Episode 158 - What is a Doula and Why Should I get One?
Mel:
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD, and each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey. Welcome everybody to today's episode of the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson, and today we are talking all about doulas. It has been too long since we've had a conversation about doulas, and I've invited Poppy Child here. She is a doula, hypnobirthing practitioner, and childbirth educator. And today we're going to learn everything we possibly can about doulas, what they do, how they can help us, how much they cost, how to find one, and heaps more. Poppy, welcome. Again, to the Great Breath Rebellion podcast.
Poppy:
[0:58] Hello. Great to be here once again. Always smiling seeing you, Melanie.
Mel:
[1:04] So, kick off. You're a doula. I guess my first question was, can anyone just call themselves a doula or is there like doula school that people go to?
Poppy:
[1:17] So we do go to doula school, but you're right in saying that anyone can legally call themselves a doula. So it's well worth asking your doula where they were trained, if that's important to you.
Mel:
[1:31] All right. So what do doulas do?
Poppy:
[1:35] Okay, so a doula is someone who provides you with emotional, physical, informational support during your pregnancy and your labour and birth. And the beautiful thing about having a doula is you then have continuity of care, which you might not otherwise have, depending on where you are. Here in the UK, it's very normal to see lots of different midwives over your pregnancy. So it's quite hard to build a relationship. And also, you don't know who you're going to get on the day. So there is that thing of someone who really can understand you as a person, your wishes, your hopes, your desires, your fears, and give you that tailored, warm, familiar support that you need as a pregnant woman. And I would say I wish everyone could have a doula because they really make
Poppy:
[2:27] a difference and they can make a statistical difference. So you are less likely to have a cesarean. I think it's 36% less likely just by having a doula present, less likely to have major interventions and more likely to perceive your birth as a positive experience. So we really do make a difference.
Mel:
[2:46] Certainly the research on doulas shows that women are far more satisfied. They feel more, I guess, listened to and heard during their labor and birth. They need less pharmaceutical pain management and less likely to have a cesarean section. There's a lot of great research about how that one-to-one care makes a difference to ultimate outcomes and also intervention rates. One thing that I think about though, and a lot of women say to me, How do I find a doula? Who should I hire? And I'm really reluctant to give them recommendations because I know how dramatically different each doula can be, just like each midwife can be different and each obstetrician can be different.
Mel:
[3:30] There's a very individual flavor to clinicians. So how should women interview doulas to find the best fit for them?
Poppy:
[3:41] It's a fantastic question. i am also asked who do you recommend and i'm reluctant to give a recommendation because i don't know the woman and i you know i don't know if they're going to be a good match because we're all so different so i would say you know on a practical level you want to find your local directory or perhaps look on instagram that can be a great way to find doulas nowadays or your local directory and search radius and then find the list of doulas and then look at their profiles look at their website see which one is kind of speaking to you and then you want to set up at least I would say three interviews because you might think that you found your doula and then you have another interview and you go wow actually this is the person for me then you'll be invited to a chemistry meeting, which is usually kind of, I don't know, half an hour to 45 minutes over Zoom or in person. If you want that in-person contacts, I'm sure the dealer would be happy to meet you in person.
Poppy:
[4:44] And then it's about number one, paying attention to how you feel in their presence. That is key. I also think that the doula relationship is like love at first sight. And if it isn't, they're probably not the right dealer for you. And that might feel controversial to say, but I would say that my connection to my clients is instant. I don't offer second meetings because if you need a second meeting, I'm not your person. It is something that you feel quite viscerally, instantly. It's a connection that you have, which you can't really articulate why. But it's that instant connection that you feel safe in their presence you feel a connection, but then I would say you know you have to have a list of questions that you want to ask them because that will give you a picture of how they operate their philosophy to birth which will give you more information which will help you make your decision so I've got I've got some questions to share with you that will hopefully help your audience. A really good question to ask is, talk me through the first 10 minutes of you arriving in the birth space. I'm having contractions. What do you do?
