And doula makes four: A look at the growing birthing trend

A doula’s a listening ear, a sounding board, a cheerleader, says doula Mary Tighe, co-founder of national doula agency DoulaCare Ireland.

“A doula’s a non-medical support for the family,” says Tighe, explaining that a birth doula, such as Meghan has apparently hired (there are also postnatal doulas), offers emotional and informational support throughout pregnancy, labour, and the immediate postpartum phase.

“It’s usually one home visit in the second trimester and another in the third,” says Tighe.

During visits, a doula helps the expectant mother draw up birth preferences.

“Mum might decide she doesn’t want to be offered pain relief; that if she wants it, she’ll ask for it.”

Doulas offer evidence-based informational support, so if a woman’s preference is for epidural — which can slow labour — her doula would explain that using a peanut-shaped exercise ball between her legs widens the pelvis and progresses labour.

But the doula doesn’t tell expectant mums what to do. Her role’s advisory, says Tighe.

“We don’t speak for parents; we support them to ask questions. For example, many parents want a natural birth.

"But baby has its own agenda. We help mums prepare for the birth they want, while giving them tools for the birth they get.

"These could be the same but, if things change, mums know how to ask questions: Is everything ok with the baby? Is there another option? What happens if we wait?

"If mum’s hoping to use the birthing pool and then needs a caesarean, that’s a big change.

"At least being aware of why makes things less traumatic.”

Tighe checks in with clients to ask how they’re getting on.

“I always do after important hospital visits. When I heard, at 34 weeks, my baby was in the breech position and I’d be having a caesarean, the first person I rang was my doula.

"I rang her [before my midwife], because I was quite shaken,” says Tighe.

Doulas can pass on helpful tips, such as the benefits of eating six dates daily during final weeks of pregnancy.

“Evidence shows dates help labour start on time; the woman doesn’t go overdue. If mum’s interested, the doula might offer date bar recipes.”

Once the expectant woman reaches 37 weeks gestation, her doula will be on call 24/7 until labour starts.

“Once labour starts and mum needs support, the doula heads straight to her home. Some mums want support early; others potter round until things get intense,” says Tighe.

The doula will have educated mum about promoting labour-friendly hormones: ‘shy’ oxytocin needs quiet; ‘calm’ melatonin needs dim light.

“Often, when we arrive, things are set up beautifully: candles burning, aromatherapy oils, music playing.

"In early labour, mum’s lucid, chatting away; the music’s upbeat, maybe Bob Marley, Bruce Springsteen! As labour progresses, mum gets quieter, more into herself; the music’s gentler.”

Doulas don’t tell women when to go to hospital.

“We help them figure it out. Women have the answers.”

Doulas provide emotional support.

One mum said, ‘when you arrived, I could relax’. Another, [enduring] a hard labour, said, ‘whenever I looked up at you, you were smiling, so I thought things must be ok’. She said it helped her keep going.

Dads-to-be benefit, too.

If he wants to be hands-on at the labour, the doula will show him comfort techniques, like the double hip squeeze, which Tighe recommends for lower back pain — partner places his hands onto mum’s hip bones, pushing them in and up towards her body/shoulders.

“It’s sore on the arms, but Harry {Prince Harry} looks fit, so he’d be grand!” says Tighe.

In Ireland, numbers using doulas are small, but growing, says Tighe.

Her early clients were second-time mums wanting to improve on their first birth experience.

Now, first-time mums are increasingly hiring doulas. On average, mums are aged 30-45 and from professional backgrounds, though “we’ve had mums from other walks of life and we’re definitely busier in cities”.

Post-natal doula Genevieve O’Malley debunks the idea that doulas are just for “airy-fairy hippies” and trendy, moneyed families.

“It’s becoming more of a thing now, women seeing doulas as a necessity. I haven’t been to any family that had a home-birth and not all have breastfed.”

As a doula, O’Malley’s focus is on that “forgotten fourth trimester”, when mum’s “landed back home after passing this tiny human out of herself and expected to get on with things”.

Years ago, she says, women had ‘villages’; people rallied round to help.

“Now, families are more fractured. And women’s expectations of themselves are massive: to mind baby, keep the house going.

"They’re so vulnerable: hormones all over the place, perhaps sore after a caesarean, and they can’t pick up the toddler who’s scooting around the house.”

For up to six to eight weeks, O’Malley’s on hand three to four hours a morning.

“I let mum go back to bed if she’s had a rough night. I make her breakfast, if she hasn’t had any.

"I do laundry, unpack the dishwasher, tidy up that breakfast bomb after the kids have gone to school.

"This is a crucial time for mum to talk about her birth story, so I listen; no interjecting. Maybe the birth didn’t go as she wanted, so she can talk, let go of that.”

Mums often recover sooner with input from a postnatal doula. And while doulas aren’t trained to help with postnatal depression, they are trained to spot red flags.

“And we’re required to always have in our toolkit an updated resource list, so we can refer mum on,” says Genevieve.

The mum who became a doula

With Charlotte, her first-born, mum-of-three Jacquie Beamish had a long labour, with lots of medical intervention and, eventually, a caesarean.

When pregnant with Alicia, now 6, the Cork mother was very anxious.

“I really wanted to avoid another caesarean and to have a more involved [birth] experience,” she says.

By now, she’d heard of doulas and had met Mary Tighe.

“I thought what I need is someone for me. Midwives and doctors are there for mums, but their focus is on progress of labour, baby’s heart-rate, medical things, whereas, a doula gives emotional support.

“At one stage during the birth, I looked at Mary and said, ‘I can’t do this’.

She held my hand, looked me in the eye, and said, ‘but you are doing it’.

"It really made me realise, ‘I am doing this; at this moment, I am’. It grounded me to go through the next bit.

“Even simple things helped: early in labour, suggesting a hot shower to ease back pain, reminding me to eat and go to the toilet.

"In labour, you’re so lost in sensations of what you’re going through that you fall into a time warp and forget your body has other needs.”

Mary was doula, too, at the birth of Jacquie’s third daughter, Matilda, 3. Jacquie has since trained as a doula.

“I thought, ‘this is amazing’. It’s something women need. How wonderful to be able to provide it.”

www.doulacare.ie

Genevieve O’Malley: www.doulacorkireland.com