What does a doula do before during and after the birth? From ordering pizza to calming new dads

Although the concept of having a close friend on hand to assist during childbirth dates back to beyond when women were welcoming their offspring in caves, it wasn't until 1973 that the term "doula" was placed in a modern context. That was when American medical anthropologist Dana Raphael used the word to describe the breastfeeding support given to new mothers. Success in this area, she noted, was just as dependent on the outside support received from non-family members – doulas – as it was from close relatives. Gradually, the term, derived from ancient Greek meaning female slave , came to encompass those who also assisted before, during and after childbirth. Yet the role still remains a mystery to many, and questions abound. W on't they get in the way in the delivery room? Will they offer advice contrary to the doctor's? Would their presence render the role of the dad obsolete? In short, the answers are no, no and no. "I see myself as a birth translator," says Nicky Langley, a certified doula and birth educator in the UAE with more than eight years' experience. "I explain to parents what is happening at all stages. I'm a constant, comforting presence in the room, someone who won't change shift or go home – and that can have a huge effect on the birth. “Doulas don’t offer medical advice or suggest going against medical advice,” she adds. “In the delivery room I’m reminding mum to breathe, showing dads how to give counter-pressure massage, getting coffee, ordering pizza, taking photos and videos and tag-teaming with fathers, so they can take a quick break.” Lala Langtry White, also a doula, describes the role as “a bit like a library for everything pregnancy and birth-related. We are there whenever you want us to be. We don’t work for the hospital or the doctor, we work for you, both physically and emotionally.” “During pregnancy, we provide information and emotional support for you to decide what’s right for you,” says Langtry White, who has worked as a doula – a role she refers to as her “calling” – for the past three years. “I always say: This is your party, you pick the venue, the guest list and the DJ, you are in control, I’m there to help you make informed choices. Whatever is right for you, my role is to help nurture a positive experience no matter whether you’re having a natural water birth, epidural or C-section.” Langley says she’s usually approached by parents-to-be around the 20-week mark. “Prenatal visits are an opportunity to get to know the couple and form a close bond and relationship as I’ll be sharing a very intimate moment in their lives.” But before the intimacy comes the information, and doulas are keen to point out that their role revolves around pointing parents-to-be in the direction of “evidence-based research” rather than recommendations or emotion-based experience. “There is a lot of information available concerning childbirth, so women can feel overwhelmed and unsure where to start,” says Langley. “I like to sit and chat with the mother and get an idea about what they would like. We talk over all the options and what that means. I always suggest people keep an open mind all the way through. I don’t have an agenda, I just want my clients to have all the information they need.” And what of the role of dads in all this? “It’s very important to get the chemistry right with your client or the relationship won’t work,” Langley comments. “Dads especially can be unsure of the role of a doula. Their main concern is if we’ll get in the way or push them out of the process, or even upset the balance of the intimacy of the event, but that doesn’t happen. Doulas feel their way to fit into the whole picture.” New dad Chris Pascoe, who, with his wife Bianca, welcomed twin girls in December, employed Langtry White as their doula in Dubai. “I had no idea what a doula was or did or even what value one would add to the pregnancy and birthing process. As we were expecting twins, we knew we would be full-on on the day and there would be so much happening that it would be good to have the extra support. From a man’s perspective, it was really helpful to have someone on hand to answer all those questions about what would happen that I had no idea about.” "To be honest, I had a perception of doulas being only for 'earth mother' types, as if it were a hippy sort of thing," admits Stephanie Asgill, 36, a mother-of-two who welcomed her second daughter in December last year with Langtry White as her doula. "I didn't know what they actually did, and I also thought doulas only supported women who wanted a drug-free, natural birth. It was only when I met Lala and we talked about how she supports any type of birth the parents choose, that I realised it would be a great experience to have her." Langtry White is keen to dispel the myth that doulas “only support alternative or medication- free births with whale music playing in the background. I support people through every birth, from natural or water to elective