What is Radical?

We use the word radical a lot, it’s in the name of our full spectrum course. It may feel like a contentious word for some, particularly those who feel that the Doulas role is still very much about simply watching and allowing physiological birth to unfold. What we know though, is that birth is not this straightforward if we’re engaging with modern maternity services. 

So what is Radical? And maybe even more importantly, what isn’t radical?

Radical Means

The whole of the OBC course is based on your radical responsibility. We talk about this throughout the course consistently. Responsibility to your client & responsibility to yourself. In the way you communicate, schedule, support and advocate. Radical Doulas centre the power within the birthing person, they make this the central point of their support. 

They hold space, they don’t control the space, which is an important distinction.  

Radical responsibility to the birthing person means that their needs and wishes are the most important thing. It’s the filter that every interaction goes through, it’s at the front of every OBC doulas mind as they are supporting their clients. 

It also means that a Radical doula takes powerful responsibility for their own well being. A person cannot pour from an empty cup, they cannot care for others if they aren’t caring for themselves.  We see compassion fatigue in the care many parents are receiving from stressed out, overworked NHS workers, who have no opportunity to care for themselves. Our clients often need us, so they need the best version of us that we can bring.

Radical as a choice of word empowers. Doulas need to feel empowered to support their clients to the best of their ability.  In order to build the confidence of their clients, a radical doula needs to feel confident. We build intelligent advocacy, strong communication skills and relationship building into how we train our Doulas. We equip them with a deep understanding of the physiological process of birth, as well as navigating all birth spaces and situations. 

Radical isn’t a dirty word.

What Radical isn’t?

What radical doesn’t mean is just as important as what it does mean.   It does not mean confrontational, it does not mean activist first, it does not mean being passive either. 

Activism is important in todays maternity world.  In a way, every birth supported by a Doula is a form of activism. But that shouldn’t be the experience of the birthing person. Their experience should be that they felt held and heard. Their experience should be that they felt comfortable and confident that their voice is heard, respected and enacted. The activism is there, but it is secondary. 

It does not mean being the loudest voice in the room. We know that that’s not how things get done. Collaboration and care are how we support positive experiences. Professionalism and building strong relationships are how we best support our clients.

Our training doesn’t leave you to learn these complex nuances of support on your own.  The skills needed are built into the content, but you’re also immediately a part of a supportive and knowledgable vast community of OBC Doulas - often there for you whenever you need them! Plus, all the mentoring that’s built in means no question ever needs to go unanswered, no concern or fear need be unsurmountable. Whether it be the work itself, or managing your personal life around doulaing. 

A Radical Doula knows that their ego doesn’t belong in the birth space. They are a part of a major change in someones life, they are there to serve the birthing person. They are providing radical service.

Radical is powerful. Radical is what we need to support birthing people in todays maternity service. A radical doula is empathetic, professional, informed and steadfast in their passion for human rights and advocacy in the birth space.

Radical is power! 

We whisper it…

We whisper it in circles, on social media, in quiet exchanges between friends, in the look between two women carrying their babies in a local coffee shop.

Birth has been sabotaged, taken from us and done to us. It leaves us broken and tired, with unresolved trauma and tension and blame, self doubt, self hatred and tears. So many bloody tears.

And yet, if we’re one of the few … the few who “got lucky” or opted out of the system that controls our births we too whisper that. Because we don’t want to further break the hearts of birthing women and people, who don’t share our joy, our passion and our awe of what we did and how we did it.

We’re told if you just do this course, or read that book, buy this product it will all be ok. “Leaving the system that makes us or takes from us untouched” (Anna Funder).

Funder wasn’t talking about birth specifically but patriarchy in general, but she perfectly encapsulates how we (women and birthing people) are constantly wondering amongst ourselves if it could have been different. We’re blaming ourselves, for being too old, too young, too far, too narrow hipped, too sick or too black, or each other. When in actual fact it’s the system, the industrial medicalised model that took birth from us and transfigured it into something terrifying and ugly and painful. Something we don’t do but that is done to us. With surgeons, instruments, drugs, beds, doctors, coercion and fear.

Are enough of us joining the dots or are we still constantly, mindlessly walking into a system that is in a near state of collapse, that does not recognise our individuality, our hopes and our dreams, about the life growing inside us and how we wish to birth it. A system that fails to understand the dance we lead with life and death every time we bring new life into the world. A system that fails to recognise and respect our bodily autonomy and the significance of not just this moment, but all the moments in our lives that have brought us to this point. Because most (not all, never all, but most) of us wish to birth our babies the way we know we’re able.

They won’t let us give birth so we must take back what is ours. Our bodies ability to create, grow, nurture and birth life.

My hope is that having someone by your side who understands and appreciates your individuality and your choices will enable others to feel secure in the decisions they make, and feel they have true support and acknowledgement of this incredible transformative event they’re moving through. Hire a doula. Become a doula. Support birth as it used be supported … as the incredible once in a lifetime experience that it truly is.

Doulas for every birth

The journey of birth is as unique as the families experiencing it. No two births are exactly  the same, and whether a birth follows a natural path, involves medical interventions, or  ends in a caesarean, having a birth doula by your side can make a significant difference.  There’s an assumption that doulas are only for natural or unmedicated births, the reality is  that we support every type of birth. Our versatility lies in adapting our approach to fit the  specific needs of each family and their unique birthing experience. 

In this post, we'll explore how doulas provide personalised support for physiological births,  caesareans, inductions, and epidural-assisted births, and why our role is essential  regardless of how birth unfolds. 

1. Supporting Physiological and Unmedicated Births 

A physiological birth without pain medication or medical interventions is often associated  with doula support, and for good reason. Doulas are trained to support women and birthing  people who want to follow the body’s natural process, offering techniques like breathing  exercises, massage and counterpressure to help manage labour discomfort. We also help  create a calming, safe environment that aligns with your birth preferences. 

2. Caesarean Births 

While caesarean births are more medical in nature, they are no less emotional or  significant. Even in the operating room, a doula’s presence is invaluable. Whether it’s a  planned caesarean or an unexpected one, we support families through the process,  helping them feel grounded and informed every step of the way. Post-surgery, doulas  assist in facilitating skin-to-skin contact, help with the initial breastfeeding latch, and  provide emotional reassurance. 

3. Induction of Labour 

Induced labour often comes with extra layers of uncertainty, as the process can take  longer and sometimes be more intense than spontaneous labor. With various interventions  such as syntocinon (synthetic oxytocin), breaking the waters, or cervical ripening methods,  

a doula’s support becomes even more crucial. We help manage expectations, provide  comfort during the longer labour process, and encourage you to stay connected to your  body and birth plan even as circumstances evolve. 

4. Epidural-Assisted Births: Support Through Choices 

Choosing an epidural doesn’t mean you need less support—it just means that your doula’s  role will adjust to meet your new needs. Once pain relief is in place, we help you remain  comfortable and advocate for optimal labour positions to promote progress, even when  

you’re unable to feel or move your lower body. An epidural may take the edge off the pain,  but birth can still be a long, emotional experience, and we’re there to provide continuous  encouragement.

5. How Doulas Adjust to Each Birth Experience 

No matter how your labour unfolds, doulas are flexible and adaptable. We understand that  birth is unpredictable, and our job is to support you in the moment, ensuring that you feel  empowered and informed, regardless of how plans may change. Our approach shifts  depending on your needs: 

• For Physiological Births: We focus on physical comfort, emotional resilience, and  non-medical coping strategies. 

• For Caesarean Births: We prioritise emotional support, advocating for bonding  opportunities, and helping you process the experience. 

• For Inductions: We offer ongoing comfort during longer labours and help you  navigate interventions. 

• For Epidural-Assisted Births: We assist with positioning, emotional support, and  maintaining a positive mindset. 