Poppy:
[6:00] And that will reveal to you their kind of preference in terms of the way that they support. So they might say things like, you know, I would give you counter pressure or positive affirmation. But even more crucial to that, it will help you to understand how they are going to work with your birth partner. And I would say that is one of the most important things. So this question will reveal to you, are they going to elevate your birth partner as the primary source of support someone who knows you loves you has that deep understanding of what you'll need or are they going to position themselves as the primary source of support whereas if you just said how are you going to work with your birth partner you'll get the answer that you know you want to hear whereas when you ask that question it reveals so much to you so for me planning for my second birth which was last year it was absolutely fundamental that my birth partner was the most important person
Poppy:
[6:58] in the room because obviously I'm a doula I.
Mel:
[7:01] Know what I'm doing
Poppy:
[7:02] I'm managing my contractions and I don't have fear I don't you know I don't need that kind of support in terms of positive affirmations but I wanted my husband to be the kind of primary person that was in the room and I wanted to remember so this question can really reveal to you their philosophy but also if they don't mention your birth partner in that story and in the kind of first 10, what they would do in that first 10 minutes, then, you know, you could then ask a follow-up and how would you work with my birth partner or is it imported to you? The birth partner is the primary source of support.
Poppy:
[7:40] And then another really good question is, if I'm being coerced or if I am looking uncomfortable, what would you do? Walk me through what you would do. So that would reveal to you what kind of approach they have to the medical staff. You know, is it that they go outside of the room to have that conversation? You know, I don't know what they're going to say, but it is a revealing question. If I doubt myself in labor, what would you do? Another really great question. And then what is the hardest part of being a doula? That can reveal a lot. How do they cope with stress? How do they reflect? And it's a deeper question that then enables a deeper conversation to happen, to emerge, rather than the kind of logistics. So those are the questions I would say write down and ask that will give you a really kind of rich understanding and a full picture of their philosophy and how they work with women.
Mel:
[8:40] And I love that idea of love at first sight. It's actually, as you were saying it, I'm like, oh, that's what happens when women come and interview me. Not all of them, obviously, but they'll get to the end. I often encourage my clients, I'm like, don't make a decision now, go home, have a conversation together on your own. You can talk about me however way you like. And so often they're like, nope, this feels good. Let's go with it. Let's go. And it's like they just need to lay eyes on you, ask a few questions, and then they go, yep, feeling good about it. Let's do this. You go, oh, are you sure? Like I don't want to, you know, play with you. Isn't it so interesting? Yeah, I know. It's quite surprising how quickly they know. That's right. And so I always want to give them a chance to make a slow decision because it's a big decision who you're going to be working with almost for an entire year, their whole pregnancy, their birth and their postpartum, and they're going to invest a lot of money. And this is a relationship-based care agreement, you know, that we're entering into. We have to have a good relationship. We have to get along. We have to, you know, trust each other. And you're about to make that decision right now. And so, so often they say, though, this feels good. Yep, this feels good. And they go with it. And I, so I love that. I mean, that's how I make all my decisions. If yeah it feels good let's let's go with it that's
Poppy:
[10:07] It and and often you know my clients will tell me on the initial zoom.
Mel:
[10:11] Great how
Poppy:
[10:12] Do we sign up.
Mel:
[10:12] I've had clients try and do that after the phone call where they went to just and i'm like no no no we are definitely meeting this is important you know i don't want you to book me without first having yeah this conversation so i think that's a great tip to be intuitively tapping into how do I feel in this person's presence,
Mel:
[10:35] your initial intuition on them, and then asking some poignant questions. I wonder when you go to hospital with women, what role do they usually want you to play? Why are they taking you with them?
Poppy:
[10:51] I think it really depends, right? So if I'm working with a woman who had a previous traumatic birth, then really they're asking me to protect and to try and make sure that doesn't happen again. You know, I'm not a bodyguard and I wouldn't say that I can be your bodyguard in labor. But I think doulas are unique in that we do have experience working in hospitals and often we will understand the kind of unspoken rules of that hospital, of the system, the culture. Often we know the midwives the clinicians we're paying attention to things like the rhythm in the room what's being said the undertone the patterns and we can kind of see things before they happen you know as a dealer i'm often watching out for when i feel as though potentially an intervention is going to be off offered so for example you know a scenario that i've been in on one too many times is that the mums had an epidural, And then it's time to push. And there's a time limit. But that time limit is not being discussed with the women. But I'm aware of it because we know different hospitals have different time limits.
