Ever been curious about working with a doula? What they do and how they can help? We have! So we sat down with Samantha Gunn, a Sydney-based doula to talk about working with a doula. And we got more than we bargained for.
Samantha isn’t just a doula herself but had a doula present at all four of her births, so she knows her stuff. And we love that she’s committed to connecting women and supporting them (and their partners and families) through such a huge time in their lives.
In this interview Samantha doesn’t just cover what a doula does and how to go about hiring one, but she also shares some super juicy tips for childbirth and a huge list of incredible resources for mums-to-be and their partners. You don’t want to miss this one!
Em: What is a doula?
Samantha: The term has its roots in Greek and originally means ‘woman servant’. Traditionally, a doula is someone who supports women through pregnancy, birth and early motherhood.
Birth doulas usually start working with a woman/couple during pregnancy to build a connection, help them understand their preferences and options for their birth, and prepare them practically and emotionally as they journey towards meeting their baby. The doula then attends their labour and birth and can also support them through their postpartum period.
It’s important to note that the role is not a medical one, we provide practical and emotional support and guidance - a bit like a coach or mentor.
Our clients should still be under the care of a midwife or obstetrician.
Em: Are there different types of Doulas? If so, what are they?
Samantha: Yes! The role has expanded to include care and support through ‘major life transitions’ rather than just birth. This can include support through events such as an IVF/fertility journey, miscarriages, terminations and even non-reproductive events such as death.
The approach is the same, people need space held for them during these significant periods - to be listened to, emotionally supported, guided, validated…. to be seen even. These are fundamental human needs and our society is no longer set up to properly meet them, and that’s where doulas come in.
Em: What are the benefits of having a doula?
Samantha: There are so many! Various studies have been conducted on doula support and the evidence** shows that working with a doula during pregnancy and birth can shorten labour, reduce interventions and improve outcomes and satisfaction.
Dr John H Kennell said that
“if a doula were a drug, it would be unethical not to use it” - that’s how effective we can be!
This is a great image from Evidence Based Birth that clearly lays out many of the benefits.
And here’s a quote from Evidence Based Birth’s founder Rebecca Dekker PHD
“But doula support is so much more than potential improved outcomes, it’s an improved experience of pregnancy, birth and early parenting. A doula is someone that is independent, someone that you can call in between antenatal appointments for a chat, help you find information, listen and support you no matter what you’re going through.”
Em: As you mentioned there is a great range of work a doula can offer. Can you explain your approach and what women receive working with you?
Samantha: I always feel a bit vague when I speak about how I work - the truth is that it varies a lot because every client is different and has individual needs.
A good doula will identify what those needs are and meet the client where they’re at.
I usually meet my clients at least twice but often more than this, as a general rule I cover the following:
My focus is to support both the birthing woman and her partner. Obviously the partner goes through their own journey during pregnancy and especially birth and having support means that they are more emotionally available for the birthing woman on the day. Some partners feel that a doula will mean that they’re sidelined but it’s quite the opposite, I work on connecting couples, not getting in their way!
I am ‘on call’ for my clients from 38 weeks until their labour starts, which means that from 38 weeks I am ready, day or night, to go and support their labour whenever they call!
I usually limit the number of clients I take in a month to 2, more than this doesn’t work for me on both a personal and professional level. I talk to my clients a lot about boundary setting in their postnatal period and I have to take my own advice sometimes too.
Em: How are doulas and midwives different?
Samantha: I think the clearest way to outline the differences is to list them:
Ultimately, both doulas and midwives care for birthing women and should co-operate to help create the best birth on the day.
Em: At The Pelvic Hub we always talk about finding the right practitioner for you as an individual and then not being afraid to seek a second opinion or trying another practitioner if you need to. But, you cannot exactly repeat your birth. How do you suggest women choose their doula?
Samantha: I think you should trust your gut when choosing a doula, in my view you’re looking for someone that you have confidence in and connection with. Definitely interview a few different doulas, not everyone will be the right fit. There’s a saying that goes “there’s a doula for every woman and a woman for every doula”. It’s one of the most important days of your life, take time to find the right fit for you.
