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Sophie Messager

Tag: doula

  • A four day long HBAC

    A four day long HBAC

    Caro and Santi (both from Argentina) had hired me and my co-doula Becky as their doulas.  They were planning a HBAC (home birth after cesarean) after having had what they knew to be an unnecessary elective caesarean with their first child.

    We met several times during Caro’s pregnancy, and built a lovely rapport together, getting to know them and their toddler son Max. They were both delightful and warm and friendly, and very well informed and researched. As Santi stayed at home to look after Max, I accompanied Caro to her hypnobirthing classes. This is the story of their birth, shared with their permission. It lasted 4 days, the longest birth I have ever attended in my 6 years as a doula.

    Day 1

    Caro texted us on Saturday morning (40 weeks and 5 days) to let us know that her waters had just broken. We kept in touch throughout the day.

    She lost some mucus around 10am, and started having mild, period cramp like contractions, soon after. She napped and ate, and rested throughout the day, keeping us updated.

    On their request I provided Caro and Santiago with evidence based papers to read about the risks of induction versus caesarean should they go beyond the 48h deadline after her waters had broken. Caro called the hospital around 10pm. They asked her to go in, which she declined. The hospitals send midwives to her home to listen to the baby’s heart instead.

    Caro declined a vaginal examination at this stage. The midwives booked an appointment for her on Monday afternoon at the hospital.

    Day 2

    Sunday morning around 2:30 am Caro texted us a screen shot of her contraction timer showing 40 sec to 1 min long contractions about 3 to 6 min apart. I called her. We agreed I should come and support her. I arrived at her house around 3am.

    She was having quite regular contractions but she was very “with it” and alert and I could tell this was early labour still. We filled the pool. Caro got in but things slowed down so she got out.

    Becky joined us around 7am. At day break things slowed right down. Max and Caro’s mother got up and join us . We shared a lovely breakfast of scones and jam.

    We hung out in the house/garden throughout the morning. It was a gorgeous, warm and sunny spring day.

    Caro was still having regular contractions but there were only 5/10 min apart. Santi and I went to get a takeaway lunch from a local South American restaurant.

    I went home around 3pm to get some sleep and spend some time with my family (it was my husband’s birthday that day). Becky spent some time lying in the garden with Caro, and rubbing her back during contractions.

    Caro messaged me around 9pm, contractions still irregular, and about one min long. I went to sleep after that. Becky had gone back home by then to rest too.

    Caro texted us around 10pm as her contractions were about 1 min long and 5/7 min apart. She found them harder to cope with. She messaged again around 11pm,by then her contractions were 4/6 min apart and 1 min long.

    Day 3

    Becky and I came back to her house around midnight. We spent another night of supporting her, both in and out of the pool. At some point in the night Caro experienced a lot of pressure in her bottom, and we got quite excited believing that baby was on his way, but it wasn’t time yet.

    I was amazed that Caro wasn’t exhausted at this stage, but somehow she managed to sleep between contractions and recover enough to cope. In the morning Becky went to sleep upstairs and I had a nap on the sofa.

    A midwife came in the morning to assess things. Caro agreed to a vaginal examination (she had been in labour for nearly 48h by now) and was found to be only 2/3cm dilated. I had a big wobble at this point. I also believed her baby to be back to back, hence the pressure in her bottom. The midwife also said that her baby was only 3/5 engaged.

    I suggested to Caro that she does some engagement spinning babies techniques, namely a technique called the bump lift, consisting in flattening her back against the wall and lifting her bump, and we also did some rebozo sifting on her belly. It seemed to help a bit, and her contractions got stronger. Becky and I had a chat and agree we should tag team and she sent me home to rest. At home I had some food then a nap, then came back at 2pm.

    I brought some loo roll with me as I’d noticed they’d run out, and I knew they wouldn’t find the time to go out shopping for some!

    Caro and Santi were snoozing upstairs when I got back. Becky told me they have agreed to a visit from the midwives, but that they only wanted to check the baby’s heart rate and mum’s vitals but not have any vaginal examinations, nor hear any talk about risks.

    Becky left and the midwives arrived. I met them downstairs and explained Caro’s wishes. They weren’t pleased by my request, and one of them said sharply that she had to tell her (about the risks) as she had a duty to protect the baby. I explained that after the previous talk of risks, Caro’s contractions stopped for over 2h, and therefore it really wasn’t a good idea. The midwives came upstairs. I crouched on the floor feeling like a mama bear, ready to pounce if the talk of risks rears its ugly head. Surprisingly, they did the checks and only mentioned to Caro and Santi that they needed to know that they are going against medical advice.

    At this stage, Caro and Santi agreed that they would go for a caesarean early the next morning (Tuesday) should she not have given birth yet. The midwives left.

    I carried on supporting Caro through the afternoon. Her contractions were still spaced out. Santi had a good long nap with Max Late afternoon I spoke to Becky and she told me to go home. We agreed we could have another night and day, possibly in hospital with a caesarean, after today.

    When I relayed our plan to Caro and Santi, Caro got upset and told me that I had lost faith in her, and she was right. I was by this point extremely weary and tired, and this affected my emotions a lot. I apologised profusely. Santi was also worried about doing bedtime without our support. I explained that we were happy to help but really need some sleep ourselves and Caro’s mum could support her during that time. I went home to sleep around 8pm.

    Day 4

    Becky called me around 1h30 am saying Caro was pushing. I got dressed and drove very quickly as I was worried I might miss the birth! When I got there I could tell Caro was nowhere near birthing yet. Her contractions were still not quite strong enough.

    Two midwives arrived at around 2am, both really lovely community midwives, calm and compassionate. One of them examined Caro and she was 5/6 cm dilated. This was hard for me to hear as I was really hoping she was ready to push her baby out! Caro carried on labouring through the night.

    When shift change was due to happen I explained to the midwives how important it was to have a supportive, confident midwife just like them replacing them. I asked for a particular community midwife whom I knew, and who Caro liked a lot. They organised for her to come :-). She was incredibly calm and supportive.

    We had a chat with Santi explaining that Caro’s mother needed to take Max out of the house for the day because Caro really needs some peace and quiet to get on with her labour. She left for the day soon after that. I went shopping for some food as we hadn’t got much left in the house.

    Sometimes in the morning, the midwife did another vaginal examination (in the pool!) and Caro was still only 6cm dilated and hadn’t progressed. This was a down point. I asked specific questions to the midwife, especially if baby was back to back and asynclitic, and she confirmed this. Her baby seemed to have completely more than one turn around the pelvis several times already, from being OP, then OA then OP again.

    I took my spinning babies handbook out of my bag again, and with Becky’s help (and Caro’s consent!) we helped Caro into an inversion. During about 3 contractions, I used my rebozo to do vigorously do shaking the apples on her bottom. It took all of us to support her through it, as you can imagine this wasn’t the comfiest thing to do at this stage. Then I did a sacro-tuberous ligament release and also a standing sacral release. Caro immediately said that she has felt the baby turn and that her back pain was gone. Her contractions cranked up big time and I knew we had changed things for the better.

