There was a time when doulas were associated with giving birth in a yurt to the sound of tinkling wind chimes. No longer. Having the support of a doula through pregnancy and birth is now an increasingly popular choice for women, particularly those living far away from family and friends. We look at how doulas can help and what that could mean for your birth.
What is a doula?
Though they are not medical professionals, doulas are mothers who have undergone training to emotionally assist pregnant women during and after pregnancy and birth, as well as give them tools to help cope with labour. A study in the US showed that the rate of caesarean sections could be cut by half if more women used doulas.
Building confidence so that parents are able to make informed choices about the birth is a key part of her service, says Natalie Wells, a doula based in Abu Dhabi.
"It's important to prepare couples for every eventuality and not to shy away from any fears," she says. "Labour and birth can be full of surprises and don't always go the way we hoped or planned."
Wells also teaches women skills to help deal with the pain of birth. "The practices I teach give them the confidence that they are not powerless," she says, "but have tools to use to help them get through each contraction, one at a time."
"It's just being there for them," says Lisa Barfoot-Smith, a doula and mother of four who lives in Abu Dhabi. "We've been through the birth they want beforehand and that's the birth we'll try to get. Obviously we're not medical professionals and we can't give medical advice but what we can say is don't rush into something, think about your options."
Who needs a doula?
Being a first-time mother and relatively new to the Middle East were two of the reasons Eve Mumford used a doula for the birth of her son Oscar, now seven weeks old.
"I didn't know anyone here who'd had babies," she says, "and being in a strange environment with a health service I didn't really understand was a bit nerve-racking.
"My mum works full-time and I wasn't able to bring her out for the birth so I felt it would be sensible to have another female there who had been through it before and who knew the system out here, who could be a supporter and advocate for us."
"I'd heard a few stories from other people where things didn't go quite right," says Caroline Porter, who lives in Abu Dhabi and had her daughter, Kaila, in December with Wells's help. " I thought that if I've got someone there who's been through the birth and knows what to expect then it would be a good idea and I could relax and my husband could relax during the birth."
How does a doula differ from a midwife?
Unlike midwives, doulas are not medically trained, and therefore cannot offer medical advice. "The midwife is there to do her job but she's normally got more than one person at a time to look after," says Barfoot-Smith. "If they're out of the room and you get a big contraction, it helps to have someone there apart from your husband."
"I was admitted to the Corniche [Hospital] with contractions at 11pm," says Porter. "They were getting faster and stronger but I wasn't far enough along to be admitted to the labour room and it was after visiting hours so my husband wasn't allowed to be with me. I was going through labour on my own, which wasn't what I wanted. I called Natalie and she came straight away and helped me do my hypnobirthing exercises."
Does having a doula mean forgoing pain relief during the birth?
"We do educate people about the pros and cons of different types of intervention," says Wells. "Epidurals can be amazing in certain situations - if the mother is really frightened or if the labour is very painful - but quite often they don't understand that there can be other knock-on effects.
"So, it's about giving parents all the information and letting them make their minds up - and then whatever they decide we will support.
"We're not there to push natural birth. It's about supporting the mother and her wishes."
How can a doula help after the birth?
Many doulas also provide post-natal support, which can be a lifeline for first-time mothers in a country where there is no such provision.
"There seems to be a real gap here," says Wells, "especially for first-time mums. They give birth, go home, go for their six-week check, but otherwise there is very little follow-up.
"Many first-time mothers might feel vulnerable with a newborn at home to look after and all the questions that arise and there not being anywhere else to go. So I offer that support as well - and if I can't help them, I'll point them in the right direction."
How do I find a doula?
Natalie Wells (in Abu Dhabi): 050 580 8134
Lisa Barfoot-Smith (in Abu Dhabi): 050 909 5416
Louise Stern (in Abu Dhabi): 050 263 7314