What doulas do

Many of the nannies I recruited in the early days of my agency now have lots of experience - and their own children. Like most mothers who want to have a balanced lifestyle that will allow them to earn an income and spend time with thier own families, they are looking for part-time work. While they insist that becoming a mother has made them more aware of the feelings of parents and thus better childcare practitioners, they often find that employers do not always recognise this. In fact, it is getting harder to place nannies who want to bring their own children to work.

However, in one new area of care it is much better if the practitioner has had her own child. This person is called a doula.

When I had my babies, a few days' stay in hospital was normal for new mothers. Even though we all longed to get away from strict routines, we were taught to bathe the baby and had certainly established breast or bottle feeding, while a nurse was usually around to settle a fractious infant so we could get some sleep. By the time they finally let us out, stitches were healing and we felt reasonably confident to go home with the baby. Nowadays, hospital stays are much shorter, and although a new mother may not be in need of medical help, she may well be totally unprepared for the demands of caring for a tiny baby, looking after herself and coping with all the extra washing, shopping and noise that one little person can generate.

Doulas have begun to fill a need in modern society where many women no longer have family members close at hand when they have a baby. Unlike a maternity nurse, who stays with the family on a 24-hour basis five or six days a week, a doula works the hours a mother requires, usually during the day. A doula may work for as little as three hours at a time, and will also give advice over the phone if there is a problem. The aim is to help the mother relax with as little to worry about as possible while enjoying the new baby.

So what is a doula? Jean Birtles, who, alongside Top Notch Nannies, runs the agency British Doulas, says, 'The doula originated in the United States. Three medical practitioners - Drs Klaus, Kennell and Klaus - did research that showed that women who were supported during labour and birth by a doula tended to need less medical intervention and fewer drugs and had shorter labours than those women who only had the hospital staff and their husbands or partners to help them. The name "doula" was coined by an anthropologist called Dana Rafael and it is the ancient Greek term for a "handmaiden".'

Thre are two types, the birth doula, who obviously supports the parents through the birth, and the postnatal doula, whose role is to pamper the new mother. Many doulas practise both skills. The postnatal doula will ensure the mother eats well by cooking nourishing meals for her, and the rest of the family if required, doing the shopping, keeping the housework and laundry under control and caring for any other children in the family. She will look after the baby so the mother can rest or spend time with her other children, and help her to establish a breast or bottle feeding routine. Her role is to support the mother in whatever way she needs.

Most practising doulas in this country will have attended one of the courses offered by Doula UK or British Doulas. These courses are taught by midwifery trainers, practising doulas and medical professionals. They cover all aspects of pregnancy, breastfeeding and birth physiology. The doula will be taught how to support both parents throughout the labour and birth (yes, fathers can find it all quite traumatic, and they welcome being sent off to get something to eat or take a break). However, the doula will not be medically qualified.

It is important for postnatal doulas to attend the birthing courses to remember the physical and hormonal upheaval of having a baby, especially the first time, as they will be giving emotional as well as practical support.

A Doula's tale

Cambridge Doula Services was started by Linda Hobbs, who is NNEB qualified and has worked as a nanny, as a registered childminder, on a children's behavioural unit and in a primary school. She has two grown-up children of her own.

Linda says, 'I feel my childcare training and experience is useful in my role as a doula. I care for the baby while the mother gets some sleep, or settle a windy baby who has not read the books that insist he will sleep for three hours between feeds. When there are other children around I look after them and involve them in welcoming the newcomer into the family, or care for the baby while their mother spends time with them.

'I find the experience of having had my own babies invaluable for this, because I can remember just how incredibly high and low you can feel in the weeks after giving birth. It is vital to be in sympathy with the mother's feelings.

'Other professionally qualified nannies may throw up their hands in horror that I am prepared to do general household chores. But I see it as necessary so the mother can rest and enjoy the baby. I get tremendous satisfaction from bringing order into a busy home. I take my cue totally from the mother's needs. Each family is different, which makes the job more interesting. I have never yet met a bored doula. I love what I do, because birth should be a happy time and it's great to be involved in a joyful situation and know that I am part of making it that way.

'Needless to say, I have made a lot of friends through my work. In terms of lifestyle, I can choose when I do and don't work, but I am prepared to work some anti-social hours, as sometimes a mother will need me to cover supper and bedtime.

'Doulas are self-employed, so they have to sort out their own income tax and National Insurance. They earn between 10 and 15 an hour depending on experience, and a birth doula will get 250-350 for a birth. Most nannies who are mothers want a job where they can bring their children with them but, since a doula needs to give her full attention to the family she's working for, this isn't possible. But the higher hourly wage means she only has to work part-time.'

Maddie McMahon is the mother of a five-year-old and a two-year-old. She also does birth and postnatal practice for Cambridge Doula Services. Maddie says, 'I am lucky to have a very supportive husband and superb childcare.

So far all of the births I have attended have started at night or over a weekend, but if I'm not at home my husband takes over and he will take the children to the childminder when he has to go to work. As I am self-employed I can decide when I want to take time off. Usually I try to do just three days a week of post-natal work, so I have the rest of the time to be with my own children.

'Just as newly-married couples have a honeymoon, we doulas feel that the first few weeks after a birth should be a "babymoon" - a time when the mother can relax and be pampered so she can get to know the new baby. I love contributing to such a happy time for the families, while being able to spend the time I want with my own children.'

CONTACTS

* Top Notch Nannies: 020 7259 2626, British Doulas: 020 7244 6053 www.topnotchnannies.com

* Cambridge Doula Services: 01223 529 337 www.doulaservices.co.uk

* Doula UK: 0871 433 3103 www.doula.org.uk