    A vaginal examination around 3pm showed that she was 7cm dilated. Caro got back into the pool and carried on labouring. Contractions were really powerful at this stage, and I was feeling very hopeful.

    Becky supported Caro by saying ” longgg deeep slowwww breaths” as she had a few wobbles. Eventually Caro started to show signs of pushing 🙂

    Around 5 pm there was another shift change, I am worried because one of the midwives is the one who talked about risks the day before. I was worried that the change of midwives at such a crucial time could upset Caro’s labour. The midwife in question hadn’t given me a good vibe the day before. By then Caro has been pushing for a while.

    I suggested to Santi that he supports her pushing by standing on the edge of the pool with a rebozo around his shoulders for her to pull on. Becky tried to make sure that the other midwife, not the one we had a bad gut feeling about, came into the room instead but that didn’t work.

    So I worked hard on changing my feelings towards her to positive ones. Luckily she turned out to be much more relaxed than I thought. Caro carried on pushing.

    At some point she shouted “I’m fucking doing it”, and she sure was! She soon started feeling some stinging.

    Caro’s baby son Leo was born in the pool in her living room around 6h30 pm, after 4 days of labour. When he was born, the emotion in the room was incredible. There wasn’t a dry eye in the room, even the midwives were crying.

    I cried and laughed at the same time for the first time in my life, with the cheer joy and relief. It was the most incredible feeling. Becky and I hugged each other like loonies. I sobbed some more. I literally shook with it. This was one of the most emotional births I have ever been at.

    After the birth I suggested to Becky that she goes home to sleep straight away as she was still on call for someone else. I stayed to support Caro and make sure she and baby were comfy

    I help her take a shower, and she was elated by the fact that she could walk around straight after the birth- a stark contrast to her previous caesarean.

    Caro was soon tucked up in bed with her new son Leo, and a nice chunk of groaning cake.

    I left around 9pm with a huge smile on my face.

    Reflection

    When I reflect on this birth several months later, I am still amazed at Caro’s resilience, at her belief in herself, and at the unwavering support of her husband.

    I also can’t believe I managed to support them for that long, with so little sleep, if I had been told that the birth would have been this long in advance I’m not sure I could have coped with it. But in the middle of it you just dig deep and get on with it.

    This is also the first birth where I experienced my first true miracle with the spinning babies and rebozo techniques.

    I teach rebozo techniques workshops, and Caro’s birth completely changed my outlook and the way I teach. It really anchored in my heart that this simple tool can really work miracles.

    I went on to have several similar miracles with such techniques at other births (though not quite at long!) since. This birth also illustrates to the extreme the commitment doulas make to their clients, and how much emotional investment be put in this job.

    I asked Caro to share her incredible birth story because I hope it will give other women the belief that they too can have an incredibly empowering birth after caesarean. For doulas, this birth illustrates how awesome shared care doula support can be. I can’t imagine how I would have survived without Becky, both in the fact that we supported each other, and the ability to tag team and get some rest!

    The day after the birth, Becky went to a study day at the hospital, and she lost count of how many midwives approached her and asked “what did you do?” about the amazing effect of the inversion with the rebozo. I am hoping to train the midwives in my local hospital to do this too. Caro is now a life long friend and is planning to become a doula. When I think back about her birth, all I feel is tremendous gratitude and joy.

    Becky and I shortly after the birth

     

  • January : a time for rest and reflection

    January : a time for rest and reflection

    I’ve just had a lovely catchup with fellow doula Hazel Acland Tree with whom I have fortnightly accountability calls (I can’t recommend doing this enough by the way).

    During our call I expressed how frustrated I am with my desire to go forward and make plans now that we’re at the beginning of the year, and the energy I’m feeling instead, which is quite inward and not at all forward at the moment.

    Whilst chatting to Hazel I had a realisation that the energies right now, during the winter time, are indeed inwards, and that it doesn’t make sense that we are expected to make our yearly plans in January. We ought to make them in spring or summer, when our energy is high, and outwards looking.

    When I was a biology student, I went to a lecture on chronobiology, the science of “when” rather than “why” and “what”. This made so much sense to me and attracted me so much I ended up specialising in it, and doing my PhD and 2 postdocs on the genes the regulate our seasonal reproductive clock.

    I remember during the introduction lecture, the speaker explained that since we are regulated by daylight, our energy is naturally higher in the summer when days are longer, and that in the past, as most people farmed the land, they worked much harder during spring and summer than during the winter months when nothing grew. When school became obligatory, the farmers agreed to send their kids to school but said they’d need them back for the harvest, which is how the tradition of summer holidays started.

    Yet, even in our modern world, we still experience this annual peak and through of energy.

    Like trees losing their leaves and returning their energies inwards before the new growth can occur, we too, during winter, need this inwards and more restful time.

    As I talked about my plans and my frustration in trying to push through, but also about my knowledge that I want to lay down some feelings for the year ahead, meditate and make a vision board before I start getting down to the nitty gritty of what I’m going to do in 2019, my friend suggested very wisely suggested that rather than looking for the fruit I needed to tend to my roots first.

    I loved this very powerful image, especially as our culture is all focused on results, ie the fruits.

    But you can bear no fruits if you do not tend to, or nourish the roots.

    This also reminded me of another powerful story in the (surprisingly spiritual) book “The 7 habits of highly effective people” by Stephen Covey.

    ” Suppose you were to come upon someone in the woods working feverishly to saw down a tree.

    “What are you doing?” you ask.

    “Can’t you see?” comes the impatient reply. “I’m sawing down this tree.”

    “You look exhausted!” you exclaim. “How long have you been at it?”

    “Over five hours,” he returns, “and I’m beat! This is hard work.”

    “Well, why don’t you take a break for a few minutes and sharpen that saw?” you inquire. “I’m sure it would go a lot faster.”

    “I don’t have time to sharpen the saw,” the man says emphatically. “I’m too busy sawing!”

    Stephen Covey goes further in saying that

    ” Sharpen the Saw means preserving and enhancing the greatest asset you have–you. It means having a balanced program for self-renewal in the four areas of your life: physical, social/emotional, mental, and spiritual.”

    You can read example of such activities here

    There is true magic in stopping, resting and taking stock and seeing the forest for the trees.

    I have written about this topic before, but today I feel that I have embedded this knowledge at a deeper level.

    So I’m going to take my own counsel today and only attend to what really needs to be done, so I can rest and retreat inside myself a little, so I can tend to my roots.

    I know that doing this will allow for more beautiful flowers and fruits in the future.

  • Rebozos, shawls and scarves : the lost art of supporting women through the childbearing years

    Rebozos, shawls and scarves : the lost art of supporting women through the childbearing years

    RebozosI was introduced to the art of using a traditional Mexican shawl called a rebozo to comfort birthing women at my doula course by Maddie McMahon in 2008.

