The ethics of birth support

Newborn - nurtureme

I entered the doula world over two years ago now and I would never choose to do anything else – I love being a doula, I LOVE working with women, being surrounded by lovely families and their babies, getting the opportunity to snuggle a baby or two and generally feel that when I leave a family, I am leaving them feeling wonderful and enjoying parenthood.

I recently read somewhere that doulas and other birthworkers (independent midwives) were akin to formula companies and pharmaceutical companies as we push our services onto women, making them vulnerable and in need of our services.  I feel so sad reading that.

Women come to us because they have been let down by the NHS – they come to us because they have been emotionally and physically affected by their births and they have lost all trust in the NHS (in my opinion, birth trauma and VBAC are the main reason women choose a doula). We didn’t do that them, nor sold them our services, they have sought us out.  Women come to us as they feel that there are different ways of birthing and they want to feel strong and safe in their births.  Women come to us at times, as there is no one else to be at their births and they don’t want to birth alone.  And sometimes women come to us as they just hear brilliant things about having a doula at their birth.  If I’d known before my births, what someone like me does, I would have SO had a doula. We support all birth choices – that includes hospitals, medication and surgery.  For the record, I am a massive supporter of the NHS – we have a brilliant health service and I’m so personally grateful to have it.  But sometimes, due to whatever reason, it does let us down.

I have this thing within me that wants to scream out – if the NHS ’employed’ doulas, they would SAVE a fortune in pharmaceuticals, interventions, surgery and then post birth counselling….. and breastfeeding rates might be higher too due to better births and continuous support.  In a time where Scotland’s medical strategy is realistic medicine and there’s massive NHS cuts everywhere – look at doulas as an alternative….

Finally, let me just mention pricing as there seems to be some real negative feelings towards pricing and charging from our work and unfortunately some of it feels to be within our own community.  We charge and it’s important we charge so that we can continue to keep providing support – I started doing this as a volunteer but realised I couldn’t volunteer, work and support my family so this is now my job. I fell into being a doula.  I never set out on that path.  In fact, I would have laughed if someone had told me I would have become one.

We provide unlimited support – I mean unlimited… from the moment we take on a client, we email/phone/text and meet.  Every client is different and what their needs are but we are there. We go on call, for 24 hours a day, from 38 weeks (earlier if twins) until your baby/babies is here – that could be and is often, 4 weeks of being on call – that means 4 weeks of ensuring I have childcare for my three children, that means no wine (that’s a biggie for me) for 4 weeks, that means limiting my movements out of Edinburgh.  It’s a massive commitment.

In that time, there can be false alarms, days of prodromal labour or days when there’s nothing and mum is just feeling overwhelmed and needs to talk about it.  In that time, I might need to come to triage with you, not knowing if I’ll return to my family.  In that time you will birth and it might take 4 hours, it might take 34 hours – there is nothing as certain as how uncertain birth is.

For the level of commitment we give, we deserve a fair payment for the work we do.  I’m always happy to discuss it if it genuinely is unaffordable.  The payment goes towards my training, marketing costs, insurance, PVG, travelling and also all the things in my birth bag.  And if I’m lucky, I can occasionally draw a salary – in the last financial year I didn’t draw a salary but re-invested it heavily into my training.  I don’t see paying for a doula any differently to paying for a birth preparation, counselling, a buggy.  Compare it to a wedding – in a wedding you will pay for the reception, the dresses/outfits/hair/makeup, the flowers, the cars, the honeymoon.  When having a baby, a doula is an item to be considered in your budget.

Birth is a cornerstone in our parenting journey.  It affects us deeply and profoundly.  When it goes wrong, it can affect our relationship with our baby and partner.  Dads can struggle with birth too.  I reckon it’s one of the MOST talked about subject with mums with perinatal mental health illness (anecdotally).  Birth is, in my opinion, one way in which we can change future generations.  Where births are a more positive experience and where parents feel in control and comfortable with the decisions they have made, we are able to bond with and love our babies more deeply.  Where babies are loved more deeply, we are improving their mental health as adults and thereby we are changing our future generations.

If I knew what I know now, I would have made different choices in my own parenting journey.  As such I’m deeply grateful to know what I know and thereby support other parents through the love and very gentle guidance I show them and that they give their children.  As doulas, what we do is love our clients and mother them in our unique way until it’s time that they’ve flourished into parents themselves and we can gently cut the cord and let them go.

Much love, Tricia xxx


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