really challenging experiences working with midwives (mainly in hospitals) where I have had to emloy my calm but assertive advocacy skilly to the max.

For me, the absolute dream team is an independant mifwife AND a doula working together as a team, which is why we've created the

and I also work with a local independent midwife to offer an Ultimate Birth Package, combining wraparound doula and midwifery support for families planning a home birth. Together, we can offer continuity of care throughout pregnancy, birth and beyond, with both clinical care and personalised emotional and practical support.

So the million dollar question… Is a hiring a doula worth the money?

Of course I’m going to say yes.

But I'm not just saying that because I AM a doula.

I believed in the value of doula support enough to hire one for my own second birth.

Your birth is one of those experiences that will stay with you for the rest of your life. It will impact how you feel about yourself and your body, your postpartum experience, your mental health, how your partner feels and how you feel about the start of your child's life.

That doesn't mean you need a particular kind of birth to feel good about it. Birth doesn't have to go to plan to be a positive experience, and having a doula certainly doesn't guarantee a straightforward birth.

What a doula can guarantee is something much simpler: someone steadfastly in your corner.

Someone who gets to know you before you go into labour. Someone who understands what matters to you, what you're hoping for and what you're worried about. Someone who can help you make sense of your options when things change, support your partner, and stay alongside you through the difficult messy bits as well as the joyful ones.

You deserve to feel heard, respected, well cared for and supported throughout your birth. You’re not just a vessel for your sweet baby.

And for me, that's really what you're paying for when you hire a doula. Not a guarantee of a particular outcome, but continuity, experience, support and someone whose focus is entirely on you.

Wondering what this all looks like in practice?

Take a look at my doula page to find out more. I offer experienced, relaxed doula support across Nottinghamshire and Derbyshire, supporting families to birth in their own power - whatever that means for them. Come and find me for a chat!

Doula support sounds great

I want to get birth ready