The constant across every birth is our unwavering presence. Birth doulas are there to  support your choices, making sure your experience is as empowering and positive as  possible. 

At the heart of doula support is a deep respect for the individual birthing journey. We  believe that every birth experience is valid and deserves the same level of compassionate  care, whether it's a physiological birth at home or in a birthing center, a planned caesarean  in a hospital, or an induction due to medical necessity. The flexibility of our support is what  makes doulas so valuable, because no matter how your baby comes into the world, we are  there to provide the emotional, physical, and informational support you need. 

Your body, your birth, your way—doulas are here to help you make it the best experience  possible.

Embracing the Warmth of Home

A Doula's Perspective on Homebirth

As I think back to the last homebirth I supported, I feel a sense of warmth and coziness wash over me. Perhaps it's the soft glow of the fairy lights that were strung across the room or the comforting, grounding aromatherapy the air…but more than anything, it's the thought of homebirth that fills my heart with warmth and joy.

As a doula, I've had the privilege of witnessing countless births in various settings, but there's something truly magical about a homebirth. It's an experience that encapsulates the essence of comfort, intimacy, and the beautiful bond between a birthing person and their partner. Let me take you on a journey into the heart of homebirth, where women and birthing people own their experience and are in charge of their space, where those who are invited in to support are true observers to the beauty and power of birth.

A Sanctuary of Love

Imagine walking into a home where soft music plays in the background, and the room is bathed in a gentle, warm light. The ambiance is carefully crafted to create an atmosphere of serenity and tranquility. This is the sanctuary where a homebirth unfolds, where the birthing person is surrounded by their chosen support team, enveloped in love and familiarity.

In a homebirth setting, everything is mindfully prepared to cater to the birthing person's desires and needs. From the choice of essential oils to the soothing lighting, every detail is thoughtfully considered. This environment is the canvas upon which the birthing person can create their unique birth story.

One of the most beautiful aspects of homebirth is the comfort of familiarity. The birthing person is in their own space, surrounded by their own belongings and the people they love most. There's no need to adapt to a sterile hospital room; instead, they can nestle into spaces within their own home.

Familiar scents, the touch of a loved one, and the sounds of their home provide an unparalleled sense of security. The birthing person can move freely and find comfort in their preferred positions, whether it's swaying in the living room or soaking in a warm bath in their own bathroom. Home is our safe place, our place where we are truly ourselves and enable us to let go.

A Symphony of Support

As a doula, my role in homebirth is not just about providing physical support but also nurturing an emotional connection. In the intimate setting of a homebirth, I become part of a symphony of support that may include partners, midwives, and sometimes even family members. Together, we create an atmosphere of unwavering encouragement and positivity.

The birthing person's partner often plays a central role, offering comfort and reassurance. I'm there to provide guidance, knowledge, and a steady presence throughout the journey. In this cozy, homey atmosphere, we work together to ensure the birthing person feels safe and empowered.

Homebirth is not just about the physical act of giving birth; it's about embracing the miracle of life in the most intimate way possible. It's about honoring the birthing person's choices, celebrating their strength, and witnessing the profound beauty of birth.

As a doula, I feel incredibly privileged to be a part of this journey. Homebirths are a testament to the power of warmth, love, and the deep connection between a birthing person and their home. It's a reminder that amidst the chaos of the world, there is a place where warmth and coziness prevail - a place where life and family begins.

So, as I sit here in the soft glow of my own cozy space, I am reminded once again of the magic of homebirth. It's a reminder that within the walls of our homes, we can create the most sacred of spaces, where the warmth of homebirth shines brightly.

So welcome little one, welcome home.

Scheduling is self care

In our last blog we mentioned balancing holding space for birthing people and managing your own commitments. It’s a question we get asked a lot, how do you balance running your own business as a Doula, and an existing job, your family or caring responsibilities. The biggest and most intimidating aspect of scheduling is how to manage being on call. Let’s dig into it a little bit.

The reality is that unless you’re booking two or three clients a month, you can choose when you go on call. Then, when you’re on call, your life doesn’t stop! You have some limitations like, don’t travel too far, make sure you have childcare on call and don’t get too drunk! Basically, be ready to show up for your client.

What about scheduling around your clients due dates? This you have to take case by case, there’s not one hard fast formula that will define how you schedule it. The due dates of your clients need to be one of your considerations as to whether you are able to work with them. You may have some overlapping on calls, but it’s important to ensure that if one of your clients goes into 42 or even 43 weeks, and another could potentially come at 38 weeks, you have a backup or shared care arrangement in place. 

When you’re not on call, you set your schedule. You’re working with your clients to meet them for their antenatal or postnatal sessions. You can pick days where you work, and days that you need to have off to manage your other responsibilities, or a day of self care. What 9-5 job can you say that about? 

Not every day will be easy, not every antenatal or postnatal session will be easy. Not every birth will be easy.  However, as you run your own business you are accountable for how you manage coming down from the more challenging days. One of the biggest things is to not do it alone! Network with other local birth workers, this is important to not only have support when you need it, but to build those trusted backup or shared care arrangements. 

In short, smart scheduling is self-care! You have the capability to make your work work for you. 

Doula maintenance 101

If you have any hope of sustaining your birth work career - whether you consider yourself a doula, a birth keeper or a midwife - you need to learn how to balance holding space for birthing people and families with your own commitments …. family, other work etc. You need to learn how to maintain yourself .. fill that cup to overflowing!

Being on call for a family for long periods of time and holding space for their birth and all the emotions that accompany it can take up huge amounts of your physical and emotional energy.

Its also important that we learn how to not take previous experiences into someone’s birth space as this can impact the way they will birth.

How we achieve both these things is an ongoing journey of self discovery.

Self care has become a bit of a tired phrase in recent times and tends to conjure up images of bubble baths and trips to the spa.

What I’m going to discuss below is a little more focused on the things we can do practically in our everyday lives to help maintain our energy and focus, and help us move that energy on once we’ve attended a birth.

1. Create routines - maintaining small routines whilst on call for a client is really important to be able to ground us in the familiarity of our life. You may think it’s impossible to stick to a routine whilst on call as you have to be always ready to drop everything and go at the last moment.
   
   However having small routines helps to keep you present and top up your ever flowing cup. Think small moments … sometimes I like to journal, stretch before bed, I keep clothes for birth work at the end of my bed (in case I leave in the night) and a set in the car. I ensure I have coffee available (because I’m a caffine addict) and my car always has petrol when I’m on call.

   I ensure that my evening routine includes something that helps me to relax - bath, a good zombie movie (don’t judge), a great book, lighting a candle and turning down the lights a couple of hours before bed, going over the diary for the following day with my partner, clearing the kitchen and laying out breakfast items and kids clothes/ backpacks in case I’m not there in the morning. Small routines to maintain normality and my sanity.

2. Be aware of the energy you’re holding onto - how are you feeling about this upcoming birth? Excited, nervous, stressed. What are you holding onto from the previous birth(s) you were present at? What if your on call period starts to really drag on? Are you checking in with yourself about how you’re doing and the impact its having on your (and perhaps your family)? Are you willing this baby to put in an apperance? There’s nothing wrong with any of this but how are your going to release this energy before you step into the birth space?

3. Moving energy and staying grounded - two different elements that can be achieved through similar practices. Getting out of my head and into my body is the thing for me if I’m going to stay focused when attending this birth.
   
   I like to move my body - dance, run, stretch, walk, ride (I love to ride horses) to feel my way back into my body. Do you have other practices that enable you to shift energy? Mediation, breath work, perhaps? Do you journal? Do you need to laugh or scream or cry to release what you’re holding onto?