Poppy:
[12:09] And so I'm able to say out loud, you know, are you watching the clock? Is there a specific time you're hoping to have this baby out? We know that it's not their decision. But just let's get that out in the open because I can see as time's going on, there's a little bit of people getting a bit uncomfortable. pacing.
Poppy:
[12:27] And they'll say, actually, we really want to see the baby come out on the next three contractions. And there we have our piece of information that we need. Then I'll say, but if mom and baby are okay, and she wants to continue, why not? And then that leads us into a conversation as, oh, well, yes, perhaps we could, you know. And so if the doula wasn't there, if I wasn't there, actually, the mom might not know that information, might get to the end of that time limit. And before you know it, help is being offered. I've had it where the clinicians are actually behind the curtain waiting during the pushing to see when the time is. You know, there's been scenarios where an episiotomy is being recommended, but the baby's heart rate's fine. We just need time. We need space. And so as a doula, I would then say, stand by the midwife and say look it's stretching and I smile and say it's gonna open it just needs time and I'm really warm and maybe a bit funny and often I'm hugging the midwives at the end of a shift I'm not there to kind of go oh well you know no it's it's more encouraging you know the midwife afterwards to say wow I'm really glad we waited you were right or and it's a nice warm atmosphere so as doulas we know we know the rhythm we know the patterns we know what to look out for in a way that the birth partner might not be able to because we had that experience.
Poppy:
[13:47] And, you know, we do reduce the chances of intervention. And that's why, because of those scenarios that I told you, and I've been in many of those scenarios where we've just managed to influence without being confrontational. You don't want that because that then shifts the energy of the space. It creates adrenaline, which is not good for the oxytocin release. So a skilled doula will be able to subtly influence the scenario in a positive way, hopefully. We're not there to kind of, you know, put anyone at danger. But if we can see that the woman just needs a little bit more time to dilate or to soften, then we will help. To kind of allow that time to emerge rather than how the hospital can sometimes be. Let's get this baby out. Come on, let's get this show on the road.
Mel:
[14:38] You can even help women to see, for example, if you know it's been four hours since the last vaginal examination was offered. And certainly this happens when I go into hospital with my clients. As private midwives, we hand care over to the staff and we sort of become a support person in that scenario. And you're able to say, hey just so you know like in in 10 minutes or so I imagine someone's going to come in and they'll be curious about where your dilation is up to and they'll be wanting to offer you a vaginal examination how do you feel about that do you want one do you not want one like if you don't want one I can go out there and say hey we know there's a vaginal exam coming up and actually she wants to wait two more hours or she doesn't want one right now or she's super keen for that like soon as you're ready she's ready you know so I feel like it can be a little bit of
Mel:
[15:28] Background management like that where the woman can get on with laboring you're aware of all the external factors that are going to play into her labor experience you also already know what she wants so for example if you're caring for a woman and she's like I 100% want an epidural when I'm seven centimeters or whatever her request is for her birth or absolutely do not let them give me an epidural or I definitely want to get in the bath, you can navigate that for her. So if you arrive and you say, right, well, if you want an epidural at seven centimeters, you're going to have to accept a vaginal examination so we know where you're up to. And so she might be really invested in regular vaginal examinations, discovering when she's reached that point. And then you can navigate by that with the staff. She's super happy because she got everything she ever wanted from her birth. And you were kind of working at that in the background. And alternatively, you know, if a woman wants a water birth, you know, right, I'm going to fill up the pool. I'm going to dim the lights. I'm going to make sure the midwife is aware that she wants a water birth. There's just all of this kind of project management at play.
Poppy:
[16:41] Yes, the invisible work. I like to call it kind of the invisible work that goes on in the background. So that's really interesting. So you almost become a doula when you go into hospital because you can't operate clinically, right?
