Doula Week - How a Doula Can Help in Pregnancy Following Premature or Complex Delivery

When I was pregnant I heard the term “doula” for the first time. Doula is a Greek work and literally means ‘woman servant’ or ‘caregiver’. I was recently presented some information from Doula UK talking about new research that shows doulas have a significant impact on birth and breastfeeding.  

Commencing on March 22^nd, this week is World Doula Week, so a great time for talking about doulas and what they do. I spoke to Iga, a doula who works in London. She gave a lovely description of what a doula does. “A doula gives love and support, she ensures that the decisions you take during birth are truly your own. We are here to empower women, and to make sure they are giving informed consent” A doula is not a replacement for a midwife or doctor, they are there as a caregiver for the mother, and also the father.

As we are all aware, in many hospitals and birthing units, a midwife is shared amongst a number of labouring women. In my case, I needed a midwife at all times, and I knew that many of the labouring mothers were missing out on attention and help as one was with me continually. A doula is there for the mother, for you alone, you are not sharing her. I think for many women that reassurance is wonderful. 

Fathers are of course brilliant, but the way Iga shared it with me, often fathers who are loving and supportive find the intensity of labour difficult to bear:  it may be heart-wrenching to see their partners in pain and - while being naturally worried about her and the baby - still having to be the calm in the eye of the storm and deal with the doctors and the midwives. Having a doula present takes the pressure off the father, and he can focus solely on taking care of the mother.

Doulas meet regularly with the couple before birth, and therefore know the couple and their dynamic, and will be prepared to be able to help that couple the best way they can. Iga explained how she will advise on massage techniques and other practical things fathers can do. 

I know a lot of you reading have had previous difficult births, and perhaps may be worried you will have a caesarean section, and like me concerned about hiring a doula. I had a terrible misconception that doulas are just for straight forward vaginal deliveries, but that is not the case.

Iga, like all doulas, has a lot of training in staying calm and bringing peace and clarity into a situation. Pregnancy is a time of great personal growth and challenge, and can often bring out feelings and fears from past experiences. Iga does a relations and visualisation exercises to help with these feelings. 

If medical interventions are required, doulas can take a step back, in a sense, and ensure that the parents can negotiate and ensure their wishes are taken into account, such as delayed cord cutting, skin to skin, finding out the gender of the baby. Ensuring a couple gives informed consent is an important part of the doulas role.

Iga explained to me that sometimes the couple decide, if a caesarean is required, that it will be best for the doula to be present rather than the father, and I can totally understand that. An operating theatre is a scary place, and to be in that situation with someone you love is a very confronting, terrifying thing.  Sometimes, in emergency situations, if a general anaesthetic is required, no one, other than the medical team, are able to be present, and in that case, a doula is of great support and comfort to the father, as well as the mother.

After the birth, in the post natal period, the doula continues her involvement, usually with 2 visits, but also with phone and email contact. This generally ends after a month, but if a baby has arrived prematurely then this may continue for an extended period of time. 

Iga was telling me of a woman she assisted who had a term delivery but that had become complicated and the baby was in the special care baby unit. Iga was called as the baby was not latching on and feeding was impossible. She came in to help with breastfeeding and kangaroo care on the second day after the baby was born. She put the mother and people around her at ease, she brought peace, calm and trust into the situation and soon the baby was latching on and feeding like a professional.

From my perspective, I can see how having a doula would be wonderful. For me breastfeeding was stressful. The unit hadn’t had a lot of experience dealing with breastfeeding tiny babies, and there was a great deal of anxiety from a number of sources every time I tried to feed Joseph. Having someone who knew me, and my parenting style, and my aspirations, who could calm me, and the situation and help me focus on being a mother would have helped me enormously.

One of the powerful things Iga said was that sometimes you just have to take the pressure off breastfeeding, and empower the woman to concentrate on mothering the baby, to cuddle the baby, give kangaroo care, and then, more often than not the milk will flow, and the baby will feed.

I came away from my conversation with Iga being very much convinced that a doula can play a vital role in subsequent pregnancies following premature birth, pregnancy loss or caesarean section delivery.

If you are interested in learning more please visit DoulaUK