Eyebrows have been raised at news that the Duke and Duchess of Sussex have hired a doula. I’m no princess but I made the same decision 10 years ago. The practical and emotional support I received made my start to motherhood so positive that I retrained as a doula myself.
Doulas are experienced lay people, taking on a non-medical role and often getting to know a family over many months. The work is intense and rewarding: from helping a woman plan her second birth after previous trauma, to answering a tearful and exhausted parent’s call at 3am.
We are on call 24/7 for at least a month around the due date and provide birth support for as long as we are needed – sometimes hours, sometimes days. We fit into whatever gap we find: making tea or cooking, physically supporting someone through each contraction or asking a woman how she is feeling and really listening to the answer.
A Cochrane review of continuous support in labour found that having an experienced supporter who wasn’t a medic, friend or family member improved women’s experiences of birth, shortened labour, reduced the need for intervention and was associated with better Apgar scores (a measure of health at birth) for babies. Happily, projects exist to provide the most vulnerable women – who, research suggests, have poorer outcomes and are more likely to experience mental health problems – with doulas. Charities such as Birth Companions have been offering doulas to women in the prison system for 20 years. Other schemes exist for women on low incomes, those with learning disabilities and for immigrants.
It is easy to dismiss doulas as trendy add-ons for the wealthy, but women have been supporting women as they become mothers for centuries. I support new families through their joy, their fears and confusion, helping them navigate this time of huge change and vulnerability. I have slept in my car in a hospital car park and lovingly washed blood and faeces off a woman’s feet. As a doula I want every pregnant woman to feel like royalty.