Mel:
[16:53] Well, so some midwives can get visiting rights at certain hospitals,
Mel:
[16:58] but it's individual hospitals have individual scenarios. And each midwife, each private midwife has to navigate how to access that hospital. They all have different processes. I first and foremost have always been a home birth midwife for 17 years I've never worked as a hospital midwife so for me to apply for visiting rights at a hospital feels so foreign it would be like saying to a hospital midwife right you now have to do everything at home with none of the stuff that you're normally used to I just don't feel like I could function that capacity so when I take my clients into hospital I become a support person, correct, like a doula. I'm not supposed to provide any midwifery clinical care. All of my work turns into doula work. Wow.
Poppy:
[17:50] So you're aware of what I'm talking about, where you're watching and you're observing. Because often midwives in the hospital will be looking at the computer, writing notes. There's a lot of kind of stuff they need to do, note-taking. And we can be with the woman paying attention to the rhythm of the room and being in that hold space observer mode that will just pick up on things that the birth partner won't know because they don't have the experience and the woman shouldn't know because she's in labor lab so it's that thing that we can't it's really hard to put into words what we do but I like to think of it as the holding space and the awareness and the invisible work well.
Mel:
[18:35] Then you mentioned it earlier is that I feel like a doula really frees up the couple to labor together and you're managing everything else. And so, you know, if I think about the times where I've had to slip into that role, the woman is laboring, her partner's right there. I'm thinking, okay, how can I get that birth ball in here? I'm going to move that bed out of the way and put the mat down here and Make sure she can get to the sling. Oh, her cup's empty of water. I'm going to make sure that's right next to her.
Mel:
[19:08] So he doesn't have to leave to do anything. He can stay right with her and she has his support or her partner's support right there. And all the other stuff is in the background. But even looking after them. So like, hey, do you need a snack right now? I'm going to grab a cup of tea. Do you need one of those? You know, turning down lights when people flick them back on. If she says something like, oh, I wouldn't mind getting in the bath. You're like, okay, see that? I'll turn the bath on, making sure there's pillows under her knees, you know, just All of that really practical stuff, or let's say as well, the partner's trying to massage and you've seen this before too, I can guarantee it. He's doing his absolute best or she's doing her absolute best to massage in the right spot and the woman's like, no, not there. No, no, no, don't. And then, you know, you're like, I know exactly what she wants right now. So you go in and you're like, okay, here's what I was doing before. She really liked it. Try that. and it's just a matter of giving a little bit of direction, boom, he's back in, she's happy and you're like, great. So I feel like it's a really complementary role to the support people that she already has. Yes, yes, yes. And you're interplaying between that unit, the parents and the system and the room and you know the resources that are available and you're just like you're integrating all of that in caring for the woman.
Poppy:
[20:37] Oh, you know, listening to you, I just, I haven't doula'd in over a year because obviously I had my baby. I've been on a bit of maternity break and it just makes me miss it so much. It's a wonderful role to be able to support women and witness birth and be there. I think the really important thing for me as a doula and something that I think is really important to women is that they remember their partner as the face and the feeling and everything because ultimately it's them, it's their lives, they're the parents. This is a huge transformative event in their life. And exactly what you've been talking about, that's the role of the doula.
Poppy:
[21:23] We're just kind of doing stuff and not doing. We're holding space. But we're kind of working around this thing that then makes it warm and safe for that woman to labor and for that birth partner to be solely focused on the woman. And that then makes that experience so rich for them. Whereas perhaps if we weren't there, the birth partner might be distracted with trying to do all of these other logistical bits.
Poppy:
[21:50] So it's that thing around the birth that we do. I don't see really doulas as the thing in the center of the birth. And maybe sometimes the woman says, actually, I want the doula to support me and I want the birth partner to do the logistics. But I'm yet to meet that woman when I've done the antenatal prep and I say, look, I'm here to facilitate your experience as a couple.