4. Give your body and mind an MOT - and build this into your birth work! Into the cost of my birth services I have incorporated the cost of a massage - or osteopathy treatment. As I’m aging, and since becoming a mother of 3, and horse riding addict I notice what aches, what feels tired and I know that in order to maintain myself I need regular osteopathy treatment! This is not a luxury … this is part of ensuring I can maintain the work long term (and I’ve been doing this for 12 years through babies, house moves, caring for parents, loosing parents an growing a doula training business). I couldn’t have maintained my doula work without looking after my body and mind.

Why New Parents benefit from a Postnatal Doula

Becoming a parent is a beautiful and life-changing experience, but it can also be incredibly challenging. The postnatal period, often referred to as the "fourth trimester," is a time of learning, bonding, adjustment, healing, and adaptation for both the mother and the newborn. In this transformative phase, new parents face physical, emotional, and logistical challenges that can be overwhelming. That's where postnatal doulas come in as an invaluable source of support.

What is a Postnatal Doula?

Before delving into why new parents need postnatal doulas, let’s clarify what a postnatal doula is. A postnatal doula is a trained professional who offers physical, emotional, and informational support to parents during the postpartum period. Unlike a midwife, postnatal doulas do not provide medical care. Instead, we focus on providing holistic support that addresses the unique needs of your family.

Why Do New Parents Need Postnatal Doulas?

1. Emotional Support: The emotional rollercoaster that can accompany the postnatal period is real. Hormonal fluctuations, sleep deprivation, and the challenges of caring for a newborn can leave new parents feeling overwhelmed, anxious, or even depressed. Postnatal doulas offer a compassionate and non-judgmental presence, providing a safe space for parents to express their feelings and concerns.

2. Breastfeeding and Infant Care Assistance: For many new mothers and parents, breastfeeding/chestfeeding can be a complex and sometimes frustrating journey. A postnatal doula can offer guidance and support, helping new parents overcome common feeding challenges. They can also provide guidance and tips on normal newborn behaviour, infant care, including nappy changes, bathing, and soothing techniques.

3. Postnatal Recovery: Birth is a physically demanding process, and the postpartum period involves healing and recuperation. Postnatal doulas can assist with self-care routines, help with making sure you are eating well (perhaps cooking you nutritious meals in your home),  providing space for you to catch up on sleep or a delicious long shower/bath by holding your baby, giving you peace of mind, so you can relax. Providing a caring listening ear as you navigate those early weeks. Their presence can significantly reduce the physical burden on new parents.

4. Household Management: Managing household tasks can be overwhelming when you are prioritising your new little one. Postnatal doulas can help with light housekeeping, meal preparation, and running errands, allowing parents to focus on bonding with their baby and recovering.

5. Education and Resources: Postnatal doulas are a treasure trove of information. We can provide evidence-based information on newborn care, feeding, and sleep routines. They also connect new parents to local resources, support groups, and professionals when needed.

6. Partner Support: New fathers and partners are also adjusting to their new roles and responsibilities. Postnatal doulas can help partners feel more confident in caring for the baby and supporting the mother. This support strengthens the family unit during this crucial transition.

7. Reduced Risk of Postpartum Depression: Studies have shown that parents who receive consistent support during the postpartum period are less likely to experience postpartum depression. Postnatal doulas play a significant role in providing this support, helping to safeguard the mental health of new parents.

8. Customised Support: Postnatal doula services are tailored to the specific needs and preferences of each family. Whether a family desires overnight support, daytime assistance, or simply a few hours of respite, postnatal doulas can adapt their services to meet these needs.

9. Long-Term Benefits: The support provided by postnatal doulas not only helps parents navigate the immediate challenges of the postpartum period but also lays the foundation for a healthier and more confident parenting journey.

The postpartum period can be an intense and transformative time for new parents, and the support of a postnatal doula can make a world of difference. These trained professionals offer a wide range of physical, emotional, and informational support, helping families transition into parenthood with more confidence, less stress, and a deeper sense of well-being. In this beautiful but challenging phase of life, a postnatal doula can be the essential support system that every new parent needs.

Let me support you, provide space for you to find your feet and confidently step into parenthood.

A Doula's Perspective on Homebirth

As I think back to the last homebirth I supported, I feel a sense of warmth and coziness wash over me. Perhaps it's the soft glow of the fairy lights that were strung across the room or the comforting, grounding aromatherapy in the air…but more than anything, it's the thought of homebirth that fills my heart with warmth and joy.

As a doula, I've had the privilege of witnessing countless births in various settings, but there's something truly magical about a homebirth. It's an experience that encapsulates the essence of comfort, intimacy, and the beautiful bond between a birthing person and their partner. Let me take you on a journey into the heart of homebirth, where women and birthing people own their experience and are in charge of their space, where those who are invited in to support are true observers to the beauty and power of birth.

A Sanctuary of Love

Imagine walking into a home where soft music plays in the background, and the room is bathed in a gentle, warm light. The ambiance is carefully crafted to create an atmosphere of serenity and tranquility. This is the sanctuary where a homebirth unfolds, where the birthing person is surrounded by their chosen support team, enveloped in love and familiarity.

In a homebirth setting, everything is mindfully prepared to cater to the birthing person's desires and needs. From the choice of essential oils to the soothing lighting, every detail is thoughtfully considered. This environment is the canvas upon which the birthing person can create their unique birth story.

One of the most beautiful aspects of homebirth is the comfort of familiarity. The birthing person is in their own space, surrounded by their own belongings and the people they love most. There's no need to adapt to a sterile hospital room; instead, they can nestle into spaces within their own home.

Familiar scents, the touch of a loved one, and the sounds of their home provide an unparalleled sense of security. The birthing person can move freely and find comfort in their preferred positions, whether it's swaying in the living room or soaking in a warm bath in their own bathroom. Home is our safe place, our place where we are truly ourselves and enable us to let go.

A Symphony of Support

As doulas, our role in homebirth is not just about providing physical support but also nurturing an emotional connection. In the intimate setting of a homebirth, we become part of a symphony of support that may include partners, midwives, and sometimes even family members. Together, we create an atmosphere of unwavering encouragement and positivity.

The birthing person's partner often plays a central role, offering comfort and reassurance. We're there to provide guidance, knowledge, and a steady presence throughout the journey. In this cozy, homey atmosphere, we work together to ensure the birthing person feels safe and empowered.

Homebirth is not just about the physical act of giving birth; it's about embracing the miracle of life in the most intimate way possible. It's about honouring the birthing person's choices, celebrating their strength, and witnessing the profound beauty of birth.

As a doula, I feel incredibly privileged to be a part of this journey. Homebirths are a testament to the power of warmth, love, and the deep connection between a birthing person and their home. It's a reminder that amidst the chaos of the world, there is a place where warmth and coziness prevail - a place where life and family begins.

So, as I sit here in the soft glow of my own cozy space, I am reminded once again of the magic of homebirth. It's a reminder that within the walls of our homes, we can create the most sacred of spaces, where the warmth of homebirth shines brightly.

So welcome little one, welcome home.

The importance of antenatal support from doulas

Pregnancy is a transformative journey, filled with anticipation, joy, and sometimes anxiety and fear. As the body undergoes significant changes, so does the mind.

During this crucial period, the support and guidance provided by antenatal doulas can make a profound difference. Doulas & birth workers are known for their role during labour and birth but did you know the continuity of support antenatally from a doula can also have a hugely positive impact on people’s experiences of pregnancy and birth?

So why are we any different to the midwife (or ‘midwives’, depending on shift changes and length of labour) that supports the client in the birth space?

Everything that happens during a birth begins in the antenatal period. Offering education, building relationships, trust and ensuring continuity of care are fundamental to improving people’s birth experiences. Let’s dive into the importance of antenatal work from a doula's perspective!

