Easing Labour's Pains - Catholic Herald 7 July 2006

My husband is better at explaining it: he has had more practice.

“Where’s Sarah?” someone will ask him at a party. “Well, she’s on call,” he will begin. Or, a couple of weeks ago: “She can’t do her Herald column because just as she’d written the first sentence her client rang to say she had started labour – and she knew this lady was a quick birther, so she had to run…” Baffled looks, or rather, baffled editorial noises down the phone.

What’s she on call for, exactly? “Er, she’s something called a doula…”

The name’s useless. A term invented by Californian doctors who thought, wrongly, it was Greek for midwife. “No, not a midwife…a kind of professional birth companion. She gets hired by mums to support them during their labour and birth.”

More bafflement. What, you mean she goes to hospital when the father doesn’t want to? Actually, the father’s usually there too. But surely there are midwives and doctors? Yes - but in hospital, you may be passed from midwife to midwife and may have met none of them before.

Studies have shown that women who are supported by a non-medical woman companion whom they know and trust are more likely to have a good, manageable labour and an uncomplicated birth. I became a doula because I reckoned that to communicate the joy of having children to more people when so many young couples think they are an expensive chore, this was surely the place to start.

Regrettably, midwives are not employed in the numbers needed to provide the personal touch they would love to offer. A typical doula client is seeking continuity. She usually wants as natural a birth as possible and fears that she will be bamboozled into unwelcome interventions.

She might want her back rubbed for hours, or simply to talk to a woman who’s been through it. Or she might “just want someone there to remind me I don’t want an epidural”.

Above all, she wants her baby’s birth to matter. Few people realise that getting the birth environment right is not an optional, New-Age-y bit of frippery: it is an essential. Ask any herd animal.

We are the only mammal who regards birth as a cue to drive through heavy traffic to a huge building full of strangers and machines. We are also the only mammal who does this, and is then amazed that the mum’s labour halts, or becomes more stressful. When a birthing antelope senses danger, her labour halts. We are not so different.

We are the only mammal deliberately to surround birth with fear, horror and obscure technical language. “Fear not,” the angel said to Our Lady: and so she didn’t. Why do we?

There are a few professionals who still don’t get it. The first midwife I encountered was also the worst: discouraging, noisy, smug and newly qualified, therefore she Knew Everything. She treated the birth room as if it were her hairdresser’s. She chatted for three solid hours about herself; her ski-ing holidays, her favourite music (Dido, as I recall) and her determination not to have children: “all those smelly nappies, and childcare’s so expensive”.

This staggeringly tactless monologue was delivered, mind you, to a single woman who had bravely set her face against advice to solve her accidental pregnancy with an abortion. Not surprisingly, the mum lost touch with her labour rhythm and, rendered as helpless as a beached whale by the Midwife From Hell’s enthusiastic topping-up of the epidural fluid, she could not give birth.

“But what would have happened to me a hundred years ago?” asked the bewildered mother as they wheeled her to the emergency C-section. “Ooh, lots of women used to die, all the time,” said the Midwife from Hell with glee.

Thank heaven many midwives have the great gift to be still, be watchful and to create an atmosphere of respect. Midwifery is often the art of doing as little as possible - and the first thing a doula needs to learn is to sit still and shut up.

The greatest surprise to me has been the spiritual beauty of my clients – not only the women but the men, too. It gives me great faith in human nature to see tough, wisecracking City slickers turning into tender, patient companions; to see intellectual women discovering their own physical strength, and being overwhelmed by emotions they never knew before. It is like watching people becoming whole.

The real drawbacks are the tense weeks of being “on call” for someone whose family life becomes virtually as important our own. Everything has to be planned – childcare, family menus, school runs.

What’s more, “on call” means weeks of a fairly puritanical regime – you don’t want to be breathing Sauvignon Blanc into a labouring woman’s face. You cannot nip off for a weekend. As you stuff your doula bag under your seat in the theatre, you realise you have already mentally measured the precise distance between the auditorium and the client’s home.

But despite the inconvenience, the immense privilege of being in that room - where a woman’s entire being is turned inward, her sense of time and place shrunk to the here and now, her “thinking brain” virtually at rest while her inner self brings forth new life - is something I will never be tired of. There is holiness in a room where a woman is birthing without fear. It’s a privilege I am glad to be hooked on.

ends