Poppy:
[22:15] That seems to be the thing that the women want most is they want to feel loved by their partner. They want their partner to feel confident in their role as a birth partner, which is what doulas can help with as well. So in by no means replacing them. And I'm really, really passionate about that. You know, I've been to births where it's romantic and it's like, I'm going to leave the room because this is just oxytocin. The woman is swaying. And it's just like so much love in the room where I feel like, you know, I'm just going to exit now because this is just beautiful and this is deeply yours. Not all births, but with the right environment where they feel safe, it can be a love act. It can be wonderful.
Mel:
[23:00] It is so lush sometimes that you feel like, do they remember that I am here and with all of this? And you do, you feel like, oh, I'm just going to turn around. But, yeah, I mean, birth can be really passionate and it's such a privilege to witness it and that they feel so comfortable with you in the space that they feel free to, you know, be so connected during birth. So I'm hearing then, doulas fill a lot of roles and I imagine that they can morph and change into what the woman needs them to be in particular moments. And that a really important element of having a doula is that they meet with you first to fully understand what you need from them. And then, yeah, I guess it's the doula's job to work out how they can provide that.
Poppy:
[23:53] Yeah, it's very intuitive, I would say, the role of the doula. A skilled doula is totally intuitive and is judging things moment to moment because every woman is going to labor differently. They need different things. They want different things i would say another little tip i have is that in your antenatal meetings it's really important to break the physical touch barrier so if your doula's never touched you before and the first time she's touching you is in labor it can feel unfamiliar you know when someone touches you for the first time it it you feel something so actually with my clients i will start with a hand massage whilst I'm coaching them, whilst I'm talking to them, just see how that feels. Then I might do a back massage, you know, and you're just, you're not saying, right, I'm going to break the physical touch, right? Here we go. You know, because that's just awkward. But can I just, I'll just give you a hand massage while I teach you this breathing technique or a shoulder massage. And then I'll check in, how does that feel? Do you want a bit more pressure? And before you know it, you're now kind of moving into a different realm where you are closer, you have touched, you have had that connection. Whereas if your doula's never touched you and they're placing hands on you, it can feel different, unfamiliar.
Mel:
[25:16] Well, you're learning so much about each other because you've got to help the woman when she's in a very vulnerable scenario and where you can't be navigating that at the time. I guess you would work out if they're a hugger, you know, do they want a hug? Don't they want a hug? What words do they need to hear? What words don't they want to hear? I just think there's so much preparation that can be done ahead of time so that doulas can properly serve women in the way they want to be served. And I think that's a unique role to fill because it's not a clinical role. It's a much more, like it's a quality, it's a quality role.
Poppy:
[25:55] I actually don't think there's such a thing as training to become a doula. I think the skills are so innate. You are a doula or you're not. I really do think that you can learn things and you can pick up things about how to work in the system. You can stop patterns and things like that, which will hopefully make you more skilled. But those caregiving qualities, that ability to hold space, hold time in your hands and really be there is something that is natural and innate as a person. So for me, when I first started to doula, my first birth was a deeply challenging birth. It was actually a stillbirth, which was my first initiation into doula-ing. Um but we knew we knew it was possible because the baby had a tries me 18 and, i i knew i would be able to help the woman because again these skills are innate i didn't feel like i needed to have a whole bunch of experience to be able to walk this path with her i just felt it and i knew and of course i had my gosh should i really take this on for the first birth isn't too much for me. Am I skilled enough to hold this woman through this huge life event?
Poppy:
[27:11] But it is that deep trust in those innate skills that we have as doulas. Every doula who's listening will agree that they just know that they are a doula.
Mel:
[27:21] I just had a thought as you were talking that it's entirely possible also that a doula could sabotage your birth and I've seen doulas who have a lot of ego in the space and sort of throw their weight around and get really gnarky with hospital staff and then all of a sudden the relationship between the doula and the people trying to care for the woman is really grated and tense. And then that translates through the birth space. And I want to call it out because I think doulas are incredible. And certainly the research on having a doula with you shows that they can be so beneficial. But then there's this shady side of, you know, potential trauma and aggression from some doulas. I don't know if I'm articulating it right. Please, yes.
