Hiring a doula for birth and postnatal period

A kind, experienced woman to hold your hand in labour and tackle your ironing afterwards – what’s not to like? A doula could be the key to a better birth and easier postnatal period


She’ll help you write your birth plan, mop your brow during labour, and won’t bat an eyelid if you turn the air in the delivery room blue. Afterwards, she’ll rustle up home-cooked meals and tackle the laundry, so all you have to think about is your newborn. So, who is this heavenly creature? Surely she’s only available to the rich and famous, not us mere mortals?

Doulas are experienced women who offer support before, during and after childbirth. The term comes from the Greek for a woman servant or caregiver. A doula’s job is not to provide medical treatment – that’s down to your midwife. But she’ll support you practically and emotionally, helping you get the most from your birth and new motherhood.

Doula duties

‘The big difference between doulas and midwives is that doulas can commit to you throughout the birthing process,’ explains Hilary Lewin, chairperson of Doula UK. ‘Continuous support from one person makes a huge difference to your feelings of security.’

The doula’s role varies depending on your needs and requirements, but generally, she’ll meet you at least once before the birth, to discuss your plans and how she can help.

On the big day, she can help you with positioning, breathing, relaxation and movement. She’ll ensure the medical staff respect your birth plan wherever possible and keep you informed about what’s going on. ‘Doulas also allow the father to be more emotionally involved,’ adds Hilary. ‘He doesn’t have to worry about making decisions, and can take time out knowing that his partner won’t be left alone.’

The doula’s role doesn’t end with the delivery of your baby. Postnatal doulas offer support for several weeks or even months after the birth. ‘As well as helping with breastfeeding and getting your baby into a routine, a postnatal doula will look after your baby while you have a nap, walk the dog, cook dinner – whatever makes your life easier,’ says Hilary.

A growing trend

Studies have shown that doulas shorten first labours by an average of two hours, cut the Caesarean rate by 50 per cent, reduce the need for pain relief, help fathers feel more confident, and increase breastfeeding success.

Given the benefits, it’s no surprise that more and more women are using doulas. ‘Doula UK started five years ago with 50 doulas; now we have around 250 on our register,’ says Hilary.

But far from being a trendy new innovation, doulas help women have a more traditional childbirth experience. In the past, women gave birth at home, supported by their mum, sister, grandmother or other experienced women in the community.

But these days, with most women giving birth in hospital, that continuous, experienced female support has been lost.

Doulas suit all types of women, but especially those who don’t have a birth partner – for example, single mums or women with older children who need to be looked after by their dad during labour – and those who’ve had a previous traumatic birth.

‘We help women feel in control however the birth turns out,’ says Hilary. ‘I worked with one woman who wanted a home birth and ended up with a Caesarean, but she felt it was a fantastic experience because she was supported all the way.’

Home or away?

Proof positive, then, that doulas aren’t simply for earth mother types who are planning to give birth at home to a soundtrack of whale song. ‘Some doulas choose not to attend high-tech births, and only do home births,’ says Hilary.

‘But most will work for anyone, whether you’re planning a completely natural birth or an elective Caesarean.’

But what do midwives make of doulas? Do they value them as part of the birthing process, or see them as an extra body to get in the way and interfere with medical decisions?

‘Women have the right to choose whatever support they want, and midwives respect that,’ says midwife Patricia Purton, former director of the Royal College of Midwives in Scotland.

‘The only possible problem is if doulas are undertaking roles that fall within the midwife’s remit – while they may give very good advice and support, doulas aren’t medically trained.’

Indeed, Patricia feels that in an ideal world, doulas wouldn’t be necessary. ‘The midwife’s role is to provide a safe, effective and nurturing service for women and their families,’ she says.

However, she admits, cutbacks mean that midwives often aren’t able to provide one-to-one care. ‘If that means a woman wants to choose female support for labour, whether from a relative, friend or doula, it’s her right to do so.’

In practice, says Hilary, the relationship between midwives and doulas is generally positive. ‘Many midwives are glad to see a doula, as we take some of the workload off them – they can have a break or check on other patients without leaving the woman unattended,’ she explains.

And arranging to have your doula present at your hospital birth is as simple as writing it on your birth plan. ‘It’s polite to inform your midwife, but other than that, there’s no formal procedure,’ says Hilary.

‘However, if you have a Caesarean, only one birth partner is allowed in theatre, which would usually be the father.’

The price is right

You’d be forgiven for thinking that such a personalised service would cost the earth, but doulas aren’t just for A-listers with money to burn.

A birth doula usually costs between £200 and £600, with the average around £500. It may sound a lot, but many doulas accept payment in instalments so you can spread the load.

Postnatal doulas generally charge between £10 and £20 an hour, but can work as much or as little as you like – from a few hours once a week to daily support. ‘More and more grandparents are paying for doulas instead of giving a baby gift,’ adds Hilary.

If you don’t have a spare £500 (or generous rellies), hiring a student doula is a cheaper option – Doula UK encourages trainees to do four births for expenses only (up to £150).

‘We also have a hardship fund which subsidises doulas so they can work for women who can’t afford the full fee,’ explains Hilary. ‘Once you’ve chosen your doula and explained that you can’t afford to pay, she can access the fund to cover her fees.’

And believe it or not, you could even have a doula for free. In some areas, the Government’s Sure Start initiative is supporting projects to provide doulas for mums-to-be in difficult circumstances. If you’re eligible, and live in one of the areas covered, you could get an A-list birth without it costing a penny. Gwynnie, eat your heart out…

‘I couldn’t have done it without my doula’

Janette Matthews, 34, from Hull, is mum to Joshua, 22 months, and Jacob, two weeks. She was supported by a doula from the SureStart volunteer doula project
Two weeks before Jacob was born, my support network fell apart. My mum, who was going to be my birth partner, suddenly passed away, and I discovered my partner was cheating. I was devastated, and had visions of giving birth all by myself.

My physiotherapist, who was treating me for SPD (a condition causing pelvic pain), told me about the SureStart volunteer doula scheme. She explained that it wouldn’t cost a penny. At first, I thought my mum would never have forgiven me for replacing her. But when I met Sharon, my doula, I knew I was doing the right thing. I felt like I’d known her for years.

My contractions started five days before my due date at 7am. Sharon met me at the hospital at 8.30am. I was 6cm dilated, and opted for an epidural. Sharon kept talking to me as the anaesthetist put the epidural in to take my mind off it, and made everything seem calmer and more controlled than in my first labour. She made me laugh and encouraged me when I became emotional about my mum not being there, without patronising me.

Jacob was born at 5.06pm, and despite the circumstances, it was a wonderful birth experience. I couldn’t have got through it without Sharon.

Find a doula

 - A free directory of Doulas is available at www.douladirectory.org.uk

 - Doula UK is a network of doulas run voluntarily by doulas. Visit doula.org.uk or call 0871 433 3103

 - British Doulas is a doula agency. Visit britishdoulas.co.uk or call 020 7244 6053

 - SureStart currently supports doula projects in the Newland and Avenue areas of Hull (newlanddoulas.org.uk, 01482 499092) and in Lescudjack, Cornwall (lescudjack.org.uk, 01736 334864). Visit surestart.gov.uk or call 0870 000 2288 for general information