With Zara de Candole – Doulabud
There is plenty of evidence that shows that having support from a doula during birth improves the experience and birthing outcomes for both the woman or birthing person, baby and partner.
But what does a doula actually do?
And how do you go about find one?
How do you choose the right doula for you?
When in your pregnancy should you contact them?
On this week’s blog we’re chatting to the amazing Zara de Candole, a Surrey-based doula with 14 years of experience. Zara has supported over 300 births!
She has trained many other women to become doulas through the Developing Doulas programme and is one of the most well-known and respected doulas in the business so we are so thrilled she took the time to chat to us!
Her warmth and passion for what she does radiates out of her and it was fascinating speaking to her and find out all about what a birth doula does and the difference they can make to the birthing experience.
Read her interview below:
Firstly, for those who might not know, what is a birth doula?
A doula is non-medical. Even if you’ve been a healthcare professional in the past, once you’re a doula you step away completely from the medical side. Doulas offer practical, emotional, informational and social support. We are like your
birthing best friend!
We don’t tell people what to do; we offer information that helps our clients make informed choices. We can advocate for them and act as ‘social-glue’ to be a calm and reassuring voice and to make sure that our clients are heard, their wishes are respected and they have agency over what does and does not happen. It is their body and their baby after all!
So often women feel a loss of control if their birth takes unexpected twists and turns. A doula can help to make this situation calmer and help you to be listened to and to understand what is happening and the choices you have. A doula can be a bridge between the care provider and the client. That relationship starts from the moment you book your doula.
Doulas support every kind of person and every kind of birth. It is really important to find a doula with shared values and to feel they are the right fit. Some doulas will be happy in the home and hospital environment and others prefer to focus on home birth.
Whilst we are non medical and must be clear about your professional boundaries, some doulas are confident and comfortable being present at free births – a birth without the attendance of a health care professional. This is a perfectly legal option for people planning their birth and a doula can really enhance the experience.
Do doulas offer antenatal support?
Many doulas with have a package that includes antenatal preparation as well as birth support, which gives the opportunity to build the relationship to help them to understand their clients and what makes them tick. The more time you can spend with a client prior to the birth the better a doula is able to support and advocate for them during birth.
There is also the option to book stand alone antenatal preparation and lots of doulas offer this option.
When should you look for a birth doula?
The earlier the better. In many cases, you’ll pay the same fee regardless of when you appoint your doula. I would say once you’ve had your 12 week scan, if you are choosing to have them, and you’re feeling ready to look ahead and start preparations, then it’s a good time to make it official.
You might want to start looking around for someone before you get to that point but doulas can be booked as early as you like, right through to seeking one out at 41 weeks!
Finding a doula that is the right fit for you is absolutely key. We always say please talk to a few doulas and see how they make you feel. And it’s not all about experience, a doula who has just finished their doula training may have all sorts of life experience that could make them the absolute perfect doula for you. It’s about how they make you feel.
Sometimes I will have people coming to me because I have so much experience and that’s what makes them feel safe and that’s fine too. It’s a very individual decision.
What happens if your doula isn’t available when you give birth?
So much of the work is done antenatally which is really important to remember. By the time you come to give birth, having worked with your doula , the aim is you’ll have the belief in yourself to get you through it and you’ll be able to
use all the tools and methods you have learnt. Your birth partner, in the same way will also have the self-belief and knowledge to support you and advocate where necessary. The icing on the cake is the doula being there, but the aim is for your client to reach that point feeling confident and as well prepared as they can.
That said, I’ve been a doula for 14 years and I have never missed a birth!
I had Norovirus once and had to find a back up doula to cover me, but the birthing mother in question didn’t give birth until I had recovered!
When we’re on call for a client, which means being available 24/7 and this usually starts 10 days before their due date. We commit to always being within an hour from our clients. I’ve missed Christmas, birthdays, saying goodbye to my son before he left to travel around the world for a year to be there for my clients. We give everything to our clients.
Of course sometimes it may happen that a doula is sick and this obviously can’t be avoided. Some doulas work in a ‘shared care’ capacity where the client books two doulas and they share everything so they do the antenatal preparation with both doulas and the on-call duties are also split ensuring that one doula is always available.
Some clients will say they don’t want a back up if their doula can’t be there but that’s a personal choice and something to discuss with your doula.
What does a doula do during birth?
The incredible thing about this role is that no two births are the same. Sometimes the doula won’t have much involvement at all and you’ll be sitting there and allowing things to unfold which can be hard to do as it’s easy to feel
like you should do more but with experience you realise that you are being everything you need to be, simply be being present and trusting the client and the birth process.
