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Birth Doula after

What Does A Doula Actually Do On The Birth-Day

and what she doesn’t do!

This post is part of a series of articles about child birth companions and it follows on the ‘What is a Doula?’ blog post.

What a Doula does on the birth-day very much depends on what the ‘agreement’ between the doula and the mum/couple is. There are infinite scenarios and options. For instance, some couples prefer to be very close together during the whole birth and delivery. Some others prefer to have more separate roles. Some dads want to be very much involved while others prefer to enjoy the day without the pressure of remembering everything they learned about birth. Also, some ladies like massage/acupressure points during birth. Others prefer not to be touched at all. Some mums prefer to have a doula around from the early stages of labour, while others only when in active labour etc.
In any case, the doula is a discrete presence and her only role is to support you in your decisions and ‘birthing-style.’

Below are some options/ possibilities based mainly on what I do as a doula. Other colleagues may agree or disagree.

Practicalities

In the case of hospital or birth centre delivery, we help in deciding the best time to go, as well as calling a taxi, carrying bags and belongings. More generally, I do anything that allows the mother to completely focus on her body sensations and switch off the cortex (part of the brain that controls thoughts and inhibitions), while enhancing the abilities of the primitive brain (part of the brain that knows how to give birth), while her partner is with her, supporting active birth positions, hugging her or massaging her back during contractions. (As most probably seen pre-natally together with your doula).
But of course, the reverse can also be the case, with the partner caring for these practicalities and the doula with mum for breathing, massage, and movement.
Your companion can also help with ‘sorting out’ which room to birth in, setting an intimate atmosphere in the room and protecting the space from unwanted visitors.
Of course your doula will also make sure you have all the comfort measures: pillows, towels, music of choice, shower, bath, drinks and food/snack for both you and your partner.

Having a doula also means you have someone to call on the day you start labour, should you have any questions at the early stages, as well as to reassure you with support at home before it is time to go into hospital/birth centre. This is usually very important for first time mothers, preventing them from going into hospital too early.

In some cases the doula can take pictures of you and your partner with your baby for the first time, while you bond during the very important first moments. She can also record a video of the birth etc. If this is something you ask your doula to do, she agrees and if the opportunity arises during birth for this to happen. The aim is to record those important moments with discretion, giving most importance to connections between mum/couple during that present moment. Technology is an amazing thing but sometimes it can get in the way! The same goes for mobile phones…

Active birth positions

Assisting you with movement throughout labour.
Your doula can suggest a new position should the one you are in at the time not serve you anymore.
Again, depending on what your birth choices are, you can sustain the position with the help of furniture or props, or your partner or doula can be ‘a shoulder to lean on.’

Acupressure points and/or massage for labour

Should you wish to receive massage as pain relief, the doula or partner, who would have learned this pre-nataly, can apply appropriate pressure on acupressure points, massage your back during contraction or release tension on your legs as well as facilitating an optimal descending position for baby.

Research shows that massage increases the release of endorphins and oxytocin, both hormones that facilitate birth.

(If you know from the start that you like to receive massage generally, you may want to find a doula that is also a qualified massage therapist for pregnancy and labour).

Relaxation techniques.

Assisting you when the need arises for different relaxation techniques during different stages of labour. These may range from breathing techniques (e.g deep diaphragmatic breathing, pouting, J breath etc.) to visualisations, or using sounds.

According to circumstances, your birth companion will also offer you and your partner reassurance.

Positively liaising with midwives for the best possible outcome, with mum and baby in mind

  • Reminding you what questions to ask the midwife or consultant if circumstances require a new decision to be made.
  • Calling the supervisor of midwives, making the call on your behalf if necessary, to explore options in a situation where the midwife present is not able to provide other options or, without medical reason, is not supporting your birth wishes.
  • The doula can also practically help the midwife in the room, by passing her what she needs, telling her how wonderful it was to say or do that particular thing perhaps, but also by being silent and letting her do her job without interfering unless strictly necessary.

WHAT A DOULA DOESN’T DO

  • Give medical advice, do any medical examination or medical intervention. Doulas are not medically trained but most often are knowledgeable about medical procedures and hospital protocols. We can therefore offer guidance about medical procedures.
  • Make decisions for you or advise on what options are better for you. Our role is to inform you with facts related to what the situation is and let you make your decision. We will not judge in any way and will be there to support you on your unique journey.
  • Your birth companion will be focused exclusively on your needs. She will not be on her phone unless in an emergency or an important family related communication. If this arises, she should find the time to do this when out of the birthing room for a break, or for some other agreed reason. She will, of course look, after herself by drinking, eating, toilet breaks etc. but without this being a distraction and or inhibition for you. She will calibrate her timing accordingly to your own rhythm of labour.
  • You birth companion will not take the place of your husband/partner and never comes ‘between’ the two of you. She will rather complement you both. Your doula’s role is to support you and your husband/partner, empowering you both in preparation to birth and during labor

This will be strictly related to what you have decided before hand depending on what makes you and your partner comfortable.

Related posts are:
‘What is a Doula?’
‘What is a post-natal doula and what does she do?’

See my services as a Doula in North London

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Posted in Child birth companion, childbirth, Doula, Doula UK, healthy pregnancy, labour, Pregnancy, well-being during pregnancy

Author Info

Eleonora Lawson

Deep tissue pregnancy and postnatal massage specialist. Birth and post-natal doula. Baby massage instructor and Sling consultant based in North London. CThA, Doula UK, AIMS, IAIM