Who should hire a doula?
The short answer to this is everyone. No matter whether this is your first or third baby, the experience will be unique. The four pillars of doula support are referenced on the Evidence Based Birth website as:
Each of these pillars are relevant to every single birth.
Helena is fantastic - so warm, reassuring and knowledgeable. Knowing she was on my team gave me a sense of calm confidence which I believe enabled me to have a fast labour. I didn’t have any concerns or worries as I knew I’d have her to support me.
Why do I need a doula when my partner will be with me?
I hear this question a lot. There are several reasons why a doula can benefit both you and your partner. A doula assists your partner in supporting you, for example showing counter pressure and massage techniques to use. A doula makes sure that your partner eats and stays hydrated so that they can stay strong for you, and they allow your partner to take comfort breaks with the peace of mind that they aren't leaving you on your own.
Still need convincing? Here's the science bit: the updated Cochrane Review on continuous labour support concluded that outcomes were better with the addition of a support person who wasn't a hospital employee, partner, friend or relative, i.e. a doula. In fact, doulas provide pain relief!
Reduction in the risk of unplanned caesarean birth
25% with a support person
39% with a doula
Increase in likelihood of a spontaneous vaginal birth
8% with a support person
15% with a doula
Average labour pain rating
44.2% without a doula
26% with a doula
Feeling of coping during
24% without a doula
60% with a doula
'When the mother directs attachment seeking behaviors to the doula, the experienced doula (25 births or more) responds in a unique manner. She is able to respond as a secure base, thereby soothing the mother’s attachment system. The accompanying diminishment in stress hormones allows for a surge in oxytocin in both the mother and the doula… theoretically, oxytocin is the hormone of attachment, and it is released during soothing touch and extended eye contact, which are habitual behaviors of birth doulas.'
Personal communication, Dr. Amy Gilliland, July 2015
'they provide a focus for attachment behavior and provide a secure base for the laboring mother. The doula as a secure base theory also offers a well developed explanation why nurses have been shown to be less effective than doulas in obtaining the same outcomes. Except in unusual situations, nurses and fathers are unable to fulfill many of these attachment functions for mothers.'
Dr Amy Gilliland, 2020
WHY IS IT EXPENSIVE TO HIRE A DOULA?
Here's an approximate breakdown of my fees.
Free - initial no-obligation meeting to see if we're right for each other.
£450 - six hours of antenatal support at £75 per hour. This is based on three meetings of two hours each; where time permits I prefer to have more than this.
£150 - two hours of research at £75 per hour. I usually spend at least two hours researching information that's specific to my client and their individual birth plans, for example gestational thrombocytopenia or Group B Strep.
£250 - based on an average number of 25 days on call at £10 per day. When I go on call at 38 weeks I remain on call until your baby is born, which could potentially be 28 days or longer.
£900 - based on being with you for an average length of 12 hours during labour, at £75 per hour.
£150 - a postnatal visit of two hours at £75 per hour. A second visit can be arranged for free on request.
Variable - time spent travelling to and from our appointments.
Unquantifiable - access to me via a private WhatsApp group.
I don't time our meetings, if they're more than two hours then okay. If I spend more than two hours doing research, yep, that's fine by me. If your labour is more than 12 hours then don't worry, you're not on the clock. The only addition to your investment of £2000 or £3000 is my travel.
In the same way, if your labour is super-fast at two hours or you give birth at 38 weeks then there's no reduction in fees. On booking my services you have peace of mind that I'm blocking out my diary for you for four - five weeks. At the most I may take one other client during this time.
I also spend a considerable amount of time reading new research studies as they're published, that way I keep my knowledge current and can offer you up to date, evidence-based information.
WHY DO YOU CHARGE MORE FOR LABOUR WARD BIRTHS?
The higher fees for labour ward births reflects the increased level of advocacy required and the more stressful environment involved. I only attend hospital births occasionally for these reasons, but I encourage you to get in touch if you would like to discuss having an 'antenatal support only' package.
The higher fee does not apply under the following circumstances:
hospital transfer during a homebirth;
labour ward transfer during a birth centre birth;
a medical issue arising during late pregnancy (35+ weeks) that necessitates changing a planned homebirth / birth centre birth to a labour ward birth or elective c-section.