    Whilst I developed my antenatal and doula career, in my usual, knowledge junkie style, whislst I learn to use the tool for myself, I decided to learn as much as I could about this magic tool by attending training.

    Over the my first few years as a doula, I pursued my knowledge further by learning from several doula colleagues (I am especially grateful to doula Bridget Baker who showed me how to properly wrap a rebozo around a pregnant woman’s belly during a doula UK AGM).

    I attended my first formal workshop with Stacia Smales Hill on rebozo use for labour and birth in 2013. In the same year I also attended a workshop by Rocio Alarcon called closing the bones, a postnatal massage technique  which included rocking and binding with a rebozo.

    Frustration over long and difficult labours, and especially malpositioned babies led me to seek more specialist training,  such as the rebozo for labour progress and malposition with Selina Wallis, micromovements with Francoise Freedman, and 2 iterations of different levels of spinning babies with Jennifer Walker and Gail Tully.

    As my experienced developed I also brought more focus towards postpartum support, and recently attended a workshop on healing diastasis recti with Birthlight which included many rebozo techniques.

    I am also a babywearing instructor and tutor, and as such use rebozos and wraps to carry babies too.

    I started facilitating workshops around this topic because people asked me to. Repeatedly.  At first, I refused, as I didn’t feel qualified or experienced enough. But after a few years of constantly using this amazing tool in my birth work and my antenatal and babywearing classes, and seeing how the incredibly versatile such a simple piece cloth could be, and the miraculous experiences that ensued, I finally felt ready to start teaching workshops around this topic, because I had so many positive experiences I felt I needed to share this skill with others.

    As I met people through teaching, I constantly questioned people I met about their culture’s practises, I started to build a picture in my mind of something much more universal than the rebozo.

    It seems that every culture has (or had) a piece of cloth of some kind, call it a shawl, a sarong, a scarf, or a wrap.

    Cold countries have thick, woollen fabrics (think Welsh Shawl or Scottish plaid), and warmer countries, cooler, thin, cotton fabric (think African Kanga or Indonesian Sarong).

    There are almost too many fabrics to count, but one thing is for sure, women have used all sorts of cloths in incredibly versatile ways, and what I’m going to say below about the rebozo is true for many other cultures too. It’s a truly universal practise.

    I spent a few years believing that the rebozo use for labour was uniquely South American but I have since met a Somalian midwife who told me how they use their traditional shawl, called a Garbasar, in a similar way during labour.

    I trained a Moroccan birth worker in doing closing the bones, and she was surprised when she started offering the massage that women came forward and told her they’d had a similar treatment in the local hammam after birth (using the traditional Moroccan cloth called a Mendil).  Tunisia offers a similar practise called a fouta massage (the fouta is a hammam towel, which is very similar in nature to the Turkish towel).

    I am lucky to be part of a multicultural family, being French and married to a man from Hong Kong. In Hong Kong I’ve been told they use a long piece of muslin cloth to bind the woman’s hips and abdomen after birth, and my mother in law also showed me how she was taught how to use a towel to bind her hips and abdomen after birth.

    It’s also quite fascinating to see how contact with foreign cultures can influence each other. For example I recently acquired a Dutch postpartum girdle called a Sluitlaken. I couldn’t help but notice how similar to Indonesian postpartum binding it looks, then a friend pointed out than Holland used to have Indonesian colonies!

    So, what can you do with a rebozo, shawl or scarf of shawl?

    Pretty much all cultures on the planet, some kind of cloth is used to cradle and carry a baby. In some cultures is used to rock and soothe the baby too. Rocking is such a primal rhythm we all experienced it in our mother’s womb, that we find it soothing all through our lives.  Even in Europe there are pictures of women wearing their babies in Welsh shawls which date from the 1940s.

    Later, when the baby grew into a toddler and child, she would use the cloth to dress up, pretend play (including carrying toys and/or animals, pretending to carry a baby), make a den etc.

    As the child grew into a young woman she would use the cloth as a shawl to keep warm, as a clothing accessory, a blanket, to carry siblings ( in traditional cultures women learn baby care from a very young age as they tend to live with extended families), and to carry loads on her back or head.

    Later still when she became a woman, she might have been given her own shawl as part of a menarche ceremony. She might have worn a special cloth on her wedding day.

    When she became pregnant, she would have used the shawl to support her belly, and her midwives would have used it to alleviate the aches and pains of pregnancy, and maybe to help the baby move into the best position for birth.

    During labour she would have used the shawl to hang from, to pull on, and her birth attendants would have used it to provide comfort measures, such as sifting, rocking, shaking, and wrapping.

    After the birth she would have had a “baby moon”. Again this is something pretty much universal in the world-women the world around have been alleviated from household tasks and cared for by family members for the first 30 to 40 days postpartum. During this time they would rest so they could recover from growing and birthing their baby and get to know their baby and learn to care for them. Her birth attendants and the community of women would have come to feed her nourishing food, and close her bones and help her body heal from the pregnancy and birth by using  a combination of their hands, massage techniques and using the cloth to help move and bind her hips and abdomen to help them back into place. In the UK we used to have this practise called “churching” you can read about it here 

    She then would have started to use the cloth to carry her baby and start the cycle all over again.

    Later as she grew old, her family members would have used the cloth to rock and soothe aches and pain.

    Women would have been buried with their shawl using it as a shroud.

    So you see, a traditional cloth, rebozo, shawl or cloth can be used to support a woman throughout her whole life. It is a universal phenomenon on our planet.

    As the shawl came out of fashion and modern practises like using pushchairs became seen as more fashionable and desirable, this skill was soon lost, and because like most traditional women-only practises, it was just passed on orally rather than written about, the knowledge was lost very quickly, in one or two generations. We also tend to embrace “modern” practises mindlessly, seeing traditional ones as backwards and old fashioned.

    Mexican and Chinese friends tell me that nobody wants to use the traditional shawl or carrier these days as only remote farmers or beggars still use them. And certainly my recent trip to Hong Kong showed me that it took less than 15 years for the traditional baby carriers to have been almost forgotten and  superseded by more modern, yet less ergonomical, models.

    This is  something that we need to reclaim and teach all women, as it is part of the essence of women circles and supporting women through life transitions.

    This is why I am so passionate about passing this skill to both expectant and new mothers, and to anybody who works with expectant and new mothers. It is our birthright!

    How fitting is it that my friend Awen Clement just wrote this poem, for me it sums up everything the use of the rebozo is about.

    “We are all weavers

    Life is a cloth
    our stories the threads
    carried across the warp by breath 
    and memory
    Every soul
    unique in its tapestry
    with tangles unpicked 
    and rewoven anew
    A rainbow of colour
    where our threads meet others
    and when we take our last breath
    love will weave the ends”

    (C) Awen Clement 2018

    You can learn more about rebozo and its many wonderful uses in my online course

  • rebozo master class

    rebozo master class

    I did a 45 min rebozo master class on facebook yesterday and I have uploaded it so you can watch it here

    Play

     

  • What do you get when you hire a doula, or why she’s totally worth the money

    What do you get when you hire a doula, or why she’s totally worth the money

    This week I saw this meme.