Trust is the cornerstone of the doula-client relationship. The antenatal period is a time to build this trust, which is essential for providing effective, positive support during labour and into the postnatal period.

1. Personal Connection: Through regular antenatal sessions and communication, doulas establish a personal connection with the family. This relationship allows for open and honest conversations, where parents feel comfortable sharing their fears, hopes, and questions.

2. Emotional Support: Pregnancy can bring about a range of emotions. A doula offers a non-judgmental space for parents to express their feelings, providing reassurance and empathy.

3. Advocacy: Trust also involves advocacy. Doulas help parents feel confident in their decisions and advocate for their preferences during medical appointments and hospital interactions. One of the primary roles of a doula during the antenatal period is to educate expectant parents. Pregnancy can be overwhelming with the all

of information available, much of which is conflicting. A doula helps to navigate this sea of information, providing evidence-based resources and personalised guidance.

Doulas educate parents about the stages of pregnancy, labour, and birth. This includes what to expect at each stage, recognising the signs of labour, and understanding the different phases of labour. They assist in creating a birth plan that reflects the parent/s’ values and preferences, discussing various birthing options, comfort methods, and interventions.

Education extends to self-care practices, nutrition, exercise, and emotional well-being. Doulas can provide tips on maintaining physical health and managing stress, which is crucial for both the mother/parent and the baby.

Beyond birth, doulas prepare parents for the early days of parenting, covering topics like breastfeeding, newborn care, and postpartum recovery. Continuity of care is a significant aspect of a doula's role and is currently filling a gap in the system that many NHS trusts are unable to fulfill. Unlike many healthcare providers, doulas offer continuous support

throughout the antenatal, birth, and postpartum periods. Knowing that the same supportive figure will be there from pregnancy to

postpartum provides immense comfort and consistent presence to expectant parents. This consistency helps reduce anxiety and fosters a sense of security.

Many Doulas & Birth Workers look at the pregnancy journey holistically, understanding the physical, emotional and psychological aspects of care. This comprehensive approach ensures that all needs are met

throughout the different stages of pregnancy. The transition from pregnancy to labour and then to postpartum can be seamless with a doula. They provide a familiar face and continued support, helping parents adjust to each new phase with confidence.

From a doula's perspective, antenatal work is not just about preparing for the birth of the child; it's about nurturing the whole person and preparing for the birth of the Mother. The antenatal period is an opportunity to lay a strong foundation of knowledge, trust, and continuity that will support the family through one of the most significant events of

their lives.

The antenatal work that doulas do is invaluable. It goes beyond the clinical aspects of pregnancy, focusing on education, trust, and

continuous care. The evidence speaks for itself: https://evidencebasedbirth.com/the-evidence-for-doulas/

• 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#

Brigstocke S. MIDIRS Midwifery Digest, vol 24, no 2, 2014, pp 157-160

#Meghan A Bohren and Sarah Chapman Cochrane review

† Hodnett ED, Gates S, Hofmeyr G, Sakala C. Continuous support for women during

childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766.

DOI: 10.1002/14651858.CD003766.pub5 and Bohren MA, Hofmeyr GJ, Sakala

C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane

Database of Systematic Reviews 2017, Issue 7. Art. No.: CD003766. DOI:10.1002/14651858.CD003766.pub6.

The double hip squeeze … the darling of doulas?

If, like us here at the OBC, you are a fellow birth geek, I’m betting that you have come across many posts on social media describing the benefits of counter pressure and biomechanics when used to support the body during labour and birth.

Social media platforms are flooded with videos and posts demonstrating these techniques, often portraying them as miracle cures for labour pain and the solution to an easy straightforward birth.

So as a doula using social media, why post about these labour ‘tools’?

1. Visual Appeal: Both techniques are visually demonstrative and easy to showcase in short video formats, making them ideal for platforms like Instagram and TikTok.

2. Effectiveness: They offer noticeable, immediate relief, making them popular among doulas and birth workers.

3. Education and Empowerment: Sharing these techniques empowers expectant parents with practical tools, contributing to a sense of control and preparedness for labour.

However, the downside of this overexposure is the potential for misunderstanding and misuse. Without proper context and instruction from trained professionals, these techniques might be applied incorrectly, leading to ineffective pain relief or even additional discomfort.

Both Alex and I have a real passion for how the body moves during labour and birth, knowing this means that we can hopefully fill our client’s tool kit with body work that they may or may not need! No need to intervene if labour is flowing beautifully … and that brings me to the inspiration of this blog … whilst the use of biomechanics can help prevent unwanted medical intervention, it is also very much an intervention itself.

So if we are to intervene, best we know why, when and exactly how to do it!

Two of the most popular techniques we see on socials are are counter pressure and the double hip squeeze.

While they may appear similar, they serve different purposes and are applied in distinct situations. Let's explore these techniques, their physiological basis, appropriate usage, and why they are so prominent on social media.

Counter Pressure

Physiology: Counter pressure involves applying steady pressure to the lower back or sacrum area of the labouring person. This technique is particularly useful during contractions when the baby is pressing against the spine, causing intense back pain, often referred to as "back labour."

When to Use:

• Back Labour: When the baby is in an occiput posterior (OP) position, meaning the back of the baby's head is against the mother's back, causing significant back pain.

• Transition Phase: During the later stages of labour when contractions are intense and closely spaced, providing relief through consistent pressure can help the birthing person manage pain.

  A doula or birth partner uses the heel of their hand or a closed fist to press firmly on the lower back during contractions, countering the pressure exerted by the baby’s head on the spine. This can help distribute the force and alleviate discomfort.

Double Hip Squeeze: Opening the Pelvic Outlet

Physiology: The double hip squeeze involves pressing the hips inward, which in turn opens up the pelvic outlet, creating more space for the baby to descend through the birth canal.

When to Use:

• Active Labour: Can help stabilise the pelvis and relieve the pressure of baby pressing on the sacrum

• Pushing Stage: To maximise pelvic opening, aiding the baby's passage.

A doula or partner places their hands on the hips (the top of the illiac crest), with fingers pointing towards the centre of the back, and squeezes inward and upward. This pressure shifts the sacrum and creates

Understanding the difference between counter pressure and the double hip squeeze is crucial for their effective use during labour.

Counter pressure is best for relieving back labour pain, while the double hip squeeze helps open the pelvic outlet, facilitating the baby's descent. Both techniques are valuable tools in a doula's repertoire, offering significant comfort and support during childbirth. While their popularity on social media has made them widely known, it is essential to seek guidance from experienced professionals to ensure they are used correctly and safely.

We work hard here at the OBC as part of our doula training to ensure that our doulas have a basic understanding of birth biomechanics and the practical uses of different pain management tools. You can find out more about our doula training here

If this is something you would love to deep dive into or just want to look into it a little more, below are some of our favourite course providers:

• Optimal Birth

• Serenity doula

• Spinning Babies

Articles about birth: help or stoking fear?

Here we are again responding to another unbalanced article written about birth. Another article with a catchy title, designed to grab the attention of birthing people, and - well adding nothing useful to the discourse.

It’s not a big revelation to say that media about birth lately has done nothing but talk negatively about both the NHS and private maternity options. Politicians have weighed in on their social media. The Green Party even tried to put something about maternity in their manifesto, which got summarily shot down.

Why can’t we get the messaging about birth right?

The latest offering by Rosie Kinchen in June 23rds Sunday Times had all the same pitfalls we’ve already seen. The NHS is failing, the NHS is underfunded, so here’s the other side - but, oh wait - it’s no good either, so I guess you’re screwed. Where does this kind of messaging leave women and birthing people who are entering the system? Or looking for ways to avoid the, what now seems inevitable, trauma associated with giving birth.

