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But what EXACTLY does a doula do?

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It can be really tough to explain what it is that a doula does to someone who doesn't already know. This is especially true when you start to talk about things like "active listening" and "holding space" which make perfect sense to doulas but can seem like really abstract and meaningless concepts to people who have never experienced them.

"So what exactly do you do then?"

"Well, you see.... I doula people. That's what I do."

Modern life is expensive, and babies can be even more so. Everyone wants to know what they're paying for; reassurance that they aren't pissing their money up the wall, and it can be hard to imagine what you're buying when your prospective doula can't really describe what she does. How do we put a monetary value on "holding space"? Or explain a charge per hour for "intelligent tea drinking"?

Our society has an obsession with observable external THINGS that we can point to and say "this!" and that doesn't often mesh well with the essence of doulaing. So, here is a list I've put together, of "things that I have done for clients so far". It is not exhaustive, but it is pretty comprehensive, and I hope it helps.

 


  

Before being pregnant

  • Gone along with them to meet the local midwives while finding out what services they offer, and what kind of support could be expected once pregnant
  • Reassured them before they were pregnant that they have choices and that things can be different from their previous birth(s)
  • Listened to their hopes and dreams, their fears and worries

 

After taking a pregnancy test

  • Celebrated their positive pregnancy test results
  • Commiserated over their negative pregnancy test results
  • Talked through the available options for terminating a pregnancy, and explored the feelings involved with either continuing or terminating
  • Accompanied them to the hospital so they could access a termination
  • Rung the Drugs in Breastmilk Helpline to determine whether accurate information was being given about whether it was safe to breastfeed while having a termination

 

While pregnant and planning to give birth

  • Attended antenatal appointments with midwives and consultants
  • Asked questions and clarified exactly what was being offered during appointments
  • Asked for evidence
  • Made notes about what was said so that they could be referred back to later
  • Asked around on their behalf for information about their circumstances, and fed that information back to them along with signposts to further information
  • Attended ultrasound scan appointments
  • Talked frankly about risks, and put them in perspective by comparing with other risks
  • Listened to previous birth stories
  • Held parents while they cried over their previous births
  • Educated parents about how labour works, what it can feel like, what hormones are involved
  • Talked about breastfeeding, the risks of not breastfeeding, how breastfeeding works, how it doesn’t work, where parents can turn for support and information
  • Talked about the microbiome (the collection of all the microorganisms that live inside us and on our skin) and how we can protect and nurture it
  • Signposted parents to resources they didn’t know about
  • Talked about normality
  • Listened, a lot!
  • Asked questions in order to gain a better understanding of internal feelings and beliefs
  • Read between the lines
  • Reflected back what things I’m hearing people say without saying
  • Loaned out books on multiple topics
  • Loaned out children’s books for reading to older children
  • Talked with older children about what labour and birth might be like for them to see
  • Talked about the realities of adding a second child into a family and how that might impact the eldest child, and how those impacts can be made as positive as possible
  • Talked about tandem nursing and whether it is an option for them
  • Helped to write birth plans, usually multiple ones covering several scenarios
  • Discussed the postnatal period and what things can make it easier or harder
  • Helped to write postnatal care plans
  • Encouraged dads/partners to talk about their hopes and fears

 

During labour

  • Set up and filled birth pools
  • Moved furniture
  • Held hands
  • Rubbed shoulders
  • Rubbed backs
  • Poured water over backs
  • Swayed
  • Laughed
  • Encouraged
  • Put TENS machines on, and been in control of pressing the button
  • Acted as a communication go-between, between mum and the midwives
  • Asked questions of the health care providers so that a fuller picture of the situation can be gathered
  • Asked for time to consider all the options before parents make a decision
  • Crocheted
  • Held water for sipping
  • Wiped brows
  • Passed snacks to nibble on, and provided emergency sugar supplies when reserves are low
  • Carried bags from room to room, or from car to room
  • Packed bags ready for transfers from home to hospital
  • Cuddled older children and told them what was going on
  • Encouraged partners to provide support and comfort
  • Seen older children out of the house with their bags
  • Braced against those who wanted to push or pull with their legs or arms, as a coping measure
  • Held bowls for vomit
  • Cleaned up faeces
  • Handled phone calls to health care staff
  • Believed that they were strong enough and told them that over and over
  • Stopped an assault

 

In the first hours after the birth

  • Whispered ‘congratulations’ and ‘you did it!’
  • Given hugs to parents, both overjoyed ones and shellshocked ones
  • Run baths
  • Taken photos
  • Tied cord ties
  • Cut umbilical cords
  • Tucked blankets and clothing around to keep everyone warm
  • Held baby while mum went for emergency surgery
  • Accompanied baby to the neonatal unit for blood tests
  • Accompanied parents while transferring from home to hospital for stitching
  • Pointed out head moulding which would explain why it took so long for baby to be born
  • Untangled babies who have cords wrapped round them
  • Supported babies before they can be brought up for skin to skin
  • Helped mums to move around and get comfortable so they can cuddle their new baby
  • Emptied and folded away birth pools
  • Moved furniture
  • Made tea
  • Made snacks
  • Done the washing up
  • Cleaned the kitchen
  • Cleaned the bathroom
  • Scrubbed blood out of the carpet
  • Put towels/sheets to soak
  • Helped with dressing, both of mums and babies
  • Made placenta smoothies
  • Cried
  • Hugged midwives
  • Loaned out my camera to those who didn’t have one
  • Held devastated partners while they cried
  • Helped with positioning for the first feed
  • Done basic baby care lessons

 

In the first few postpartum weeks

  • Cooked food
  • Washed up
  • Taken rubbish out
  • Put the washing on
  • Tidied up
  • Held baby while their parents slept
  • Held baby while their parents got a bath or shower
  • Talked with older children about what newborn babies are really like
  • Played with older children
  • Given breastfeeding support, including several different positions
  • Spotted a possible tongue tie and signposted where to go for support and revision
  • Debriefed births
  • Held parents while they cried
  • Visited admitted parents in hospital or other medical facility
  • Helped access donor breastmilk
  • Talked about bed-sharing safely
  • Bathed babies
  • Demonstrated babywearing
  • Assisted parents babywearing for the first time
  • Talked about tandem nursing and how it is going

 

Weeks or months (or sometimes even years) later

  • Attended the GP to request therapy for trauma after an assault
  • Attended hospital for retained placenta
  • Attended smear tests as a chaperone
  • Talked about introducing solids
  • Talked about bed-sharing with older babies and older children
  • Talked about gentle parenting long term

 


 

What do you think? What kind of monetary figure would you put on someone who did all that?

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Comments

  1. Claire Davis

    I'd say that Doulas are worth their weight in gold, yet only charge their weight in copper. Thank you for pointing out why the profession should be so much more valued - by EVERYONE.

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  2. It's priceless, isn't it? un-quantifiable.

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