DOULA: “a woman whose job is to give advice and comfort to a woman who is giving birth”

I believe that a doula can mean different things to different people, and the role she fills can be different woman to woman and depending on clients needs.

A doula can be a teacher, a personal trainer, a coach, a sister or a friend, an advocate, a wise woman, a witness. I see myself as all the above. I know that for my second birth, I specifically wanted a doula who would be my bodyguard if I ended up transferring to hospital again from my planned home birth. Even doulas have doulas!

Doulas can be highly trained and educated on a topic, but they did not go to medical school. I have not attended medical school, but I have read the works and teachings of well respected medically trained individuals who are educating about the nuances of childbirth, and I feel like I have formed opinions based on their birth philosophies. Ina May Gaskin, Dr Sarah Wickham, Dr Rachel Reid, Dr Melanie Jackson, Dr Stuart Fischbein, Dr Kirsten Small are a few of my favorites.

But there's a more practical reason to consider a doula right now, and it has to do with the state of maternity care in this province.

Having a doula on your team can help you have a more personalized birth experience. Whether you are under the care of a family physician who attends births, a midwife, or an OB, there are medical standards and guidelines that are followed, typically referred to as “Standard practice” or “Hospital policy”. When you have a doula, it can be eye opening to learn that any and all standards are offerings, some offerings you might want to accept and others you might want to decline depending on your personal life experience, your wishes and desired outcomes for your birth. It’s my job as your doula to help you understand your options, so that you can make true and informed decisions regarding your birth.

In the Fraser Health region, staffing has become a real issue, maternity units have at times been put on diversion to other hospitals and in some cases that means women are birthing without a known practitioner. The system women are navigating isn’t always set up to give them the kind of individualized attention. A doula is a constant and continuous support person who follows you wherever you go. A well-known Cochrane review looked at continuous labor support across thousands of births and found real benefits. There were more spontaneous vaginal births, lower rates of cesarean delivery, shorter labors, and fewer women reporting a negative birth experience.

The staffing limitations we’re facing also mean that women can be put under real time constraints during labor. I suspect this is contributing to higher rates of intervention, especially for first-time mothers, who tend to have longer labors and take up more of a system’s limited, rationed resources. Providers may move to intervention sooner than medically necessary to do procedures “while they have the staff available.” and That’s not speculation on my part - this is an actual quote from a provider, said during one of my client’s births.

It’s hard for me not to feel a little cynical about the situation we find ourselves in. My own first birth ended in a cesarean, and I’ve come to believe it was, at least in part, a victim of exactly this kind of time pressure.

Women in Fraser Health are facing a health care system with a very high cesarean rate. For comparison’s sake, Canada’s C-section rate was 28.8% in 2018-2019, a steady increase from previous years and well above the World Health Organization’s recommended range of 10-15%. BC has long run above that national number too, and Fraser Health has had the highest cesarean rate in the province for years. According to the Perinatal Health Report for 2023-2024, it was 46.3%, nearly half of all births! It’s almost a David vs. Goliath story for women who want to experience a normal birth.

So, are doulas as woo woo and hippy dippy as they once seemed? Attitudes are changing, especially among younger generations who are asking more questions and taking a more active role in how their births go. Having a doula is starting to look less like a “nice to have” and more like the ultimate hack for better odds at a normal birth, with fewer interventions along the way.

Now, I’ll be honest with you: no doula can guarantee a birth outcome. Nobody can… not me, not your OB, not your midwife. Birth doesn’t work that way. But we can darn well try our best to set our clients up for the best possible chances and walk beside them through whatever unfolds.

Thank you, gentle reader.
— Angela

I would hear this a lot, pre-pregnancy, during my pregnancies and in my postpartum! Eventually, it started to stick.

“You should become a doula.”

“You should become a doula.”

For two years before my first pregnancy, we had been trying to have a baby. I became an instant birth nerd, I researched, I listened to birth podcasts, I followed all of the Instagram birth gurus, and I sought out women’s birth stories. I read Ina May Gaskin, I watched the documentary, “The Business of Being Born”; all just in case, this month was the month I finally fell pregnant.

Just in case, I learned about interventions, hospital policies, induction, cesareans, breastfeeding, postpartum recovery, and all the things I thought I would need to know when the time finally came.