A lot of what she says in the article is true, just that the message is nothing new. We know that there are problems in the NHS maternity system right now, and that private maternity services are becoming more visible and accessible. Birthkeepers, doulas, lactation consultants, antenatal educators have always been there. In the past, these private maternity workers have been considered a part of the natural mummy world, one of many misrepresentations of birth workers. The reality is that birth workers are becoming more popular because of the lack of trust in the NHS, not coming JUST from the media, but from peoples experiences of using the NHS, either antenatally or prior experience. Many Doulas will tell you that they were approached by potential clients because of a previous experience of medical gaslighting, poor communication or lack of listening or understanding by NHS care practitioners. Before even knowing how challenging NHS maternity is now, they are afraid of what entering NHS maternity care will be like based on their previous experiences.

The article highlights some experiences of Doulas being “as useful as a chocolate teapot”, or behaving like a sulky teenager and creating a weird energy. Focussing on the negative experiences, without creating the balance by discussing the studies that show that having a trained Doula present improves outcomes. The 2017 Cochrane Review found that continuous support from a practitioner, not a member of staff at the hospital and not a part of their social network (ie a Doula), reduced the likelihood of a caesarean birth and increased the likelihood of a spontaneous vaginal birth. Continuous support also shortened labour by up to 41 minutes, and increased satisfaction in the birth experience.

In our discourse on birth, would it not be helpful to create balance in how we represent the options available to birthing people, and give them the information that empowers them to know their choices. You don’t have to hire the first Doula you meet, if you don’t get along with them, don’t hire them, meet more. You can do the same with your midwives (limited by how much you might want to travel - conversely most Doulas will come to you!) These articles could highlight the multiple points to access birth education, there are antenatal educators in most areas, and many birthworkers will do free coffee mornings locally to discuss your options.

The author of the Times piece also really makes a point of highlighting the cost of each of the birth workers that she quoted. The implication that this support is expensive AND unnecessary. This suggestion that birth workers shouldn’t be charging is narrow minded and unfeminist. Why is charging to support birth viewed so negatively? Are physiotherapists and counsellors and acupuncturists treated with the same disdain for charging for their work? Is it because birth is seen as womens work? Is it a lack of understanding of the level of training most birthworkers have? Are they considered untrained or unprofessional? It is naive to think that money doesn’t impact any part of birth, your NHS midwife is getting paid to work. Your obstetrician is getting paid to work. We can love the job and believe in it, and ask for appropriate remuneration for our work. Finally, suggesting that any birth worker charges too much is another ploy to devalue independent birth workers.

A lot of the language used in the articles we’re reading about birth are about trying to find blame. No doubt NHS maternity services needs to do better, but it’s bigger than even lack of funding or staffing. Yes, there are medical failings at the point of care. But also, medical intervention is under researched, and short and long term impacts of decisions made in the name of care are not well enough understood. The accuracy of technologies is often called into question, with aspects like late pregnancy scans having a wide margin of error, often confusing matters rather than clearing them up. Ultimately, decisions need to be made by the birthing person, but they need balanced and clear information, this is difficult to come by when the research and the technologies actually make decision making more difficult.

Media articles about birth have a long way to go to actually inform birthing people rather than sensationalise the state of affairs and terrify them. There is so much misinformation, many birthing people don’t know where to look for balanced and helpful information. We’ve been taught that we should trust and cherish the NHS, and we should - free healthcare is invaluable. But should that trust be blind? This isn’t an issue unique to birth, it’s in conversations we’re seeing in end-of-life care, in care for long term illnesses, and most commonly, in care for women.

Why we need Radical Doulas

If you didn’t know already, The Original Birth Connection trains Doulas. That’s what we do, to date we have trained over 100 new Doulas to go out and serve their communities as birth professionals, so we believe we do it well!

You may have noticed, especially if you subscribe to our mailing list that we have started talking about a Radical Doula Revolution. In recent months we have started to see the conversation around birth change. There has been a lot of media around the terrible state of maternity services in the UK, there have been drastic actions taken by the Quality Care Commission, there have been multiple investigations and there has been a lot of news. Most recently, the inquiry into instances of Birth Trauma in the UK published their report, citing key themes and providing 12 recommendations to the government.

After all this, and after all this time, we’re saying enough is enough. This is why we’ve launched The Radical Doula Revolution.

We know that the politics of birth is complicated - most birthing people do not need to know it, nor should they be concerned about it. The reality is that it is everywhere. All of this attention and media can seriously disrupt pregnancy and birth. We know that fear is often the greatest threat to a person achieving their ideal birth. So while it’s important to be informed, there is a risk that listening into the zeitgeist can take a pregnant person out of their ideal state for labour. The flipside of this, an uninformed birther is at risk of being negatively coerced by a medical system that prioritises funding, scheduling and fear of litigation over a birthing persons right to choose. So where is the ideal balance? A birthworker needs to be aware of all this, know what’s going on, and know how to support a birthing person through it. Earn their trust, work intelligently with the health care practitioners where required so as not to make a birthing persons experience even worse, and know how to speak up and advocate for a clients wants and needs.

Advocacy is increasingly becoming an indispensible skill for all birthworkers. It used to be that Doulas were there solely for physical and emotional support. Able to simply and gently hold space. Now, we know that it is becoming increasingly difficult for midwives to support physiological birth, in particular in a hospital setting. Midwives these days are beholden to the NHS first, their patient second. Fear of litigation, a heirarchy which puts obstetricians above them, burnout and lack of staffing means that midwives are being dealt a pretty shitty card. There are not enough of them, they don’t have enough time, and so the compassion fatigue is setting in and they are leaving the profession. Training new midwives will take time, and is like trying to fill up a leaky bucket. All this means that it is often a lottery (not just postcode, or trust - but shift to shift) whether a birthing person will get the care they deserve.

Doulas now provide the only instance of continuity of a care a pregnant person is likely to receive. Doulas will build the trusting relationship, they will get to know the birthing person, they will end up holding the space they need to birth in the way their client wishes, not the midwives.

Just an FYI - we’re not anti-midwife! Many of the Doulas we trained are trained midwives, and many Doulas we’ve trained have gone on to do midwifery training. The fact is that midwives are not free to practice their role without fear of reprimand, burnout or vicarious trauma. There are AMAZING midwives still practicing within the NHS. However, more and more are leaving because of the way the maternity system operates today.

Finally, Doulas now must also practice radical responsibility. This is not just in what they promise their clients (remembering they cannot act clinically), but must also be radically responsible for their own wellbeing. With the added pressures and vicarious trauma affecting birth professionals, we have a duty of care to ourselves as well as our clients, to ensure that we can continue to practice.

To this end, as an OBC Doula you receive radical support. Ongoing mentoring means you’re deeply supported as you start your journey as a birthworker. Peer-to-peer support, a “doula village” is included for life! We also include continued learning into your investment, regularly holding extra courses which not only help you build your business, but also encourage self-care, and areas of expansion. We’ll soon be launching extra courses on supporting Freebirth and intelligent advocacy. We also regularly enable doulas to access the best available further training opportunities out their in the UK such as an up coming Traveller and Gypsy birth workshop.

We need GREAT Doulas working in the UKs maternity system right now. Each OBC Doula supported birth is an opportunity to better birth for everyone in the UK. Each OBC Doula supported birth is an opportunity for advocacy and education. Each OBC Doula supported birth is a chance for a positive birth experience. Each OBC Doula supported birth is one less birth trauma suffered in the UK.

Our next training starts on June 10th.

What’s in your doula kit?

As a doula with over 12 years experience and doula trainer this is a question I get asked a LOT.

And the answer does vary from time to time depending on what kind of births I’ve been attending and what new and wonderful things I’ve found useful in supporting people. I don’t tend to be a doula rocking up to a birth with a suitcase of stuff but these are some essentials I carry.

