Why would anyone pay for that?
I've been thinking a lot about how to be a doula in earnest and also earn a living. I'm not in the position where I don't have to work, or can volunteer full time and so I have to consider how I will make enough profit to pay our bills.
This is the first time that I will have to earn money and not be receiving a paycheck. That becomes difficult for someone like me; for a lot of people I would imagine, because to make money, you have to tell people what you think you are worth. And you have to view that realistically, comparatively, quantitatively.
Also, my recent hobby of repeatedly explaining my new career to friends and family means I come across sceptics and non-believers. People who challenge my choices, understanding and belief in what I'm doing and what I'm going to do. On wobbly days, these conversations hit me in soft spots of self doubt. On good days, these conversations, and the thoughts they inspire afterwards, help me to explore the validity of my choices and actions.
Now, I believe that the correlation between calm births and a doula in attendance is evidence of doulas reducing trauma. I believe that with all my heart.
Yet, I still find it difficult to even practice (in my head..) telling someone that they should pay me to be their birth companion. "Why would they pay me just to be there and not even take their temperature?!" Desmond (my impostor syndrome, he's a bit of a dick) sneers from my anterior cingulate gyrus.
Because, dear fellow, among other reasons, having a doula in attendance is correlated with:
- 60% reduction in epidural requests
- 40% reduction in forcep use
- 30% reduction of analgesia
- 30% reduction of Pitocin
- 50% reduction in cesarean section
- 25% shorter labour
And why is this stuff good?
The life saving, pain salving tools in the list above have side effects, risk and are sometimes used inappropriately. Sometimes they are used without consent. Consent as defined by Montgomery vs. Lanarkshire, not a confused and belittled yes in-between contractions to speed everything up for convenience (this is a cynical view, but not out of the ordinary). You'd have thought we might have learnt something from the Milgram experiment.
9% of women suffer PTSD after birth. One third of women report that they have experienced a traumatic birth. A lot of studies record how trauma often comes about after feelings of being out of control, of being silenced and ignored.
So why isn't it seen as a priority to protect women in labour by giving them a voice and control of their bodies and experience? Why don't we see it as a priority to strengthen and protect ourselves?
I saw a good post on Kicki Hansard's Instagram about the average cost of a wedding being £27,000, yet it's seen as a waste to spend money on the other most important days of your life. On days that are very intense and that few of us know what to expect.
Why is that?
- Is it because we think we already pay for healthcare with our taxes?
- Is it because we don't think birth can be beautiful?
- Is it because we don't think we deserve a beautiful birth?
- Do we not believe a doula can make a difference?
- Are we so terrified that we ignore how bad we think it might be and just try and get it over with?
- Is it because we feel comfortable with the situation and think we will cope on our own?
- Do we think our birth partner (maybe our partner, wife, girlfriend, husband, boyfriend, mother, friend) will advocate for us?
Despite the evidenced correlation for a more positive outcome, if you have chronic mental health considerations, are medicated and you highlight the possibility of postnatal mental health issues to midwives and consultants, you will not be recommended a doula in the UK.
The word is spreading and the value of a doula is seen and felt by many more each year, but we have a lot more work to do before a woman's (and her partner's and baby's) right to a birth without trauma is protected as it should be.
I just need to get over my own selfworth issues, so that I can fairly promote and provide the worth of a good doula to families who value it.
Support for previous birth trauma can be found here: The Birth Trauma Association.