C-section, and that’s what makes my job so diverse and wonderful. We are there to help and encourage parents.” A 2013 Cochrane study found that the presence of a doula during pregnancy and childbirth resulted in a wide range of positive outcomes, including reduced risk of Caesarean and instrumental birth, reduced need for painkillers or epidural during birth, shorter labour, increased parental satisfaction with the birth experience and increased likelihood of initiating breastfeeding. Both Langley and Langtry White are also quick to point out that the role of a doula is 100 per cent non-judgmental. “All I want is for women to be informed and be part of the decision-making process of their pregnancy and birth – there is absolutely no judgment about the sort of birth a woman chooses to have,” says Langley. Langtry White adds: “What we do is be that consistency and emotional support for mum and dad. We work together as a team all the way through.” Another misconception is that doulas gloss over the realities of the birthing process. “A criticism I’ve heard about doulas is that we ‘pretty’ up the birthing process and make it sound like a picnic, which of course is not the case,” says Langley. “I always start by saying that it’s going to be a tough day in your life, but that you’ll get through it.” Doulas are also there to help the dads on the day, says Langley. “I teach them the techniques they may find helpful and explain how during labour they’ll often see their wife go inside herself, into the animalistic side of her brain, and that he is there to be the safety, love and nurture – I give him the confidence to be those things.” That was the experience Pascoe had. “My wife had a C-section and when the babies were born, my attention turned to them, as they were on the warming tables and I was cutting the umbilical cords. But I was also conscious that I was not by my wife’s side at that point, but it was fine because Lala stayed with her until the babies were brought to her.” “I have cooked, done the ironing, looked after the kids, taken the baby while mum has a long shower – everything!” says Langley, who is also a mum-of-four, of her postnatal doula role. “I’ve been at more than 80 births during my career and every one of them has had a huge emotional effect on me. At the time of birth, I’ll often be at the business end telling the mother that I can see the baby’s head and reminding her to breathe and concentrate on the last push. "I take lots of photos and videos for parents and I get to participate in all those lovely first moments. To witness a birth still amazes me, and I still cry when I watch mum and dad together. Sometimes it feels sad when the time comes to leave them." Doulas may leave the delivery rooms, but they rarely leave their clients’ lives. “Still to this day, I feel a special connection with Nicky,” says fashion designer Sheena Dogra, who welcomed her daughter in August 2018. “After the delivery, she guided me on having a close, quiet moment with my baby for an hour, and when we came home, she would come for a visit and a cuddle with the baby. She comes to my daughter’s birthdays and, because she played such a special part in my journey, the emotional bond remains.” Langtry White, who has been present at 70 births, has a similar experience. “I don’t leave until the baby is fed, mum is fed and everyone is ready to rest and get to know their baby. Afterwards, I’m always at the end of the phone to help grow the parents’ confidence and with the emotional transition, which is enormous. Within the first six weeks, we’ll debrief about how they felt it went, their thoughts and to reflect on the experience.” Specialising in preterm and multiple births, Langtry White has also trained extensively in bereavement counselling, something that she looked into after she faced complications during the birth of her own twin boys, now aged 4. She is involved in support and information group TwinsPlus Arabia and also works closely with Small and Mighty Babies, which provides support to parents of premature babies in the UAE. “I had a tumultuous journey with my twins, which made me realise how isolating a pregnancy or birth outside of what is considered ‘normal’ can be,” she says. “It made me realise how much I wanted to support other families in special circumstances.” For the Pascoes, Langtry White helped with expressing, latching and feeding after the birth. “She made sure we were all OK, just knowing she was there with expertise to answer the impossible questions,” says Pascoe. “She was also there for support when I went back to work, and having someone other than me who could reassure my wife that she was doing a really great job was especially nice to have.” “Elation, exhaustion … all of it is just amazing,” says Langtry White. “I can’t put into words how special it is and what a privilege it is to share that moment with a family.”

What does a doula do before during and after the birth? From ordering pizza to calming new dads

Two UAE doulas speak to us about their work and the bonds that last a lifetime