Poppy:
[28:17] Can I say something? Ask your doula, what was your birth experience like and how does that inform your work? Yeah. If they had a really challenging birth experience and it was traumatic and they said, you know, that could also be quite revealing. Because there are doulas who have had very difficult births who are in the mode of trying to save. They don't want their clients to have the same. And immediately, what kind of energy is that? Defensive.
Mel:
[28:48] Yeah, well, they're coming in defensive. They're also coming in as a trauma response and almost trying to heal some of, they've become a doula is a kind of redemptive act for themselves. And it's less about giving women the type of birth that that woman's asking for and more about trying to give them the birth that they hope, they wish that they had themselves. And then potentially if they're holding on to big feelings or anger towards medical staff or a particular facility that that could come out in those scenarios.
Poppy:
[29:27] Have you worked with doulas like this?
Mel:
[29:29] Not like personally. I mean kind of. The doulas that I work with, obviously women are hiring them to come for home births and the majority of doulas that I've worked with, I know because they're the ones in my area and I'm comfortable with. But then I hear down the grapevine of some other doulas in other areas and at certain hospitals where they get a reputation for being a certain way. And then the staff, as soon as they see that doula come in with a client, immediately their reputation precedes them. And I just think it does a disservice to the woman because the staff is immediately frightened. It's like they're not working together as a team. They've set up some kind of battleground that the daughter feels like they need to fight for this woman, but it doesn't go that way. It doesn't work out that way because there's so much tension in the room now.
Poppy:
[30:30] Yeah, it's a sad reality and I think the really sad thing is that, you know, it could possibly lead to doulas being banned. Who knows? You know, like if it does sort of, become a really big thing then you can imagine that if there's enough midwives who say hang on I can't do my job properly because of this that would be a really sad thing because not all doulas are like that in the same way that not all midwives are coercive not all clinicians are coercive so it's the same kind of issue that we have there in the doula community is that yes you will find dealers who are acting like bodyguards who perhaps haven't dealt with their own traumas who are defensive so then again in the same way as it's up to the woman to navigate the system it's up to the woman again to ensure that she's choosing a doula who is operating from a space of trust and who isn't dealing with their own traumas and who is able to work with the midwives and the system and who maybe is has a positive and warm energy that you need but it's difficult but i I would say that most women would be able to figure that one out from the chemistry meeting, from the reputation that they have, from some research. So, yeah.
Mel:
[31:48] Yeah, I agree with you. And I think, too, women are excellent at sharing top tips and having conversations in chat rooms and all kinds of things that eventually if you start to ask the women in the community about, hey, which doula do you think I should choose? Immediately, recommendations start coming out. You know, women know as well. I think you're right. You can build an intuitive understanding. And perhaps some women will hire a more aggressive doula for a purpose.
Poppy:
[32:21] That's what I was just thinking.
Mel:
[32:23] So the woman might think, I want someone who is robust and aggressive and full of just clout, who's going to go in there and just really advocate aggressively. That might be what you want in a doula, or you might want a quiet, soft, gentle presence who's going to try and smooth over as many rough edges as possible. So, you know, I know I kind of came across as a bit like, you know, poo-pooing aggressive doulas, but maybe there are women, that's the type of energy they want in their birth space.
Poppy:
[33:02] Totally. Yeah. If you've had a really difficult birth and you're like, I don't want that to happen again and I need someone fierce by my side.
Mel:
[33:10] I don't have any trust,
Poppy:
[33:12] Then if you sense that kind of energy, you'll say, I want that.
Mel:
[33:16] Yeah. So my question is, I mean, there's no doubt doulas are beneficial. They fill a role that nobody else can fill, I believe. But, you know, doulas are a service and women have to pay for them. So I'm curious, what's the, I mean, what are women looking at here? What's the financial investment if you're thinking of hiring a doula? Anna, is there a ballpark of what, how much money do you need to put aside for this investment?
Poppy:
[33:43] Investment I'm glad you used that word because it is an investment in you in your future and your birth and your baby and your connection to your partner and it's possibly one of the best investments you will make if you make the right decision around the doula so I can only speak to the UK obviously so here in the UK you will be paying around anything between 800 and four thousand pounds.