    It made me want to write about what you get when you hire a doula.

    The birth/wedding spending is a very well known analogy in the birth world. Most people spend A LOT more time and money planning for their wedding day than they do for their birth.

    I’ve written about this before here.

    So why do I feel compelled to write about why doulas are worth the money?

    Because I keep hearing/reading stuff about the fact that doulas are expensive.

    This simply isn’t true.

    The fact that people are reluctant to invest much time and/or money is preparing for their birth is a reflection of the low value our culture places on motherhood, and of a lack of understanding of the impact that birth has on women, and on society as a whole, but this is a topic that deserves its own blog post.

    I’ve written recently about the value of a doula, but this time I’d like to explore and explain what you really get when you hire one and why it’s worth every penny.

    My friend Maddie McMahon also wrote a brilliant blog about doulas and money this week.

    And doula SallyAnn Beresford also wrote about budgeting for your birth.

    I’d like to correct some misconceptions about doula work and its worth.

    I think the biggest misconception is that you hire a doula to support you through the birth of your baby and that’s all that matters.

    Recently a colleague was asked how much she’d charge to only come to the birth, and do no antenatals.

    This has happened to me too and I had to explain it just doesn’t work like that.

    Much of the work we do is in the preparation, the getting to know you and the support and information we give prior to the birth.

    I saw another meme last week that summed it up very well “the power of a birth plan isn’t the actual plan. It’s the process of becoming educated about all your options”.

    It’s a big myth that there is no point writing a birth plan because birth is unpredictable (and I encourage all my clients to write 3 births plans (Read about this here)

    So back to what you get from your doula, and I’m in the thick of it at the moment as I’m supporting a woman pregnant with twins and one planning a VBAC , one having her first baby, one having her 2nd baby and one having her 3rd (they are not all due at the same time!).

    The minute you hire a doula, she’s completely dedicated to you.

    Whilst most of us have letters of agreement that cover a certain number of antenatal appointments, we also state that you get unlimited phone and email support from us.

    These days I’m in contact with my clients via email, text, phone and whatsapp groups.

    All this work can seem invisible because it’s not face to face, but I spend hours for each client beside the face to face meetings, researching information for them, on whichever topic they need information about.

    I send them various signposts, from online articles, examples of birth plans I’ve collected through the years, books etc. I contact other people for information when I’m facing a situation that is new to me (this happens all the time by the way as everybody is unique).

    I help them write their birth plans, reading through and making suggestions about things they haven’t thought about.

    I send them up to date hospital policies that I’ve managed to collect through my knowing of the right person to contact at the hospital.

    I lend them books and DVDs, slings and other pieces of equipment.

    I signpost them to the huge network of midwives, doctors, osteopaths, massage therapists, and other complementary practitioners that I trust and with whom I’ve built links over the years in my community.

    I suggest they meet with a different consultant or with the consultant midwife, and I often accompany them to the appointment.

    I’m truly passionate about this (and all the doulas I know are too), so I put absolutely no limit on the time I spend doing this.

    With more complex pregnancies,  it can mean an incredibly high number of hours.

    And of course I meet face to face with my clients at least twice antenatally (not including the first time we meet for an interview).

    I prepare extensively for these appointments, discussing what they want ahead of time and preparing the right props to take with me.

    I listen deeply to their wishes, their concerns and worries, and I try to provide the information that maximises the chances of them achieving these wishes.

    This is the antenatal prep.

    Then there is the on call period. Most of the time we go on call from 38 to 42 weeks pregnancy, or until the baby is born which can be longer than 42 weeks.

    This means that for up to a month (it’s pretty rate that it’s shorter than 2/3 weeks especially for first time mums, and I’ve been on call for 5 weeks in the past), we are on standby 24/7.

    We literally put our life on hold. We don’t go away more than an hour from our house. Most of us have young children ourselves so we have to make very complex childcare arrangements to be able to drop everything and come to your whenever labour starts (including at night). We can’t drink alcohol, even at a party. We can’t let our hair down. We tell all our other professional engagements that we’re on call and may need to cancel at short notice (“unless I’m at a birth” becomes a recurrent sentence).

    We pack clothes ready for the next day so we are ready to disappear in the middle of the night when needed. We need to be careful what we wear in case we have to hot foot it to the birth. We repack our doula bag, making sure everything we need is in there, and replenishing supplies.

    Our phones are glued to us 24/7, and placed on the bedside table at night (And we’re always making sure the battery is charged).

    We sleep less well (we experience a level of heightened alertness and often wake up at night to check our phone in case we missed a text/call from you). We always make sure we are reachable, are paranoid about phone reception which something means giving someone else’s landline just in case (some clients live in areas with poor mobile reception).

    Our clients are always on our mind. We care deeply for you at this vulnerable time.

    We know that we might need to come to you very quickly when labour starts. We never know when.

    We have to remind our partners of the fact that we may disappear in the night or day, and make sure they know what’s happening with the kids etc.

    Our partners and children find the unpredictability difficult to handle ,especially as they don’t know how long we’ll be gone for.

    We keep telling our friends and family : if my client calls I’ll need to go. I choose to take the car instead of the bus when going to town, incurring extra parking charges, because I want to be as quick as possible in case I get called, plus my doula bag is usually in the car and it’s really big. I have to remind my kids when we go to the park or the cinema, remind my husband when we go for a rare meal out. Several times I have had to tell my choir leader at the beginning of a concert that if I may need to disappear.

    We miss study days and conferences we have paid for because we don’t feel safe going that little bit further away in case labour happens during that time.

    It takes a very special kind of person to cope with this level of unpredictability and low level tension on a constant basis. It gets easier as you become more experienced but it never quite get to the state when you feel completely relaxed.

    The on call period is up to 30 days, 24h a day. This can mean a total of 730h or more. So if you think that my birth package starts at  £950, one third of which is for the on call period, that’s 316 divided by 730, which amounts to 43p per hour. Not exactly minimum wage hey?

    Then there is the birth itself.

    I’ve been a doula for 6 years and the shortest birth I attended was about 3h long (I always stay a few hours after the birth to make sure mother and baby are ok and help with establishing feeding etc, so I was there for 6h). The longest was 4 days. The average was 21h.

    We spend hours supporting you and your partner, holding you, massaging you or whatever other comfort method helps at the time, managing on very little sleep and food.

    We help you navigate unexpected curve balls. We stay strong. We cheer you on.

    We have a firm commitment to the families with support and we’re not going anywhere until the baby has been born.

    When we get home after a birth, we often take days to recover.

    Then there is the post birth support. I offer a minimum of one postnatal visit and unlimited phone and email support for 6 weeks after the birth. I also offer standalone postnatal support for an hourly rate of £25.

    Some parents take to parenthood like a duck to water and require very little support from us. The shortest postnatal job I’ve done was a one-off visit of 3h. The longest one was 2 years.

    Some parents have very complex situations to deal with and this can mean hours of support.