I didn’t realize it would take two years. You can imagine the disbelief and happy tears I cried when I finally conceived.

All of the content I was devouring, led me to seek out a homebirth midwife. I had this innate feeling that the safest place for me to birth and allow my body to work as nature intended was to do it all in the comfort of my own home.

Let’s just say for now, that all the planning and preparation I had done, did not save me from the scenario that occurred during my first birth, I will go into more depth on this birth story in a separate publication as it deserves its own special place. But I will say that my first birth ultimately ended in a transfer to the hospital and a cesarean.

The experience was deeply life-changing, traumatic in ways I didn’t fully understand at the time, and afterwards, I found myself questioning a lot of things. I went through the stages of grief which might sound silly if you’ve never experienced a traumatic event but It was truly like that. I was wounded deeply in my soul, it felt like my whole world had been flipped upside down and my saving grace was the perfect little Angel who had risen out of my abdomen. I thank God for her every day!

My sister in law would later ask “are you still thinking about becoming a doula?”

But HOW?! how could I doula others when my birth had derailed like it did? Who was I to help another woman navigate something I hadn’t been able to do myself?

But… maybe that’s the point…

Maybe being a doula isn’t all sunshine and rainbows and having amazing easy births.

Maybe a doula is someone who has braved the fire of birth, been struck down and was able to rise again.

Maybe a doula is someone who can guide their clients through not just the easy births but the births who literally send you to your knees and make you go places you never thought you would or could.

After all, I was a doula before I was a doula.

I was the friend people called when they were pregnant. I was the person sending research, answering questions, talking through options, helping a friend prepare for an appointment, or sitting with a woman who simply needed someone to ask, “What is your gut telling you?”

Eventually, while I was on maternity leave, I took a doula course. Little by little, I started turning something I had been doing informally into something I could offer to other women.

Alas, for myself, there was still a piece of my own story that I hadn’t made peace with.

It was a faster process the second time around, “trying” for a baby that is. I fell pregnant in a matter of months. Deep in my gut. I felt a little fear, afraid of the unknown, I knew too much, and I knew how birth can go sideways, but I also knew without a doubt that I wanted to try for a home birth again.

I set my sights on having a homebirth after cesarean (HBAC). No easy feat by the way! Not every midwifery practice in my region would be accommodating but I am so lucky to have the midwives I do. It might have helped that I told them I would do it with or without them!

I had a wonderful and powerful HBAC. I like to say that it was the hardest but very best thing I have ever done in my life. The adrenaline, the oxytocin, the absolute HIGH after birthing my baby was intoxicating.

My hbac wasn’t about proving anything necessarily. It wasn’t about erasing what happened before, and it certainly wasn’t about having the “perfect” birth. I had complex feelings about what happen the first time around that left me questioning whether my cesarean was necessary, so, for me, I needed to completely surrender to labour, trust in myself and my body, and for me, it was healing.

I stopped thinking of my first birth as evidence that I wasn’t qualified to support other women. Instead, I began to understand that perhaps it was part of what brought me here.

I don’t believe there is one right way to become a mother. I don’t believe a vaginal birth makes someone stronger, or that a cesarean makes someone less of a mother. I don’t believe a birth plan is a measure of success. I believe women deserve information. They deserve choices. They deserve someone in their corner. And they deserve to feel supported, not just while they are giving birth, but as they cross that enormous threshold from maiden to mother.

I’m here…

For the woman who had a difficult or traumatic birth and isn’t sure how to approach the next one.

For the woman who doesn’t have a specific birth plan at all, she just wants to have someone walk alongside her.

And for the new mother who needs someone to help guide her through it all.

Becoming a mother is more than giving birth. It’s a transition. A transformation. The birth of a baby and the rebirth of a mother, whether its a first baby, a second or third. You meet your most powerful self in birth, and I think that’s where the name Maiden 2 Mother comes from.

Maybe all those people who told me, “You should become a doula,” were onto something. It just took me a little while to believe them.

I’m still here. Still learning. Still listening. Still becoming.

Helping women feel listened to, held and fulfilled in their birth and postpartum.

Welcome to Maiden 2 Mother.
XOXO Angela