Here’s my top 5:

1. The first thing that I probably use the most is a birth pool, liner, and of course the pumps to inflate and empty the pool. I’ve been using the same brand of pool for a while now and always buy a professional grade pool if possible as these last the longest. Owning a pool is incredibly useful as you can lend them out to clients and even hire them out to other home birthers.

2. Secondly it would have to be my Elle TENS. People and TENS machines are a bit like marmite … they love them or hate them. That said I find used properly from early on in labour women/ birthing people tend to find they bring much needed relief, at least in the initial stages. I always have a huge stash of spare pads and batteries. I also have 3 different TENS machines as I tend to lend these out to every client regardless of where they’re planning on giving birth.

3. Of the other tools I have that provided relief from the sensations of labour my favourite would have to be aromatherapy because not only can it be used on the individual in labour it can also be used to relax a space and help create a sense of calm and grounding within a new or medicalised space. One of my favourite forms of aromatherapy is the relaxation roller balls from Jess (an OBC doula) at Oyster and Olive birth.

4. My trusty rebozo wrap has been with me to every birth I’ve attended since I bought my first one (I now have several in different lengths, materials and colours). I’ve taken a long time and done many different practioners trainings to enable me to be confident in using rebozo in the birth and postnatal space.

5. Finally …. labour combs! They’ve become increasingly popular recently and I’ve always found them to be a really effective form of pain management as birthing person has full control over using it, its completely non invasive and as soon as its released from your hand it stops having an impact … so no long term effects!

I also have a huge collection of hard boiled mints and sweets (for me and for my clients,), hair bands, lip balm, straws and an adaptor/ charger. Other bits and pieces - an eye mask (very useful for keeping out those bright lights and building oxytocin) and headphones, and a variety of massage balls and space fairy lights! All these things have been useful I have a small wash kit for me including a toothbrush, pain meds, and some homeopathy.

If I’m supporting home birth I will also take a peanut ball and a birth ball and a night sky projector but I do try to encourage all parents to have a birth ball at home to support them through pregnancy so its not often you’ll find me carrying one around!

Please note this blog post contains an affiliate link for Elle TENS.

Failure to progress or just normal - how doulas can support and normalise physiological plateaus in labour

A physiological plateau or pause during the process of labour is something we see a lot as doulas supporting people to have physiological births (that’s unmedicated and unaugmented). There are many reasons they can occur and can occur at different points within labour … naturally not because something or someone has intervened.

There is no technical term for this process and it is often referred to as a failure to progress which is an awful phrase to throw at a woman or birthing person in labour. The term “rest and be thankful” is also used or physiological plateau.

This well known, and well researched rest and be thankful stage is something that is heavily pathologised in maternity care (particularly within hospital settings) where up to 40% of first time birthers are having their labours augmented due to a failure to progress (M. Weckend 2023)

There is a clear understanding that physiological birth is not a linear upward curve (the Friedman’s curve created roughly 70 years ago). And whilst that may be the “average” that does not mean it’s normal. Normal labour for the individual may vary considerably from this outdated notion, and yet still not be problematic unless we make it so because it doesn’t fit the medical model of average. Pathologising normal physiological labour leads to the increasing use of augmentation during labour and unplanned Caesarean birth. For example, “Failure to Progress was the cause of about 42% of Cesareans in Queensland, Australia, and 34% of Cesareans in the United Kingdom. (Nippita et al. 2015). In the United States, Failure to Progress is the most common reason for primary (first) Cesarean deliveries (Boyle et al. 2013) as well as the most common reason that people who give birth at home with midwives are transferred to the hospital (Blix et al. 2014).” (Evidence based birth 2022)

So what can those of us who support and understand physiological birth help our clients to do when these physiological plateaus occur? 

Like most doulas, experienced home birth midwives will be well aware, and extremely comfortable, with such pauses and it is likely you’ll all do, what appears to be nothing, as the birther rests (not uncommon to see women/ birthing people fall asleep after labouring well). 

However, midwives and doulas will be quietly assessing the situation. By closely observing the birther it is simple to gauge whether someone is perhaps tired and requires an energy boost (food and water), is holding onto something psychological which means she/they don’t feel ready to meet their baby quite yet, or if there is obvious fear that may be preventing the physical progress of labour (something that is often verbalised).

It is incredibly important that as doulas we are comfortable that labour is not a continuous linear progression and that we familiarise our clients with this as well. It’s particularly important to normalise the fact that for many this is completely normal as long as the clinical picture remains the same (not your job …. midwives job). 

So doulas … talk to your clients antenatally about what a physiological pause can look like, how it may feel (rest and be thankful after your body has worked incredibly hard), things they may want to look out for during this time (are they holding tension, fearful, not ready to meet their baby, or simply physically tired). Help your clients to embrace all that labour has to offer. 

Have you seen physiological plateaus in labour as a doula or as a birther?

Doulas work for you … and no one else

It’s World Doula Week 2024 and this year's theme is “Doula Support You”!

People often ask me what makes doulas unique within maternity care and my answer is that doulas work for you and no one else.

We only work for our clients and no one else. We are not responsible to an employer (NHS or private company) or a professional body setting out exactly what we can and can’t do. for our registration which means we have true autonomy in our work.

This means the support we provide is as unique as you and your pregnancy are. We are able to advocate for your needs and wishes. That is our only agenda. We have no judgement around how you should give birth, where or with whom.

We won’t tell you you’re not allowed to do something or that you have to give birth in a certain setting or way. If you want an elective Caesarean we’ll support you to ensure that your needs are met, your well supported and informed (about the procedure, long and short term risks/benefits), ensure your birth setting looks, sounds and feels the way you would like and then support you to recover, whilst you begin the incredible journey to becoming a new humans parent. You may want to give birth in a yurt in a field without medical support. Many doulas will support you to do this too (though not necessarily all - make sure you find the right doula).

However you choose to give birth a doulas role is to support you to tap into what instinctively feels right for you and your baby, help you find the information you need to make decisions you feel comfortable with and then support you through the birth process. Need a hand to hold, want someone to provide massage, an extra pair of hands to help fill the pool, provide snacks .. that’s you’re doula. Want someone to support your partner to ensure they’re able to support you to the best of their ability … or give them space/ time to tap out if necessary … that’s your doula. Want an advocate in the antenatally to help you decipher what your consultant has told you during an antenatal appointment … that's your doula. Want an advocate in the birth space who will help ensure your wishes are respected, allow you time to birth and help you understand and make decisions should the need arise … that’s your doula. And postnatally when you’re recovering from your birth your doula will be there with nourishing foods, an extra pair of hands, support with all the newborn feeding, sleeping and routines that you will be navigating in that immediate postpartum period. All this is undertaken without judgement, placing you at the centre of your experience.

Given the current state of maternity services in the UK we're seeing increasing numbers of people turning to doulas and birth workers to support them through pregnancy, birth and the postnatal period so they can be reassured they receive balanced information, true continuity of emotional and physical care and have someone with them who can help them navigate maternity services and advocate for their choices in birthing their babies.

This role is as old as the hills (ancient Greek hills in fact ... but that's another story) and is needed now more than ever! Perhaps having a doula for your modern birth experience is the way forward. This World Doula Week let’s take a moment to celebrate this incredible, diverse calling and career.

The First Conversation

Typically, the first step after someone contacts you to be their Doula, you want to meet up. I often say that as I’m going to be in your birth space, you need to be certain that the way I swallow or hum along to your birth playlist doesn’t annoy you. The first interview is an important opportunity to get to know each other before agreeing to work together.  As you’re reading, keep an eye out for some questions our OBC Doulas will typically ask during their first conversation with potential clients. 