    I recently supported a new mother of premature twins so she could achieve her goals of breastfeeding them and this took much hard work, sweat and heartache, with incredibly rewarding results at the end.

    Some parents struggle with feeding, with adjusting to being parents, with sleepless nights, with conflict with their partner, with being a single parent, with complex medical situations and more.

    We’re there for them and we don’t go anywhere until we have helped them achieve their goals. We move heaven and earth, we reach out to other knowledgeable people, we spend hours talking and researching topics.

    I haven’t written this to moan about it all and I sincerely hope it doesn’t come across this way.

    I do this because it’s all worthwhile and I don’t resent it.

    I do this because it’s a calling and because I care about birth, and about women.

    But I just want you to know what it means to be a doula, and how challenging it can be at times.

    I want you to know that when you hire a doula, she puts her life aside for you for weeks or even months at a time.

    Because you are worth it.

    And your doula is worth it too.

  • On being an independent doula and a proud member of Doula UK

    On being an independent doula and a proud member of Doula UK

    I wrote a blog about what it means to me to be a member of Doula UK

    https://doula.org.uk/on-being-an-independent-doula-and-a-proud-member-of-doula-uk/

  • The miracles that happen when you have no expectations

    The miracles that happen when you have no expectations

    As I write this, I just came back from the annual doula retreat.

    This year was my 6th year there.

    I’ve written about the retreat before here.

    Organised by doula Selina Wallis, the retreat is a unique space for doulas and birthworkers to gather and recharge. It’s held in the most magical place. Cae Mabon is an eco retreat located near Llanberis, in Snowdonia. It’s a ten min walk down from a car park located at the end of a dirt road.

    Located on the side of a mountain, with a stream running on its side, and a lake at the bottom, the eco village is composed of dwellings that look like they belong in a Tolkien novel. One of them, in fact, is called the hobbit hut. Low ceilinged, and with grass growing on their roofs, the dwellings are dotted around a clearing in the forest.

    The dwellings are basic, containing about 4 beds each, and there is no running water or electricity in most of them (there is a shared washroom and a gas powered shower, and compost toilets). This maybe off putting for some but for me it’s part of the charm of the place, because it encourages us to spend much time outside.

    The place it’s in is just beautiful, with wild, ancient forests, and nature untouched by humans.

    There is a deep feeling of reconnection with nature, and the place is not only beautiful and peaceful, but it has a lovely, benevolent and calming energy too.

    As well as the huts we sleep in, there is a Viking style roundhouse with fire pit in the middle where we gather to sing songs, drum or listen to stories, from our resident storyteller, Rachel O Leary.

    There is a barn/kitchen with electricity and we take our meals and workshops there too. Someone is cooking for us whilst we’re there, which is bliss in itself for a mother like me.

    And the cherry on the cake is the fire heated cedar hot tub on the side of the stream, in which we hang out at night with a glass of white and put the birth world to rights.

    All of this would be blissful enough by itself, but we also have workshops there.

    I can trace almost every single aspect of the work I do today back to the retreat.

    The first year, in 2013 I attended the Closing the Bones workshop with Rocio Alarcon there. If I had been told back then 6 years later, I would have, together with Maddie Mc Mahon, trained nearly 350 people in offering this beautiful ritual, I would have laughed.

    But back to this year’s retreat and the title of this blog.

    This year I wasn’t as excited as I’d been in years past about the workshops planned at the retreat. We had a singing workshop and a Henna workshop booked. Singing is always lovely but I’ve been singing in a choir for over 16 years so it’s not something that’s new to me. Same with the Henna as we had done this already at the retreat in 2014.

    I was still looking forward to hanging out with like minded spirits in Cae Mabon this year, but I was also a bit disappointed about not learning amazing new skills.

    As with many other occasions in my life, when my expectations are low, it’s usually when I end up having a complete life changing experience.

    It wasn’t part of the official plan but when we got there, Alexandra Wilson, a celebrant, doula and end of life doula, offered to do a talking about the end of life doulaing training that she does, followed by a grief ceremony the next day.

    As with many topics and experiences I know little about, I was curious but not overtly excited.

    I went with my usual curiosity though.

    The talk about death doulaing blew my mind, because Alexandra talked about her experience moving from being a death doula to a birth one and talked about the similarities about the grief in birth and in death, and about the joy too. I didn’t get it so I asked a lot of questions and also for examples. I had never seen it through that angle, and by the end I got the concept of the grief in birth (namely the huge changes for both baby and parents), and for the joy in death too. She presented death in a completely different way to my own mindset. She explained that the more she worked with death the more she saw death as a welcoming big mama rather than the grim reaper most of us have in mind.  It made sense to me, after all, if you believe, like I do, that we are all spirits having a human experience, then all we are doing when we die is returning to the lovely place we came from.

    The grief ceremony blew even more of my mind away. After taking us through a guided meditation through the different doorways of death, Alexandra placed 4 objects representing tears, fear, numbness and anger on the floor and invited those of us who felt drawn to come forward to hold the objects and express their feelings. Something very interesting happened as we all shared loud, messy powerful emotions and tears, without the need to speak, each one of us sending and receiving what we needed. I was reminded of Brene Brown’s book, “Braving the wilderness” when she says that we need to share collective joy and collective pain

    ” Funerals, in fact, are one of the most powerful examples of collective pain. They feature in a surprising finding from my research on trust. When I asked participants to identify three to five specific behaviors that their friends, family, and colleagues do that raise their level of trust with them, funerals always emerged in the top three responses. Funerals matter. Showing up to them matters. And funerals matter not just to the people grieving, but to everyone who is there. The collective pain (and sometimes joy) we experience when gathering in any way to celebrate the end of a life is perhaps one of the most powerful experiences of inextricable connection. Death, loss, and grief are the great equalizers.”

    Alexandra then held the object herself and expressed her emotions loudly and powerfully. I had the realisation that it didn’t matter that I hadn’t gone to hold the objects myself (I had been drawn to so but had hesitated : something had held me back and I had come to understand that others needed it more that day), because when she cried, she cried for all of us, when she screamed in anger, she screamed for all of us.

    I’m 48 years old. I’ve never seen a dead person, because as a child when people died my family sheltered me from it, believing it was the best.

    The grief ceremony felt like it was the most powerful experience of shared grief I had ever had in my life.

    The following day still we had yet another unplanned workshop. A woman called Samina who works at Cae Mabon did a movement/dance workshop for us. Again I didn’t expect much but it was another incredibly powerful experience as we moved silently and in an undirected manner as a group. I shed a deep layer of lack of self love during that experience. We all have deep rooted fears of not belonging and not being loved, so when during the danced we had to pair, fears around lack of self love I have been working on for well over 2 years (since I took my Reiki Master training) resurfaced, and once again I was the little girl who was worried about not being picked and not having a partner. Only this time it didn’t happen and I had a deep realisation that a layer had been peeled away. Just like that. Difficult to put into simple words, but it was instant and deep, yet the culmination of many months of work.

