What is it really like to witness someone else’s labour and birth?

AIMS Journal, 2023, Vol 35, No 3

By Anne Glover

I’ve been working as a doula for 8 years now and have been so blessed to have supported over 100 births. I sometimes wish I had known about this vocation earlier in my life, but I take great comfort knowing that my previous life experiences have gently shaped me into the doula I am today. I have three grown-up children and as a family we worked and travelled overseas for almost 30 years. My life’s experiences enhanced my own personal skills by having to be flexible in different circumstances, adapting to various surroundings, and developing my interpersonal skills – I have dined with presidents and worked with homeless people. I feel confident in my role and I love connecting with families as they prepare to meet their darling wee baby(ies).

There is no other feeling quite like being asked to support a woman during labour and birth, yet many people don’t understand why I enjoy it and question why I would even want to be present at other people’s births. I feel saddened when I hear this, as I know I get to enjoy a beautiful, joyous, sacred, intimate, life-changing event, no matter how the baby is born. Sometimes the partner will say to me after a birth that they don’t know how I can do what I do, and I get it. I’m not as emotionally invested as they are and they have just seen the one person they love most in the world go through labour to birth their baby. I can understand how it feels for them, and as part of my role as a doula, I will have been discreetly keeping an attentive eye on them during the birthing process too.

So what is it really like to witness someone else’s labour and birth? It is exhilarating, thrilling and unpredictable! Sometimes I just make it to the birth in time to hear mum breathing her baby into the world, and other times I am with the family for hours and even days. Sometimes my presence is all my client needs, and other times I utilise all the wee tricks I know as a doula! A feeling of deep peace sits in my belly as I attend a birth and play the waiting game. I feel confident as a doula, and I have confidence in the physiological birthing process, that women can make informed decisions based on their own personal circumstances, and women can birth their babies. Sometimes it can feel scary for a split second, especially if you are on your own, but when that wee baby is born, enormous relief and joy fills the room.

Unfortunately being a doula does have its challenges. The biggest challenge for me to date is being witness to obstetric violence in the form of assault and I’ve also seen interventions being carried out without consent, too quickly to stop them from happening. The challenge is to question what just happened, knowing that my client would never consent to it, but also minimising fear in the birthing space. It is disturbing and painful to see, and I have to find coping techniques to deal with what I witness.

Supporting people within the current maternity care system also has its challenges. There is a lot of fear around as a result of the Ockenden Report^[1], the Kirkup Report^[2], and ongoing regional reviews^[3],[4]. The fear is felt in the birthing community, including the midwives and doctors. Sometimes there can be misunderstandings about the role of a doula^[5]. For example, some people think that the doula will give advice to her client and tell her what to do, especially during birth. This is not the doula’s responsibility. People who have employed a doula to support their pregnancy, labour and birth are well-informed about their options, the local maternity policy and about the birthing process. I hope that the midwives and doctors feel supported by my presence, as we work together as a loving team so the person we are caring for has the best possible outcome.

Sometimes a woman will ask her doula to be an advocate for her during labour and birth, especially if she, like many labouring women, would prefer not to think or talk rationally during birth, or if she feels that she may just say anything to appease the midwife or doctor during labour. Chatting through her preferences with her midwife and doula beforehand, and noting these in her birth plan, can help to alleviate any misunderstandings later. Being an advocate can mean holding space for the woman, and maintaining a safe environment where she feels secure and loved. It’s important to understand the role of the midwife^[6], their duty of clinical care, and their requirement for informed consent.

The benefits of having a doula are evidence-based^[7], and I feel we need more validation around having a doula, and to continue to raise awareness of this as a choice for pregnant women and pregnant people. How can you make informed decisions, if you don’t know all your options? Also, I look forward to working alongside the continuity of midwifery carer maternity model^[8] as it begins to be rolled out in Northern Ireland. This model provides consistent care by the same midwife or small team of midwives throughout pregnancy, birth and in the postnatal period. To have a known midwife providing maternity care, and having a doula alongside is the perfect combination!

I read somewhere recently that we feel good, even feel rewarded when helping people^[9], but I don’t do this job to feel good. It’s not about me.

Author bio: Anne is a volunteer on the AIMS Campaigns Team. She is a well known doula in Northern Ireland with over 8 years experience, and is the Doula UK Area Representative for NI.