Experts always advise expecting mothers to chart out a birth plan during pregnancy. It helps you prepare well and ease out stress in the final moments before childbirth when things are chaotic. 

After all, pregnancy is an exhausting and extremely demanding journey. The mum endures a lot – both physically and mentally. And you need all the support you can get in the moment. 

Sometimes, having your spouse or partner by your side isn’t the only support that you need. At times, you may need professional intervention and that’s when a doula comes in handy. 

For those who don’t know, the role of a doula is that of a provider who lends physical, emotional and informational support to the mother. This is before, during and after birth.

There are even specific doula services for the postpartum period when mums are especially vulnerable and can suffer from postpartum depression. In today’s world, the role of a doula during a woman’s pregnancy is that of a professional who can help with all things related to natural birthing. 

A doula does not replace the labour-room nurses. In most cases, they work together to help you have a smooth and trouble-free delivery. 

To tell us more about the role of a doula and how do they contribute towards a mum’s pregnancy journey, theAsianparent recently caught up with professional doula, fertility coach, and founder of Blooming Birth Doulas, Chantel Kismet. 

She spoke to us about how a doula assists in birthing and what parents should consider before hiring one, plus the role of the spouse and more. Here is an excerpt.

The role of a doula and why you need one

TAP: What is the role of a doula and how do they assist in birthing?

Ms Chantel: A doula is essentially a birth coach or birth advocate. She is a trained professional who provides families with emotional, mental, physical and informational support.

They do not provide medical assistance and are very different from a midwife. A doula not only assists in births but prepares parents through pregnancy and the postpartum period as well. The word “doula” originates from the Greek language and translates to “a woman who serves”.

Through informational support, a doula can provide a couple of tips especially when it comes to labour progress or any aspect of a mother’s labour. She can also bridge communication gaps between a couple and their care providers such as their doctors, nurses etc.

She is able to guide the birth partner and give him the confidence in what he can do or say to help a mother feel more comfortable. A doula can help ease labour discomfort through coaching, relaxation techniques and massages.

Even simple gestures like holding a mother’s hand or gently touching her face can encourage her during the labour process. She helps a woman remain grounded through emotional support.

Research has shown the significant benefits of having a doula at birth:

• 31 per cent decrease in the use of Pitocin
• 28 per cent decrease in the risk of cesarean
• 12 per cent increase in the likelihood of spontaneous vaginal birth
• 9 per cent decrease in the use of medicinal pain relief
• 14 per cent decrease in the risk of newborn admission to NICU
• 34 per cent decrease in the risk of being dissatisfied with your birth experience

What to look out for when hiring a doula

TAP: What should Singaporean couples consider before hiring a doula and what can they expect?

Ms Chantel: The first thing to understand is that the role of a doula does not replace your medical care provider nor your husband. She is an addition to your birth team and works in tandem with your partner and care providers.

Next is to understand what your motivation is behind wanting a doula – are you looking for someone to guide you through your journey or are you needing a birth companion as your partner may not be able to be with you?

Do your research and speak to a few doulas, find someone that you can connect with – this person will journey with you on the most intimate experience you will ever have.

Perhaps look out for similar values and belief systems, ensure that you are comfortable with your doula. I recommend looking for a doula in your second trimester and take the time to get to know them.

Take a look at finances, is this something that you can add to your budget. Consider package prices and what other services are included, each doula possesses different skillsets and you want to find the ones that resonate with you.

There are some doulas who only do birth work or postpartum care whilst others provide both types of services. Find out if your doula is able to provide post-birth services as a continuity of care.

Hiring a doula is an important process, trust your gut at the end of the day!

Water birth deliveries and doulas

TAP: How popular is water birth in Singapore? What are the stipulations that any expecting couple should prepare for?

Ms Chantel: Water immersion is a form of comfort relief during labour and water births are getting more popular these days. It is a popular choice for mothers who are looking at a natural birth with no drugs.

Some hospitals provide an option of hydrotherapy, meaning you can labour in water but birth your baby out of it. In current times of Covid-19, some hospitals have suspended water births until further notice.

With hospitals like Thomson Medical Centre and National University Hospital, you require a midwife (or a team) to be present during the birth. This is to ensure that safety requirements are adhered to.

Some hospitals require you to come prior to your birth for an orientation and go through the dos and don’ts of using the water tub.

Yes, I’ve had the honour of helping mothers bring their little ones here through water birth. You will usually be allowed to enter the tub when you are about 5cm dilated. In a hospital setting, you are not allowed to remain in the tub for more than an hour.

You will have to come out of the tub for a short while and then return back to the tub again. Partners are not allowed to be in the tub and so there is a comfortable spot beside the tub where they can sit.