    I came away from this retreat a different person, feeling I’d healed deep wounds and peeled away layers of myself I no longer needed.

    Once again I was shown the magic that can happen when you have no expectations

     

     

     

  • Why a rebozo, shawl or scarf might be the most powerful tool in your toolbox

    Why a rebozo, shawl or scarf might be the most powerful tool in your toolbox

    Why a shawl or scarf might be the most powerful tool in your tool box

    Over the last 8 years, since I started my reconversion in the world of science to that of a birthworker, the one tool that has amazed me the most is the humble shawl or scarf.

    You might know it foremost as a rebozo, which is a Mexican shawl, traditionally used by Mexican midwives to provide comfort and support to pregnant and birthing mothers.

    But to me, it’s much more universal than that.

    All through history, women have traditionally used shawls and scarves for all sort of purposes, from clothing to carrying and indeed providing comfort, but not just for the childbearing year.

    Lately I have felt a drive, actually a real sense of duty, to pass on this skill.

    This is because I have been having one amazing experience after the other using shawls of scarves.

    “Recently, I supported an amazing woman through a very long birth at home, which also happened to be a VBAC. She laboured for 4 whole days. Through the early parts of her labour, I used my trusted rebozo scarf to relax her belly and help engage her baby. On the last day, when she got the dreaded “stuck at 6cm” situation (her cervix seemed to remain dilated at 6cm for several hours, with no further progress), a simple inversion with sifting on the buttocks through a few contractions, completely changed the pattern of her contractions for the better. In fact, when she got back her from her inversion, she said “My back doesn’t hurt anymore”, the midwife confirmed shortly afterwards that her baby had turned in a more optimal position, and she roared her baby out in the pool a few hours later. There wasn’t a dry eye in the room when that baby was born. I have no doubt that the rebozo technique made a big difference to her labour progress.”

    I had heard of amazing stories like this one at the various rebozo and Spinning Babies trainings I had attended, but this was the first time  I had my own experience of a miraculous difference like this, and it really drove the message home.

    Since I starting showing families how to use a shawl or scarf for their own comfort, I have received many more testimonials of the same nature.

    Jess used a shawl to great use to comfort herself during labour

    ” I was in labour recently, homebirth, my husband squeezing my hips was helping so much to keep me grounded. At one point our younger son woke up, this was late at night, and my husband had to go to him to settle him. Right at the same time I had a massive contraction while I was bouncing away on the ball and desperately thought, “OMG, I need pressure on my hips now!” I also happened to be sitting next to a box of wraps, so I grabbed one out and did the hip squeeze on myself. It was super helpful and really empowering at that point to remember I had so many tools in my tool kit to draw on and I totally could rock this birth”

    Recently, after sending a rebozo to a mum who suffered from PGP, I got the following message the next day ” It’s the second time I’ve had pgp. I was induced early because it was so bad and this time is even worse! Your videos were the first time I had ever heard of rebozo or using the shawls to wrap your hips and thought that anything was worth a try as I am in such horrendous pain. Since using the wrap I have been able to do shopping and walk around without crying in pain, it makes a huge difference, so easy to use, looks pretty and I love that I can use it during labour and after the birth as a sling!” Hannah

    I also offer and teach a postnatal ritual called closing the bones, which involves some hip rocking with a rebozo shawl (or a manta as it is called in Ecuador, which is where this particular massage comes from) a massage of the abdomen and wrapping.  The experiences women have with this ritual can be life changing.

     

     

    Here are some examples of what women have said after receiving it:

    “The massage felt incredibly calming and nurturing and I felt very relaxed (almost went to sleep!) I felt a lot of tension which I was holding from the birth just disappear. “

    “Amazing, emotional and cleansing. I feel very supported as a new mum and feel hugged by the love this ceremony brings.”

     The massage and rebozo wraps not only felt absolutely amazing, they also helped remind me of the importance of caring for myself. During the ceremony, I felt so safe and comfortable and at peace, and I was aware of how strong, resilient and loved I am. “

    You can read more here 

    In terms of using it to carry and calm babies, I have also lost count of how many times I’ve seen parents with this wonderful look on their face when they realise they can meet their baby’s needs for closeness AND get their hands back. And, as a doula myself, I recently supported a mum of twins,and I found it pretty elating to be able to carry both twins together in a stretchy wrap!

    So you see I have accumulated many more stories like these, more than I can share here.

    I have a innate desire to share knowledge (funnily, it’s even in my name, Messager means Messenger in French) so others can benefits from it too.

    I started teaching live rebozo workshops a couple of years ago but there is only one of me and whilst I travel up and down the UK to offer it, I wanted it to be available to a wider audience.

    Today I am proud to announce that my rebozo, shawls and scarves course is now available as an online course-which you can find here.

    This means that I am now offering 3 different levels of training, an ebook,  the online course, and a live course (link coming up at 9pm tonight!). (and of course, I also have a my online rebozo shop too)

    If you’d like a short taster of what’s available in my training, just sign up to receive a free guide with 3 different rebozos techniques on my website here

     

  • What’s in your doula bag, and does it really matter?

    What’s in your doula bag, and does it really matter?

    When I started working as a doula nearly 6 years ago, I spent much time researching what other doulas had in their bags.

    I loved looking at blogs and getting ideas from other more experienced doulas.

    I discovered and bought much stuff, from honey straws to massage tools.

    Interestingly, many more experienced doulas told me that my bag would get smaller as I got more experienced. I didn’t question that, they had been doulaing for longer than I had, so they must have been right.

    I started with a smallish tote type bag (pictured above).

    But this soon became too small, and the tote bag is now my antenatal appointment and postnatal doula bag.

    I also had a period of having a spare sports type bag in the car with change of clothes, and heavy stuff I could only use at homebirths, like microwaveable rice bags.

    I moved on to using a rucksack.

    The problem with the rucksack is that, whilst it was roomy, getting stuff from the bottom meant emptying the whole bag. This annoyed me.

    When my friend Maddie raved about her skip hop twin duo bag, I got myself one off eBay too and tried that for size.

    But I still needed something bigger, because I couldn’t close the skip hop bag once I had put all my stuff in it.

    Also, I like things to be organised in different compartments and being easily accessible and organised.

    So last year, when I bought myself a new gym back called a Workplay bag (aptly named “the goddess” bag!), I realised it would work very well as a doula bag. Workplay bags are expensive but I got mine second hand on eBay for about £20.

    It’s great, there is plenty of room and it’s very organised and easy to find stuff. The only problem is that the bag is very heavy when full, and I cannot carry it on my back and still have my hands free for my client mid contraction when we walk from the car part to the hospital. I’m now toying with the idea of buying something on wheels, I’ve been ogling a midwife friend’s new Zuca bag…

    Interestingly because my bag has so much kit, I’ve shied away from sharing it online over the last couple of years, because so many doulas say they take almost nothing with them at a birth, that I felt that I was somewhat a lesser doula for having so much kit, that there was something wrong with me.

