As we hear more and more about doulas, it’s easy to get the impression that having a doula will somehow magically lead to having a better birth experience. It often feels like one of the things on the ‘positive birth’ checklist; hire a doula, do a hypnobirthing class, read a birth book etc. and it’s true that having a doula can significantly reduce the risk of interventions and birth trauma, but that is largely due to the work that a woman does with her doula, and by herself, during pregnancy.
What we have learnt from women
Through our years of working as doulas in Greater Manchester, we have come to realise that birthing within the maternity system can and often will come with complications, barriers and difficulties. One of the best ways to combat these hurdles is to know what’s coming. Knowing how the maternity service works and knowing their policies gives you a head-start and also shows you that there are other options, such as birthing outside of the system. Knowing your rights and your options are the first steps to having a positive birth. A doula can support you in learning all of this, provide you with information and books on the subject, they can give you information about how the system works and how you can navigate it, and tell you all about the birth process, but it takes you to make the difference.
Women who have had a traumatic birth in the past often come to us believing that their body failed them and that they need to do something different this time. Hiring a doula is a great start because it gives them the space to talk openly about what happened last time, a place to wonder whether those things were necessary or completely unacceptable, a place to cry and ask questions. Once women learn and start to believe that the process of birth is not inherently dangerous, and is not a medical event, it leads to an awakening that is incomparable. Getting to this point though takes a whole load of courage and openness from that woman, and when that woman is heard, she can find the answers she’s been looking for. So many of the women we listen to were having a perfectly normal, healthy pregnancy and labour until it was interfered with by medical staff, and realising that sometimes complications in birth are caused by the interference is key to protecting themselves against it. Their body did not fail them, the system did.
We have been programmed to think that authority means safety, but in so many instances we have been proven that in fact, the opposite is the case. When we trust someone else’s word over our own feelings of discomfort, we are left feeling violated. When we look to someone else for the answers, especially in birth, we are handing over our control and ignoring our intuition. We often hear in women’s stories that the parts that felt the most traumatic are when they went against what their body was telling them, and just did what they were told – so far I haven’t met a woman who regretted following her body. Our intuition is what has kept us alive and safe for so long, and birth is such a private and personal event that it makes very little sense to look for external approval or guidance. When we trust women, birth is safe. A doula is often the only person in the birth room who is solely focused on you, as the birthing woman, and having someone who completely believes and trusts in your body at that moment can make a huge difference to the energy. Questioning the authority of medical staff is necessary to get the birth you want, because going with someone else’s flow will inevitably lead you down a path that makes you uncomfortable or feels wrong. You ARE the authority, and you DO know best, even if you have never birthed before. Birth is a hormonal event and a normal bodily function – if you were monitored, observed and examined whilst trying to have an orgasm it probably wouldn’t go very well, would it?
Birth is led by the hormone oxytocin – as are orgasms – and for oxytocin to be released it needs the right environment. For women to release oxytocin they need to feel safe, warm, unobserved and undisturbed, so when you put a labouring woman in a brightly lit hospital with a bunch of strangers, unfamiliar loud noises and smells, and continue disturbing her with monitoring and examinations, it’s no surprise that birth takes longer or is more difficult. When birth is undisturbed, endorphins are released to match the intensity of labour as it builds – this is what makes labour pain manageable. When we interfere with the body’s natural pain killers, we cause more harm than good. Understanding what birth needs is a great foundation for planning where you want to give birth, and who you want to be there. Doulas can be really helpful in supporting you to navigate the maternity system when you are “going against medical advice” or just declining what you are being told is “how they do things”.
What we wish women knew before giving birth
We wish that all women knew that they were in charge of their body and their birth, that they didn’t have to agree to anything that feels uncomfortable or compromise with medical staff. We wish that women knew that birth doesn’t need to be fixed or monitored or sped-up and that they have the right to say no or to seek the care they are not being offered. We wish that women who have had traumatic experiences knew that they were not alone and that what happened to them was not okay. We wish that women weren’t expected to be “good girls” and do what they are told even when it feels wrong and that it’s okay to be “difficult” or “bossy” – in fact, that shows a belief in yourself, and the ability to assert your boundaries!
The work we do is to create the space for women to ask questions, to speak up and use their voice, to take what they need and to take back their power. We listen to women’s traumatic birth stories, we help them to write birth plans, we share information and experiences, we are behind them when they are navigating the system, or choosing to birth outside of it, and we have that unwavering trust in the birth process and in the woman in front of us.
We support their choices, we hear their voices and we are privileged enough to witness their power.
But ultimately, what makes a positive birth is a woman who is ready to go deeper, to question what she is being told, and is fully supported in her decisions.