Other times you’ll need to be very hands on so giving massages, holding the birthing person and supporting the birth partner in a myriad of different ways. It’s very much about looking after the birthing person and their partner. Some people worry that their partner will become redundant if a doula is present but that absolutely doesn’t happen and part of my role as a doula is to enable that person to be the very best birth partner they can be which is really beautiful.
Some partners find it easy and others don’t so we need to find ways for them to be comfortable in that space. It might be by giving them practical jobs to do and teaching them massage techniques.
I have had clients in the past who have decided not to have their birth partner in the room at the time of birth. There are lots of different ways you can do things. As long as the clients are happy and it’s working for them then anything is possible.
In the antenatal preparation we look at what is likely to work for our individual clients. We look at their personality type what is their attachment type, what is their ability to cope with pain like. For many people birth is a painful process but this is pain with power and pain with process. So you can step into this ahead of time and work at that mindset because often they don’t trust themselves so we look at breaking down patterns of thought and stories we tell ourselves to empower them and prepare them.
Sometimes I’ll get a client who starts off planning their birth on a labour ward using the available pain medication, which we will fully support, but then through discussions they come to their own conclusion that they can birth in a different way and they can be empowered to make different decisions.
How do you find a doula?
Doula UK is the longest standing members organisation that represents doulas in the UK. They formed in 2001.
There are also lots of other directories and course providers who train doulas – such as Developing Doulas who I have trained doulas with in Surrey – also have their own directories. So it’s worth doing a google search and seeing who is local to you and reading the reviews and seeing who you might like to connect with. Social media is also very fertile ground for doulas and birth workers. It can be useful following a handful that share a message that resonates with you. The personal recommendation is also a powerful option. Podcasts and Youtube channels are also a brilliant way to learn and prepare for birth and immerse yourself in things.
What training do doulas have to do?
You don’t need a medical background to become a doula. The doula world is unregulated. If fact, anyone can set themselves up as a doula but many doulas out there will do a Doula UK approved course. All the approved courses are listed on the Doula UK website. There are also a number of courses providers that are independent but offer excellent training options. Of course, a doula isn’t obliged to undertake training but having an organisation behind the individual does seem to offer peace of mind to our client base.
All doula training options differ slightly in course content, delivery and length. There is however, a ‘gold standard’ core curriculum, that ensures new doulas come away with a solid foundation from which to start working as a doula.
This Developing Doulas course outline is a good example.
Fun fact – the collective noun for doulas is a cuddle!
What are the benefits of having a birth doula?
You might well hear a lot of negativity around birthing within the NHS due to a lack of staff and funding, and it can be scary for woman. Midwives and hospital staff are (on the whole!) doing their very best in a system that is underfunded and understaffed. Doulas can actually help take the pressure off that system by supporting women during the childbirth year.
There is very clear evidence which shows us that a positive experience is more likely, intervention rates are lower, occurrence of postnatal depression is lower, instances of cesarean births are reduced, inductions are less likely to happen, there are lower instances of instrumental births and breastfeeding is more likely to be established.
These stats are from the Doula UK website:
In having a birth doula there is:
■ Reduced risk of Caesarean birth
■ Reduced risk of instrumental birth
■ Reduced need for painkillers or epidural during birth
■ Reduced rate of induction of labour
■ Shorter labour
■ Increased parental satisfaction with the birth experience
■ Increased likelihood of initiating breastfeeding
■ Increased likelihood of successfully establishing breastfeeding & breastfeeding at 6 weeks
■ Lower incidence of depressive symptomatology
■ Improve equity and provide culturally responsive care
Is having a doula present at your birth a bit of a luxury most people can’t afford?
No I wouldn’t say that and it’s a message that needs to be dismissed. Yes, we tend to be privately hired and that does come at a cost but these services are also available to people who might struggle to afford a doula. There are many charities (both national and local) which offer support to women and birthing people on low incomes or those experiencing difficulty.
One example is Doulas Without Borders, a UK wide network of volunteers offering accessible, grassroots services to women and birthing people experiencing multiple disadvantage and financial hardship during pregnancy, birth and early parenthood.
I personally charge package prices for my services (which are clearly visible on my website), but every year I give one low cost option to a client and one free one to a client which makes sure that my support is available to people who need it and perhaps can’t afford it.
It’s important for me to give back. I also help run a free breastfeeding drop in service in Godalming, near where I live which is another way I like to give back to the local community. Find out more here.
If you’re considering hiring a birth doula visit the Doula UK website and have a look at their directory. As noted above, there are now many doula directories with a large membership of amazing doulas to choose from. Googling ‘doulas near me’ is a good place to start.