“What made you think about inviting a Doula into your journey? And what are you hoping they bring to your experience?” -Michelle - The Kiwi Doula

Being a Doula for someone means building a relationship with them. You don’t necessarily have to be the best of friends at the end, but you need to build a trust and a rapport together. It’s a mutual interview where both your potential client, and you, decide whether you can work well together.  In my experience I’ve heard several Doulas suggest that a person they’ve spoken to meet with other Doulas as they don’t feel they could best serve them.  I recently heard this called a “chemistry meet”, which I think encapsulates the objective of the meeting perfectly. 

“What’s your Vision?” Leanne - The Doula Diary

There are a few questions I ask myself as I meet potential clients:

• Do we gel? Does our conversation flow? Does anything feel awkward?

• What are these parents learning styles? Does that fit with how I work?

• What are these parents communication styles? Does that fit with how I communicate?

• What do they understand a Doula does? Do I need to manage their expectations?

If I feel that we gel, that I can work within their learning and communication styles and that they understand the remit, and limitations of a Doula, then I will ask more questions about what their hopes and visions are for their pregnancy and birth. 

“What are the biggest challenges or fears you’ve experienced on this journey so far that you would love to overcome?” - Lyddie - From Fertility Doula

Even if I’m not sure whether we’re going to be working together, it’s like an interview, we carry on the conversation until it’s natural completion.  I like to clearly explain what a Doula does in general, and how I go about my work.  I’ll explain some of my core philosophies and what I hope they will get out of working with me. I will explain their responsibility in this relationship, much of the hard work is done by the client, as a Doula, you guide them and provide support. You may also be skilled in aspects which could help with easing previous traumas that could impact their birth experience.  I will clearly explain how we will work, including all of the practical aspects like organisation, how often and when we will visit, what the on-call period means, any extenuating circumstances. I will also frankly and honestly discuss money, you are self-employed after all, and being paid for the great work you do is important!

Once we’ve been through all of that, I will always check in to ask if there is anything we haven’t discussed. Often asking was there anything surprising about our conversation? Anything they didn’t expect, or expected to discuss that hasn’t been yet. Any concerns that they need to get out there now. 

Honesty and a frank conversation about yours and theirs expectations is important, even at this early stage of a potential relationship. Be honest about who you are, be honest about any challenges you may face. Be genuine, be yourself, and if you were meant to walk within this partnership towards your clients parenthood, then consider yourself lucky. 

What we do is an honour. It is also powerful. Be as fierce in advocating for yourself as you will be for your clients. 

Let’s talk about Freebirth

You may have seen some news stories lately about Freebirth. The Royal College of Obstetricians and Gynaecologists  (RCOG) and some Midwives have issued a statement expressing their concern about the rise in Freebirth.

In case you’re not sure what Freebirth is …. it is the active decision to (typically) not engage with medical professionals during pregnancy and birth. This is different from a “Birth Before Arrival” (BBA), where maternity services are accessed throughout pregnancy and midwives are summed to a homebirth, but do not arrive before the baby is born.

So, as Doulas, what do we think?

If you’ve read the articles you may have had a mix of emotions, thoughts, gut reactions ranging from anger, to frustration, to even maybe agreement. One aspect of the reporting that stands out is the blanket statement that Freebirth is dangerous.  One of the key tenents of good Doula practice is the advocacy for individualised care. Another is to respect the instinct of the birthing person.  Perhaps Freebirth isn’t right for everyone, but birthing people should be given up to date information about risk and their rights. These discussions are often not had, and blanket statements such as those shared in the media are unhelpful.

WHAT IS FREEBIRTH?

Freebirth is entirely legal in the England. It is the choice to birth without medical attendants present.

Freebirth has been gaining momentum, impacted by several factors. The first being the availability and flexibility of good maternity care during the pandemic, where birthing people who birthing within the NHS were serverely restricted on where they could give birth and when … delivery suite was generally the only option in most trusts and we saw a huge rise in inductions. To counter this many more people chose to birth individually at home in order to have their chosen partner(s) with them.

Since the pandemic the state of maternity services in the NHS has left many people feeling that birthing independently, at home, with their chosen partners around them will feel safer. 2/3 of maternity services in England are currently considered inadequate by the Care Quality Commission.

Freebirth isn’t a knee jerk reaction to a previous bad birth. Or to a single bad interaction or a general belief that “natural”, pain-relief free birth should be the objective - no matter the cost. Parents who choose to freebirth tend to well informed. They consider their knowledge and understanding of birth and the potential risks/ benefits of birthing without assistance very carefully .

SUPPORTING FREEBIRTH AS A DOULA?

It’s important that as Doulas and other birth workers we are not idolising “natural” birth, unless it is what is right for the individual. Toxic positivity can have as damaging and longterm negative impacts as a traumatic birth experience.

Those who choose to freebirth often opt for the continuity of care a Doula provides. Many have done research into what Freebirth means, and know the risks in detail. Most have spent a great deal of time internalising their sense of wellbeing and their babies wellbeing.

Looking inward for signs of anything wrong instead of relying solely on monitors and external information puts them in tune with their body and an ability to react quickly should something go wrong.

What they come up against is fear mongering, such as what you’d read in the above media pieces.

Being told that no ambulances would be able to attend, no midwives would be able to come, no one will help them because they have had the audacity to attend to their own well being and birth.

Freebirth is not for everyone. Understanding the risks of all birth, how comfortable your clients are with those risks are important for doula supporting freebirth. It’s important to have a  have a plan in place should medical care be required.  Up to date studies about the safety of home births, medicalised procedures and the realities of birthing in a hospital should be explored. As doulas we’re able to make independent decisions about whether we choose to provide emotional and physical support to parents intending to freebirth.

What Freebirth should not be is ignored and maligned. Nor should it be entirely discouraged.

So what do you think?

Doulas are not an insurance policy

Are you (doula) setting yourself up as an insurance policy for your clients birth experience? Are you being hired by people as an insurance policy so they have a “positive birth”?

Do clients say things to you like "I couldn't have done this without you?" Do you find yourself working ridiculous hours (that no mortal would work in a row without a break .... 24 hours at a birth anyone)? Do you find yourself foregoing social events, family events, complaining that your clients can't make a decision without you (or then don't listen to what you tell them anyway)?

All these things suggest you have boundary issues. You're a doula - a heart centred, knowledgeable, empathetic birth professional. Not a super hero (with or without the cape).

Your work is to ensure your client feels equipped to birth as they choose (whether you're there at their side or you fell down a well). Obviously ideally you're there every step of the way. But you are just part of the birth team - not all of it!

Your work is to ensure that your clients know how to tap into their instincts, how to advocate for their choices (or at the very least, their partner should be able to do this and understand why they have to do it rather than the labouring person).

And yes ... we absolutely 100% want to be there for our clients (for as long as is humanely possible) but you need remember the old adage "Can't pour from an empty cup".

If you're not transparent with your clients; need to be able to sleep and tag team with another birth partner; need to breastfeed a baby/toddler, need to stretch your legs, eat or have a wee; need to attend a family event, then you're setting both your clients, and yourself up for a fall.

What are the ways you can remedy this situation?

1. Always be transparent about what you need to support them at your absolute best (I'm going to kip on the floor by the pool/ make me up a spare bed etc just in case it becomes a marathon birth). It’s important that your clients understand from the get go you’re a normal human being with normal human being needs. Also - your clients deserve the absolute best and this is you when you’re primary needs aer met too.

2. Be clear in your communication with clients - write stuff in your contract, discuss it with clients. The discuss it again and again until everyone is happy and comfortable with arrangements.

3. Don't take on births that you know may be tricky (got a family event in the middle of on call, baby/ toddler not sleeping through the night) without ensuring you have secured back up; and don’t take on births you don’t really, really want to do.

4. Do not spend the "birth" proportion of your fee until you've attended the birth. You may need back up (if you get sick or it goes on for a really long time) and they will need paying!