    So I’m super grateful for doula Staci Silvan to having stated that she likes to bring a lot of kit in her bag, and to Zara de Candole, for saying that she should embrace all the kinds of doulas, the ones who just bring themselves, and the ones who bring everything but the kitchen sink.

    It’s interesting how most of us can’t help but judge and compare ourselves to others, instead of seeing the beauty in the amazing variety of uniqueness each one of us brings.

    So I’ve decided to embrace the fact that I am a “hoarder” kind of doula, and not be ashamed of my enormous doula bag.

    I’m coming out as a big doula bag doula 😉

    The thing is, I am also a fully paid up member of the “doulaing is about being not doing ” school.

    I know that the most important thing I bring to the table is me, and how I hold the space for the woman during her labour and birth (which is also why a large chunk of the contents of my bag are actually designed to keep me going rather than for my client)

    Most of the time I don’t take much stuff out of my bag at all. But I’m the kind of person who would hate not having something available if I knew it could help.

    I really want to emphasise the fact that, (especially as I’m a doula mentor and the last thing I want is my mentees to think that they need to have everything that in my bag-it’s not about me), I am not writing this post to encourage you to do it like me, or to say that my doula bag contains the perfect kit.

    But I often see posts from new doulas asking what people have in their bags, and I know how useful it was for me when I started, so I want to pay it forward, because I think it’s really helpful to have it in a link that’s easy to find rather than trawl through stuff on facebook.

    Just remember: This is my kit. It fits me. This isn’t necessarily the kit that is right for you.

    I would like to encourage you to look at my very large amount of kit, and and thing to yourself: do I need this shit? Do I want all this stuff in my bag?

    You may want to experiment and try it for size, and when you realise that you like something, then by all means keep it, but also feel free to dump it when you realise it’s not working for you.

    Heck less than a week ago I went to a birth with only my handbag-it was for an elective cesarean and I knew it was likely to be short and that I wouldn’t need my labour comfort bits and bobs.

    Let’s embrace variety and celebrate all doulas, the ones who go to births with just their handbag, and the ones who go to birth with a ginormous bag, and everybody else in between!

    The right doula bag is the one that is right for you!

    Here is my current birth bag. I know it’s big but I love it!

     

     

     

     

     

     

     

     

    Here are some other doulas who favour big bags

     

    Staci Sylvan who is another member of the big bag club, sporting her doula bag, which a Stanley tool bag

     

     

     

     

     

     

    Zara de Candole another fan of big doula bags

     

     

     

     

     

     

     

    And for balance, here are some examples of doulas who prefer  small bags!

     

    Eva Bay and her basket (Cards, rebozo, notebook, diary, birth beads and water)

     

     

     

     

     

     

     

    Mars Lord and her tote bag

     

     

     

     

     

     

     

    Amber Strong and her handbag style doula bag (contains snacks, lip balm, essential oils and homeopathic kit, straws and honey. For me – clean underwear, deodorant, mints, charger and purse)

     

     

     

     

     

     

     

    And if you’d like to know what inside my huge bag here are some pics

    My antenatal/postnatal bag (pictured at the top of this blog) contains a small pelvis and baby, a beaded birth line and client notebook (for antenatals), a small knitted boob, baby and syringe, to explain hand expressing/positioning, some slippers (I hate getting cold feet), and most importantly, some good quality, dark chocolate (I once got caught up without chocolate at a postnatal job, mum was taking a nap, baby was asleep in the sling (I usually chuck a stretchy wrap in my bag too), I’d done what I needed to do and was having a cup of tea and there was NO chocolate-never again).

     

     

    The snack section. It’s all for me, so I can keep going when I am at a long birth and can’t get away. Hospitals are a very dehydrating environment so I have a Hydaway collapsible silicone water bottle. I’ve tried plastic water bottles in the water and didn’t like the taste they gave to water. It’s much more convenient than the horrible polystyrene cups from the hospital, and also helps in not creating more waste. I usually add some squash or some sports tablets in the water too, to encourage more drinking (has to be balanced against not needing to pee every 5 min though) I also have a Pokito silicone collapsible coffee cup, for pretty much the same reasons I highlighted re water. Good coffee is important to me (hospitals usually only have the most vile cheap brown powder instant coffee) and I love the coffee “teabags” from Taylors of Harrogate. I have some cereal bars, some nuts, and sweets and other high calorie, nutrient dense stuff.

    The “therapy” section of my bag. Helios homeopathy childbirth kit, rescue remedy pastilles, essential oils in a tiny little keyring pouch (I take lavender, clary sage, peppermint, frankincense, and Katseye blend 10 and 1) , sports tablets, earplugs and eye mask, washcloths, honey straws, various smelly sprays and roller balls and crystals and amulets (mostly for me), and a homemade poo-pourri (a small, essential oil based product to spray onto the toilet because you do a poo-so if your client goes in straight after you it doesn’t stink), and some disposable gloves just in case. The little pouch on the top left had toiletries for me, toothbrush and toothpaste etc.

     

     

     

    The birth pool kit: plastic mirror, thermometer, collapsible jug to pour warm water on the mother’s back, torch, and a wet bag.

     

     

     

     

    The comfort measures section: wheat bag, birth ball pump, portable air conditioning unit, fairy lights, massage balls (got mine really cheap in Tiger), small hot water bottle, portable essential oil diffuser.

     

     

     

     

    The spare clothes section: tshirt, knickers, socks, leggings, swimsuit (in case I need to go in the pool with mum)

     

     

     

     

     

    The comfort/rebozo section: 2 rebozos (you can buy some here), one blanket and one poncho (for when both me and mum or dad feels chilly in the middle of the night, I once lent both my poncho and blanket to cold midwives at a homebirth, and wrapped myself with my rebozo), one cooling towel for when mum feels too hot, a couple of inflatable neck travel pillows (handy for a labour nap for me or the partner, especially in hospital)

     

     

     

     

    A shewee. Sometimes the labouring mother loves to labour on the toilet. If you’re in a flat this might be a problem for the doula, hence this handy piece of kit (I have not had to use it yet)

     

     

     

     

    The book section-speaks for itself

     

     

     

     

     

     

     

    And I also always take two more things with me at a birth: when I go on call, I bake and then freeze a groaning cake for my client, and I also freeze myself a sandwich made with something that won’t perish quickly at room temperature (like cured ham and cheese). I take these with me when I get the call (the sandwich is for me). Once the baby has been born I share the cake between the parents and the midwives.

    Update November 2018: I finally got a bag on wheels as my big gym bag was getting too heavy to carry comfortably. It’s a Santoro wheelable craft tote.

     

  • The value of a doula

    The value of a doula

    3 years ago I wrote my first blog post, in response to an article in the independent, accusing doulas of being money grabbing opportunists.

    Today I feel compelled to write another blog post, as this time a medical professional is saying that we charge “extortionate prices”.

