The devotion of tabloids to pregnant celebrities, recent examples being Meghan Markle and Countdown presenter Rachel Riley, spans from exhaustive comments on their maternity wardrobe to tedious scrutiny of their birthing plans.
One topic of interest was Markle’s decision to hire a doula for the birth of her first child in mid-2019. The doula industry, which has only hit Irish shores in the past ten years or so, is little understood to date and often must contend with preconceptions held by the public.
The word doula, meaning ‘caregiver’ in Greek, refers to a trained professional who supports a woman and her partner through either birth, postpartum, bereavement or IVF treatment. Agency owner of DoulaCare Ireland Jen Crawford explains that the role of a doula is a diverse one where no two days follow the same pattern.
“Our role is really dynamic- we go to a lot of events and Continuous Professional Development (CPD) days for training- because the evidence is always changing and there’s always new studies coming out on what’s best practice,” Crawford explains.
She’s quick to stress the efforts of DoulaCare Ireland to ensure work their members carry out is recognised as a valid and authentic profession. While she admits that the work of doulas is sometimes perceived in the media as a hippy wave of “Kumbaya” singing Mother Earth types, Crawford remains cautiously optimistic about public opinion towards the occupation.
“We’re really trying to make the doula profession a regulated industry that is seen as a profession and that people take seriously. I think that is coming with time,” she says of DoulaCare Ireland’s efforts to safeguard the profession in Ireland.
Birth doulas, who meet with the mothers several times during pregnancy and then support them through labour, are not a mere soothing voice in the maternity ward. They also provide parents with non-biased information on what’s ahead and are trained in delivering physical comfort measures that, if desired by the mother, can help ease labour pains.
These techniques involve women sitting on yoga balls, kneeling on a chair or standing, as well as the more startling but surprisingly effective approach of sitting on the toilet. Crawford explains that few women will lie down naturally themselves while giving birth as it is one of the most uncomfortable positions to be in. Additionally, doulas are often tuned in with their clients’ needs and can pick up on when something is not right.
“Doulas recognise what’s going on with a woman when she’s saying she’s having a pain in her hip, and that might say to us that the baby’s head is getting caught a little bit. So, we’ll get women into a position that gives the baby the opportunity to move into a different position,” she says when asked of the importance of these techniques. Doulas often show partners massages they can perform on their loved ones, which not only relieves pressure build up for the labouring mothers but allows their significant others to play a role in an event that often leaves them at a loss.
The doula’s expertise pays off. A Cochrane Report, an international review of medical findings and health policies, published in 2017 suggested that women who have continuous emotional support during labour are less likely to require medical intervention, such as forceps or vacuum, and generally have a lower cesarean rate.
Furthermore, women who employ a doula tend to have a more positive outlook on their birthing experience. Although the data in the Cochrane Report linking a doula’s involvement to less incidence of postpartum mood disorders or depression is inconclusive, postpartum doulas can provide stability and assist in the home to support new parents during one of life’s most stressful transition periods. Duties of the postpartum doula vary from counselling parents during home visits, to batch cooking meals and even minding babies while a mother has a shower and winds down.
The important role doulas play while present in the homes and lives of new parents, however, is all the more reason why Crawford believes stricter regulatory measures are needed in the practice nationwide. She hopes that DoulaCare’s efforts to self-regulate, including ensuring potential new members have completed certified training and are fully insured, will lead to doulas outside their organisation following suit.
“If a doula had a bad experience with their own labour and birth, where they may have been treated unkindly, we need to help them debrief that so they are not going in with that chip on their shoulder when they’re supporting another family,” Crawford clarifies on why training is essential for those interested in joining the profession. Interestingly, although the majority of doula workers in Ireland are, it is not a prerequisite to be female, nor to be a mother. She cites passion for helping families and a commitment to keeping up with evolving research as important qualities for aspiring doulas.
Ultimately, Crawford said she believes the publicity generated from celebrities hiring doulas is positive as it sparks a much-needed conversation on their work. While people may associate the word doula with birth or midwifery, a birthing doula is only one role within the industry alongside postpartum, fertility and bereavement doulas. Additionally, she maintains that it has helped women feel more informed as they embark on parenthood and empowered them in the daunting maternity ward and beyond.
“Women need to know they can have a positive experience, they can gather information and be informed about their choices. That’s huge, and I think that’s coming more into the media, especially since Repeal the 8th,” Crawford says.
Image Credit: Peakpx