5. Ensure you have left you're client feeling like THEY are in control of their birth and THEY can rock anything - whether you're there to rub their back and provide continuity of care (or you're at home nursing a sick child/ fell down the well etc) and can only be there on the phone or your’ve had to call your back up.

6. Make sure its worth it financially - if it leaves you out of pocket because you had to pay for child care or your fee was eaten up in petrol … no one wins. Birth work won’t be sustainable for you in the long run and potential clients will be missing out on an amazing support system.

Birth work is the best work in the world (after 12 years of this I'm absolutely sure) but its also incredibly taxing sometimes. Make sure it works for you and your client. If you want support from our team of experienced doula mentors to ensure you’re doula business practices are sustaining you and your clients click here for mentoring support

Where our Doulas work. Pt.2. Jess of Oyster & Olive Birth Support

The second part of our feature on where our OBC Doulas are and what it’s like for them where they work.

Hi, I’m Jess of Oyster and Olive Birth support. I’m based in South Bristol but I cover all of Bristol and North Somerset

There are a lot of doulas in Bristol! But we are quite a close knit bunch. When meeting clients I do encourage them to meet as many as they can and will usually have met the others doulas they've seen already. It also means I can recommend another doula if I don't mesh that well with someone. That comes from knowing the people around me. It was a bit daunting in the early days, trying to make a name for myself. But I think coming from the OBC doula group, I felt more comfortable finding my voice in a group of other birth workers and not constantly feeling the imposter syndrome creep in!

We have two main maternity hospitals in Bristol and they are quite different (different trusts). We used to have a brilliant birth centre as well but I quietly don't feel that stoked about birth centres so I'm not missing it all that much! I have found that it has had to be a careful negotiation when working with these trusts. One has an excellent home birth team and I have got to know lots of the midwives on the team and we are becoming good friends and supportive of each other in our very different roles. The home birth provision by the other hospital isn't good at all, run by, often begrudged, community midwives, and less confident to support physiological birth.

My approach is definitely not an all-guns-blazing one. I make an effort to be kind and courteous to ensure the birth environment stays positive. But sometimes I do ask to have a chat outside of the birth room and try to make it clear that I am there to 100% advocate for this family and my ears and eyes are open! 

I co-host a Pregnancy & Parenthood drop-in group in South Bristol - a sort of 'come along if you fancy and have a cuppa and a chat'. I usually take a few books and props but so far the conversation has flowed nicely and they have been really great! I feel like it's important to offer this space for free - something really informal but where you could go with a newborn or when you felt a bit fed up in your third trimester! Sometimes people bring their older kids along and it turns into a bit of a playgroup! As well as this, I have started reaching out to other birth workers and related professionals to include add-ons to my doula packages. Things like pregnancy/postpartum massages, Mummy MOTs, postpartum food boxes. To try and create a network of people who offer different things so parents can see what's available to them but also really easy to access - I do all the bookings etc!

Finally, I volunteer for ProjectMama, supporting refugees and asylum seekers through their pregnancies, births and fourth trimesters. This is hard work, where a lot of time and attention needs to be offered. I have learned that I can only manage to support one woman at a time with this because they need and deserve a lot of care. This feels really important to me though, to balance my workload and be able to support them and work with this beautiful charity. 

It definitely helps me to feel enveloped in the birth world. To feel 'real' and knowledgeable. It also opens my experience net massively, just talking to people about their pregnancies and births. I hope it gives me some credibility as well!

The work also impacts my community positively! Our pregnancy group was shared by a few people on local WhatsApp groups and that felt great, like it was needed! 

In the greater Bristol community, the ProjectMama work definitely feels very important - raising awareness as much as anything else.

We know that it takes a village - becoming a parent can be so isolating, lonely and scary if you're unsupported. Not everyone can afford to have full doula support but luckily some can - and those that can fund the extra projects when the support can be extended out to everyone. Where I live in South Bristol we are a community - there is a high street with a bookshop, greengrocer, butcher ... the primary schools all come together for a lantern parade every year. The community centre is active and central. These things help us to bring the community together and our community is rife with families. Things like free drop-in groups can be a real life line, a way to make friends and merge into the community. This feels like a way to give back to a community that I was raised in and ensuring people don't feel the loneliness that is so often felt by new parents.

Where our Doulas work. Pt 1. Leanne of Doula Diary- Lake District

A new feature highlighting where in the UK you can find OBC Doulas, and what it’s like for them where they work.

I moved back to my home town of Ulverston, Cumbria just before Easter 2023. Before the move I was based in North Buckinghamshire. It was the right time for us to return as me and my husband wanted our daughter to have the gorgeous Lake District as their playground like we did as children. We now have another child due any time now and being back north has been blessing after blessing.

Cumbria is very much a “being in the know” kind of place. Once word of mouth takes hold it makes a huge impact on your reach and connections with people. People really appreciate value for money and having an opportunity to get out to a place that feels safe and inviting. That can look and feel very different to different people. I focus on who would benefit from connecting with me as this is my target audience. I want people to feel supported throughout pregnancy and beyond, have access to best practice information, be signposted to reputable organisations and groups and generally feel part of a community that understands the challenges they may face through pregnancy, birth and parenting. Even with social media and various marketing campaigns, lots of great support networks and free resources are overlooked unless you know someone who is in the know.

As a part of the move I’ve been reflecting on what it’s like working with my new local NHS trust (University Hospitals of Morecambe Bay). Compared to other trusts I have personal experience with and experience supporting clients with, the trust near me has been very open to supporting individual birth choices and working with families. I have been particularly impressed with the consultant midwife who is like a breath of fresh air and finds ways to overcome the barriers that policies put in place. The key things I’ve noted is that being informed is key. If you can demonstrate knowledge and your personal reasoning behind your choices, you will be heard. I have had the pleasure of working with clients and now I am on my own journey for a home birth after caesarean, with no monitoring or checks unless requested. This is unusual practice within the current nhs maternity model and usually results in people birthing outside of the system. To see such a proactive and sensible approach in maternity has been such a boost as I have come from an area where it feels like a real battle to be heard and have your wishes upheld.

Being accessible in different environments and to different people opens many doors. Most interest is sparked by a conversation. People gravitate towards you naturally. As I have a little one I find ways to be supportive in my community which doesn’t impact on my time with her. She enjoys the play dates and I enjoy connecting to other parents. I see it a little like networking. I’m a volunteer for doulas without borders and I have set up a free local parent meet up so others are able to come and go as they please to find connection and be signposted to reliable and helpful information on their journey, at whatever stage they are at.

I understand myself to be the only Doula within the south lakes, there are a handful of others doulas which cover the area and travel in but they do not offer a community or group gathering. We are all so different too and part of the OBC programme encourages you to find your own niche and personality within the birth world, being true to yourself really pays off. It has been a journey for me helping people understand the role of a doula and navigating the gaps that are missing in my local area so I know where I need to focus my energy first. Variety is limited here so bringing something new to the area has been lots of fun and encouraged some really great conversations around preparing for birth and postpartum.

When I moved away and had my first child I was so shocked at how isolated I felt, I missed real connection with like minded people, in an environment that focused on mums/parents rather than the baby. I really struggled with any form of baby sensory or play group. I needed adult time with my baby. This is why I took the extension to train in baby massage and hold circles. I wanted something practical to teach and build confidence in connection and soothing new parents and babies but I wanted to offer an environment which was focused on the parents and building their confidence. My classes are strip backed and a confidential safe space is held. This has given me confidence to generally hold space for others and parent connect was born which welcomes anyone at any stage. I have been so pleased that people have felt comfortable to come early pregnancy. It helps people grasp the role I can offer in pivotal points in their journey and having an offering which can support from fertility, birth then having a community space to welcome people has been a dream come true for me.