I personally feel that water has a very calming effect on a labouring mother. With that being said, water immersion is not for everyone and that’s okay!

TAP: How do doulas provide help post-birth? What can new parents expect and how can they also in turn help the doula?

Ms Chantel: Postpartum doulas can help a family in so many ways; they provide emotional and informational support.

The main aim of a postpartum doula is to empower a family and help them transit into their new roles by guiding them with strategies.

ALSO READ: 'I had to poop in front of a stranger': 4 Singapore mums share their most memorable labour experiences

This encompasses the following (but not limited to!) breastfeeding guidance, newborn care, being a listening ear to parents and watching baby as parents take a snooze. Some doulas even offer light cooking, cleaning or massages!

The care of a postpartum doula is very much centred around giving parents the confidence they need. We don’t take over their role and instead help them through education and demonstration. Parents can definitely expect a level of care that’s focused on a mother and her family.

Millennial generation and the role of a doula

TAP: What are the main challenges for a doula during the birthing process? Are people aware and/or willing, especially the millennial generation?

Ms Chantel: The role of a doula is gaining more popularity these days, with social media and available information, I do see the younger generation opening their doors towards engaging a doula.

There are still a portion of locals here in Singapore who find the idea of having a doula at their birth “weird” and “not normal”. They feel that having an extra person at birth can seem unnatural and could feel like an invasion of privacy.

There are, of course, situations where a mother is all for engaging a doula but their partners may feel otherwise – the biggest concern they share is being replaced by a doula and not being a part of the birth experience.

The older generation finds this intriguing too and has yet to wrap their heads around a random person being at their child’s birth.

Some of my clients engage a doula without letting their parents know to save the hassle of explaining to them! As a doula myself, I believe it is key to educate our society on what doula care is all about.

Best breastfeeding tips for lactating mums

TAP: What are your top tips on breastfeeding a new first-time mum?

Ms Chantel: People often have the misconception that breastfeeding should come naturally. In fact, breastfeeding is an art that requires practice and patience.

Knowledge is power and I encourage all parents to educate themselves. Understand the basic science of breastfeeding and what is actually happening to the body.

Here are my top five tips:

1. Be kind and compassionate to yourself; you just had a baby and both of you are learning. Know that with time, things will get better!
2. Change your perspective; understand that the first few weeks may come with their challenges. Pair sleep deprivation with a crying baby, it is no wonder new parents give up.
3. Attend a breastfeeding preparation class; understand the proper techniques of latching and positioning baby, learn how to read hunger cues, know what your alternate options are, create a breastfeeding plan and learn how to identify breastfeeding problems.
4. Build your support team; look for lactation consultants, breast engorgement specialists, postpartum doulas – these people are your village! This way when you need help, you’ve got a team behind you.
5. Find your "why". What is the motivation behind your breastfeeding journey, what are your long term and short term plans? There will be days where you feel like a constant milk machine, it may seem endless and you may think of giving up. Going back to your “why” can push you along

I think it is an amazing decision to re-lactate and if you are a parent who is trying to do so, throw in a mix of determination and a dash of belief. Always go back to the art and science of breastfeeding, it is all about demand and supply.

Ensure that you stimulate your breasts or express, pump and latch to help generate your supply. Incorporate lactogenic foods into your diet, be adventurous and try holistic approaches such as acupressure even visualisation exercises!

Dads and childbirth

TAP: What do you think is the role of the father in the birthing process, how can they help?

Ms Chantel: This is such a wonderful question! The role of a father is a pretty big one – think of childbirth as a performance, the mother being the main star of the show and the father basically runs the show in the back.

He takes on the role of the logistics team, does the sound check, mends the ticketing booth and ensures lighting is in place!

The partner plays such an instrumental role in helping a birthing woman remain calm and relaxed. He also acts as an advocate for her birth preferences and communicates with the medical staff.

I encourage mothers to discuss with their partners prenatally how they would like to be supported during the birth.

Firstly, being present and holding space for their wives – remaining closely by their side, even a gentle touch can often ground a labouring mother.

Offer lots of encouragement (if they need it!) or just remaining silent. Secondly, gentle massage and acupressure can help her cope with labour discomfort.

Using techniques such as the “double hip squeeze” and “sacral counter-pressure” is often effective! It definitely helps to be observant, notice when she tenses up (encourage her to relax) or licking her lips (that’s a sign she’s thirsty!).

Encourage her to get into different positions, this can help cope with the intensity of her surges. Connect with her through touch and movement such as swaying together – it can help increase the flow of oxytocin.

Lastly, taking charge of the situation by being proactive and remaining calm – I like to tell fathers that even if you are freaking out inside, always leave your “game face” on!

This article was first published in theAsianparent.