    Dr Ahmed Rashid, an NHS doctor, wrote this piece in the British Journal of General Practise

    ” I first came across a doula as a junior doctor working in obstetrics and the idea has fascinated me since. In case you haven’t heard of them, they are trained or experienced lay women who provide social, emotional, and practical support during pregnancy and birth, but do not provide any clinical care. Although the practice has ancient origins, the modern doula movement began in the US in the 1970s and private doulas, hired by mothers (often for extortionate prices), have been popular in certain parts of the UK for some time. A recent Oxford study focused instead on volunteer doulas, trained by third-sector organisations. After interviewing 19 doulas and 16 mothers who had received their support, the authors concluded that they can play an important role in improving women’s birth experiences by offering continuous, empowering, female-focused support that complements the role of midwives, particularly where the mothers are disadvantaged. Perhaps it’s not such a bad idea after all.”

    The part of this piece that triggered me, was the ” often for extortionate prices” comment.

    Nothing could be further from the truth.

    When I left a prestigious career in science to become a doula (you can read why I did that here), I also left behind a salary over 40K, regular and predictable working hours, and job security.

    I did this to follow a calling, something that pulled at my heart, the deep need to support women through birth and make a difference to their experience.

    I sure didn’t do it for the money!

    I started as a new mentored doula (Doula UK, the association of doulas in  the UK, has a strict mentoring process  in place, which means that new doulas called themselves mentored doulas, and usually charge lower fees to reflect this, until their mentor feels that they have acquired enough experience and  can become recognised doulas), charging £250 for a birth.

    When I wrote my first blog post, after 2 years as a doula, I was still not earning enough to pay tax.

    Now, 5 years down the line, I only just paid my first tax bill. And this wasn’t because of my doula work, this was because of my other  hats, in particular the fact that I teach workshops. Most of us have “side jobs” to complement our income, because it is very difficult to make a decent living at a doula.

    5 years down the line, I am still quite far from earning what I earned as a scientist.

    Doulas charge as little as £300 to as much as £3000 for a birth. On average, most of the recognised doulas I know charge between £600 and £1000 for a birth.

    My birth fee now starts at £950.

    What does this include?

    This includes several antenatal meetings (those tend to be at least a couple of hours each), and unlimited support on the phone/email, accompanying clients to medical appointments etc. Whilst I offer a system with a set number of appointments, I find that I cannot restrict my support when a woman needs it. For example, I have been supporting a woman pregnant with twins , there have been many complications to her pregnancy, and I have attended well over 10 appointments with her. I am also in contact with her several times a week. It takes a lot of headspace, and I am more than happy to do it, but, with this in mind, it is easy to understand why I feel so rattled by the accusation of money grabbing.

    At 38 weeks, I go “on-call” until the baby is born. This can be a week, 2 weeks, or up to a month or more. The majority of my clients are first time mothers, and on average they tend to birth beyond 40 weeks (last year, one of my clients birthed at 43 weeks so I was on call for 5 weeks).

    During this time, I need to be able to leave everything and go to my client at very short notice when she goes into labour, at any hour of the day or night. I (like most of the doulas I know) have young children so this means complex, multilayered backup childcare arrangements, sometimes including at night (which cost money).

    Whilst on call, my phone is always with me (I even bring my phone to the side of the pool whilst going for a morning swim so I can check half ways through that she hasn’t called). I cannot go anywhere more than an hour away from home. I do not drink alcohol, and I always tell everybody I have made plans with that I’ll come “unless I’m at a birth”.

    This also means that there is a lot of pressure on my family and social life, as births have to take precedent over almost everything. This means always knowing that I may not make important family events, like birthdays or other celebrations (yes even your kids). My husband and I rarely go out and I have had to cancel a rare evening out more than once as I was called to a birth. Being on call makes us lose “brownie points” with our friends and family – who as much as they try and understand it, still find it stressful. I remember once during a difficult on call period (my client was a repeat client and her first birth had been very traumatic, and I was very invested emotionally in making sure this didn’t happen again), my parents were visiting and my mum said “you’re not there”-meaning I was physically present, but mentally, I was with my client.

    The on call period, up to 30 days, 24h a day. This can mean a total of 720h or more.

    When on call we also tell all our other clients, including the ones who have hired us for postnatal support, that we may need to cancel at short notice. Of course, when we get called to a birth, it also means that we lose out on the money we would have earned for supporting other people that day.

    Then there is the birth. Many of my clients are first time mothers, and it’s quite normal for a first birth to take anything between 24h and 48h. One year, all the births I attended were between 30 and 40h long (that’s the length of time I was with my client). The shortest birth I have ever attended was about 3h long, but I was there for 6h because I always want to make sure the mother is settled and her baby feeding well etc before I leave. The longest was 4 days (a long induction).

    Then after the birth I make a postnatal visit (again at least a couple of hours), and I am available for 6 weeks for unlimited email and phone support. New mothers contact me for support, for example when feeding isn’t going well, and I do everything I can to help them. I put no limits on the hours I spent doing this. This means many unseen hours talking to them, sending them links, and signposting them to other professionals. For example, last year when my nephew’s daughter was born, and they had problem with breastfeeding, I couldn’t support them myself because they lived too far, I spent a couple of hours late at night, when I should have been in bed. contacting my network of doulas, until I found a breastfeeding counsellor who was able to visit them the next day. We doulas constantly pull incredible feats like this because we’re all very passionate in supporting women.

    Many of us have discussed this in the past, and found that when we break down the hours spent on average with our clients, it usually works out at less than the minimum wage per hour.

    To top this, up, I personally only take 6 to 7 birth clients a year. This is because being on call in an intense, emotionally demanding time, and I have suffered burn out in the past and learnt that I need to keep the Christmas, Easter half Term and the last 2 weeks of August free for relaxing time with my family in an absolute requirement.

    Because I make a strong commitment to my client to be available for her, I also almost never take clients with overlapping on call times. This means turning clients down, or working as a shared-care team with another doula, splitting the fee in half. Most of the doulas I know do the same. So if you imagine taking on a maximum of 12 clients a year, even at my fee of £950, this only makes an annual income of £11400 before tax (and doesn’t take account of all the other expenses associated with this job, like travel, hospital parking fees, etc).

    Even the rare, top of the range doulas, who charge £2 to £3K, assuming they took on a birth client every month, would be looking at earning between 24 and 36 000 a year. Hardly a six figure salary.

    And let’s not forget that Doula UK has an access fund, which allows women in personal or financial hardship to access the services of a doula for free. The doula, in this situation, only gets paid expenses. I have done this myself, and so have most of my colleagues.

    I love my job, I love supporting women, I love making a difference, seeing the transformation that true, unconditional support does, especially when women have had a traumatic first birth, and end up with a positive, empowering one with doula support.

    I wouldn’t go back to my previous job for anything in the world.

    The value of a doula, how transformative and life changing it can be for many women, goes well beyond how much we charge, and most of our clients, after they’ve been doulaed, feel that our support was worth a lot more than what they paid for.  You can read some of the testimonials my clients have written about I supported them at the bottom of this page.

    But please, do not ever imply that this is an easy, money grabbing job.