Poppy:
[34:10] And that depends on the skill level of the doula. You can also ask for payment plans. So lots of doulas will accept payment plans. Some doulas would even, you know, look at reduced rates. When I first started out as a doula, I would give reduced rates to the women who needed it. I even took on a birth for £600, you know. So there are doulas that will do that. and i would say that if you can invest in one take up the payment plan if you need to, it will be a really good investment and you know it is a lot of money for some but it's worth it think about how much your pram is you can pay upwards you know thousands thousands of pounds for a high quality pram think about the nursery and how much you would invest in that nursery Imagine you put that money and you, you know, you maybe buy less premium products or you save for that doula that then helps you to have a really great birth, which then impacts you forever. It's one of the best investments you will ever make.
Mel:
[35:19] I absolutely agree. I think investing in the quality of your birth is a lifelong investment. And certainly, you know, if you're listening here in Australia and the US and elsewhere, women need to know they're probably up for thousands rather than hundreds of dollars and so that's in your mind if you're thinking, I want to hire a doula, how many? It's going to be at least a few thousand in order to hire somebody. The other thing that I've seen women do is some of the doula colleges or the doula training centres, they might have students who are training you know doulas sometimes if they're getting qualifications they will be told okay you've got to do five births before you're a fully fledged doula um so you know you might be able to find a student who's just on their training who's looking to support some women you know certainly if you're looking to save some money or if you really can't afford it um that's such a great
Poppy:
[36:15] Point melanie and just just remember what what i said is you're not getting a less skilled doula, they're either a doula or not. So if they have the passion and all of those innate skills, you're going to get someone great. Don't feel as though you're going for anything less than. One thing to really be aware of is that doulas are not medically trained. So ideally, we are complementing the role of a midwife, a clinician. We do not do things like catch the baby, you know, cut umbilical cords, episiotopies, nothing clinical. That is absolutely out of scope. But what we do is provide emotional support, physical support, massage, counter pressure, affirmation, warmth, encouragement.
Poppy:
[37:03] But by no means will we be doing anything clinical.
Mel:
[37:07] Yeah. And that's why, you know, doulas don't need to be regulated. They don't need to be specifically trained there's not a unique skill set that must be attached to the to do the work in the same way for example midwives we have to have very formal training there's a registration process we're heavily regulated to make sure that we are doing you know doing our work safely and appropriately and that's the reason why doulas don't need all this other legislative infrastructure around them is that there's no clinical tasks being applied. So that could be another thing to ask your doula is what do you see your role as being clinical or otherwise because I know sometimes, and it might not be the case so much in the UK, but sometimes there can be a little bit of greyness where there's no sometimes doulas overstep that the doula boundary so you know asking your doula about you know where do they sit on their role in the clinical sense could be a good question as well to just
Poppy:
[38:13] Oh make sure that you know there's doulas that have been around 10 20 years worked with midwife seen lots of things but if.
Mel:
[38:19] You have a
Poppy:
[38:20] Highly experienced doula who knows stuff often well you could ask that question but I think you would probably find that if it was a situation where they knew how to possibly do a life-saving movement or whatever procedure that those experienced dealers may do that may I don't know obviously if something were to then go wrong that could be uh you know result in them being sued or being jailed so you know again these are questions you could absolutely be asked.
Mel:
[38:51] Thank you so much for being with us, Poppy. That's been this week's episode of the Great Birth Rebellion podcast. We've spoken all about doulas and I will put all the details about Poppy's work in the show notes so you can look into her further. See you next week.
Poppy:
[39:08] Love it.
Mel:
[39:10] To get access to the resources for each podcast episode, join the mailing list at melaniethemidwife.com and to support the work of this podcast wear the rebellion in the form of clothing and other merch at thegreatbirthrebellion.com follow me mel @melaniethemidwife on socials and the show @thegreatbirthrebellion all the details are in the show notes
This transcript was produced by ai technology and may contain errors.
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