If you are considering doula support I would recommend researching and interviewing as soon as possible. I have been booked by clients who were 5 weeks pregnant and also 39 weeks pregnant - the price is the same but the earlier you engage a doula the longer you have access to her support.
I actually wrote a blog last year on ‘Questions to Ask a Doula’, there’s a long list on there and you don’t need to ask all of them, just the ones you find useful.
Em: What are your top 5 tips/resources for birth!?
Language is important so I prefer ‘Birth Preferences’ to ‘Birth Plan’ - you cannot plan birth! But the purpose of writing your Birth Preferences is not to plan how it will be, it’s to educate yourself about your options in a range of scenarios and then to communicate your choices to your care providers. Of course, think about what your choices are for your ideal birth but also what your choices might be should your pregnancy or birth take another path. Going through this process doesn’t commit you to any decision, staying flexible is important, but it can reduce stress on the day because you’ve already thought about different scenarios.
This is a common decision making framework for pregnancy, birth and parenting - and for life, actually!
The acronym stands for:
B - Benefits
R - Risks
A - Alternatives
I - Intuition
N - Nothing/nothing right now
If something that you’re not sure of is being recommended during your pregnancy and birth then using this framework can be really helpful. Unless your situation is urgent or an emergency there is always time for a conversation.
Ask what the Benefits are, what are the Risks, are there any Alternatives to what is being recommended, what does your Intuition or gut tell you (or how do you feel about it), and what if you do Nothing or nothing right now (or wait for 10 minutes or half an hour and reassess)?
This may seem very basic but it is actually one of the most common reasons that labour can be derailed. Firstly, it’s very easy to become dehydrated in labour so remembering to drink, especially early on, is crucial. Your body is working hard and dehydration can increase your perception of pain, increase your body’s rate of effort and potentially cause baby to cope less well with the rigours of labour.
So, just as important as drinking is going to the bathroom to urinate. There are a few reasons for this, the biggest one is that your bladder can actually be in the way of your baby’s descent so keeping it empty is important. But, as long as you’re mobile, there are other benefits to regular bathroom trips: we are conditioned to ‘let go’ on the toilet, it can get you moving if you’ve been stuck in one position for a while, it makes for a perfect squat for many women (it’s not called the ‘dilation station’ for nothing!) and it can give you some privacy and we all naturally birth/progress better with some privacy.
So - I recommend at least a cup of fluids (water, coconut water, fruit juice, cordial, Gatorade etc) and a bathroom visit per hour to keep things moving.
Birth happens best when we feel safe, confident and loved. This is more easily achieved when you’re at home but when you move to the hospital or birth centre you are in an environment that is not your own. There are definitely things that you can do to make more ‘homely’ and keep the show on the road.
Hospital rooms are functional spaces so taking the edge off and bringing comfort into the room makes for a nicer experience and helps labour stay on track. I recommend extra pillows, a cosy blanket, electric tea lights, fairy light strings, music, any printed visualisations that you’ve been using, even photos of family or locations that might help you when you’re feeling vulnerable. I know it sounds basic but it makes a big difference.
For example, this is a photo of a bathroom in the RPA Hospital, you can see the difference this makes to the room instead of having the ceiling strip light on!
Below is a list of resources that I often recommend, just like anything, it won’t all suit everyone so take a look around and see what’s helpful to you:
Ina May’s Guide to Childbirth - Ina May Gaskin
Birth With Confidence - Rhea Dempsey
Gentle Birth, Gentle Mothering - Sarah Buckley
Birth Skills - Juju Sundin
Hypnobirthing - Marie F Mongan
The Positive Birth Book - Milli Hill
Inducing Labour - Dr Sara Wickham
First Forty Days - Heng Ou
Baby Love - Robin Barker
The Business of Being Born - a great documentary on the system of modern birth
...and for some light relief check out Netflix for The Letdown and Workin’ Moms