Response to The Times:

My response to the article "Rise of the doula: a helping?hand or a danger to mothers?"

Dear Rosie,

I read your article "Rise of the Doula" with great interest. However, I noticed several points that seemed to lack balance and omitted crucial information necessary for a well-rounded discussion on childbirth options.

Firstly, it's important to acknowledge that complications can and do happen in all birth settings, including hospitals. Babies die in hospitals too, despite the presence of highly trained staff and advanced medical facilities. For example, in England and Wales, the neonatal mortality rate was 2.9 deaths per 1,000 live births in 2022. This equates to 0.29%, showing how very rare these occurrences are. Highlighting only the negative outcomes of home births without mentioning the risks associated with hospital births provides an incomplete picture.

Moreover, the focus on freebirthing and radical birthkeepers could lead readers to believe that non-hospital births are inherently dangerous. However, it's worth noting that many women successfully have safe and fulfilling home births, especially when supported by trained midwives and doulas. These professionals often provide continuous care, proven beneficial for maternal and neonatal outcomes. Research shows that for low-risk pregnancies, home births attended by certified midwives are just as safe as hospital births, with no significant difference in perinatal mortality.

Additionally, the claim that biting on an umbilical cord or placenta can stop a haemorrhage is often dismissed by obstetricians. However, there is some evidence and anecdotal support for traditional practices. The power of the placenta in preventing postpartum haemorrhage has been discussed in various traditional and natural birth communities . When obstetricians dismiss these practices, it is fair to ask for proof or scientific studies that explicitly disprove their effectiveness, instead of outright dismissal of traditional knowledge. The human race has survived for millions of years without obstetricians, which suggests that childbirth, in its natural state, is generally safe. Therefore, traditional practices should not be dismissed outright but rather studied and understood within the context of modern medicine.

Regarding financial aspects, obstetricians in the UK can earn an average of ￡82,000 annually, while midwives earn around ￡34,000. In contrast, doulas, who provide essential non-medical support, typically earn between ￡1,000 and ￡2,000 per birth package and usually if working on their own have around 10-15 births per year. These figures illustrate families' significant investment in securing personalised, supportive care during childbirth. Interestingly, it always appears that women in the caring industry seem to be more heavily highlighted. This hidden misogyny reveals how the patriarchal view is embedded in our society. There is an overriding feeling that these women should be ashamed of asking for money, which overlooks the immense value and care they provide, crucial for the well-being of mothers and babies.

Doulas play a crucial role by offering emotional and practical support, helping mothers navigate their birthing options, and advocating for their preferences. This support can be invaluable in a healthcare system where midwives are overworked, and continuity of care is often lacking. The presence of a doula during childbirth has been shown to significantly improve birth outcomes.

Research indicates that women who have continuous support from a doula are:-

• 39% less likely to have a caesarean section.
• 15% more likely to have a spontaneous vaginal birth.
• 10% less likely to use any pain medication.
• 31% less likely to use synthetic oxytocin to speed up labour.
• 34% less likely to rate their childbirth experience negatively.

These statistics highlight the positive impact of doula support on reducing medical interventions and enhancing the overall birth experience.

Your article mentions the tragic outcomes of some home births but does not provide context about the high rates of interventions in hospitals. Interventions like inductions, epidurals, and caesarean sections, while sometimes necessary, can also lead to complications such as increased postpartum haemorrhage and higher rates of maternal mortality and morbidity. Not to mention the number of women who are left traumatised and experience postnatal depression as a direct result of how they were treated during childbirth.

In conclusion, while it is vital to discuss the potential risks of home births and the importance of medical intervention when necessary, it is equally important to present a balanced view. Recognising the benefits of doula support and the successful outcomes many women experience with home births can help expectant mothers make informed decisions that align with their personal circumstances and values.

Best regards,

Kicki Hansard

Certified Birth and Postnatal Doula

Founder, The BirthBliss Academy

Full article from The Times here.