‘Women become a bit more wild in their pregnancies’ The highs and lows of working as a doula

THE SHIFT: Saima Kara works as a doula, providing guidance and support to pregnant women

I’d been feeling out of place in the corporate world and thinking about more meaningful work when I ended up supporting a friend through her pregnancy in 2016. I went travelling afterwards, did a bit of reflecting and realised it had been the most meaningful thing I’d ever done.

When I returned I looked into midwifery and then I found out about doulas and thought it sounded similar to what I’d done for my friend. I started my training in 2017. I really enjoy the one-to-one connection you make, building a deep trust, at what is a quite vulnerable and special time.

Every day is a little different. I check my messages when I wake. There could be overnight requests for calls or questions on Telegram from the online birth preparation course that I run. I’ll also check social media and see if anyone has booked a complimentary consultation with me on saimakara.com.

I may have a post-partum visit, I do two or three a week, and it means I’m usually with them for four hours during the day. On Sunday evenings I teach my birth preparation class and I also host online pregnancy circles in the evenings throughout the month. And I’ll check my phone again at bedtime.

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Sometimes I might do post-partum work at night, which would mean spending the night at the client’s home. And if I get the call, which can happen at any time as I’m on call for 28 days around the due date, then I might be away for two or three days depending on how long the birth takes.

The pandemic made my working day very different. All my ante-natal preparation had to be done online when it used to be in person. I’d do phone conversations and video calls. It was pretty sad not to physically be able to be with these women who wanted me to be there. I think the pandemic made people question things more, particularly whether a hospital was the best place to give birth when it was a potentially risky place to catch the virus.

I really enjoy witnessing women and families on this journey, seeing them transformed from being unsure to stepping into their new roles as parents. I see women become a bit more wild in their pregnancies, when that natural mother’s instinct makes them assert themselves, to make decisions for themselves. Previous to pregnancy they might not have done that but they find this new part of themselves through the process. That’s amazing to witness.

The worst thing about my job is when medical staff don’t ask for consent, which happens more than one might think. It happens a lot less when you have a doula because we’re there to advocate for you and support you. I offer something called a birth trauma debrief and I hear some really horrible stories of consent not being asked and women having to live with the consequences.

Saima says: ‘The most common misconception about my job is that only middle class or rich families can afford to have a doula’

Random moments, though, can be funny. Humour and laughter really help with oxytocin, so I might suggest to women late in pregnancy that I’ll put on a comedy show so she can just relax. In labour me, the woman and her partner will often make very natural jokes and the laughs help things progress. It can make for quite a different experience at a home birth, as hospitals are more of a serious environment and we don’t tend to laugh as much.

The most common misconception about my job is that only middle class or rich families can afford to have a doula. We want to support families in all circumstances so we have a sliding scale of options. Doula UK has an access fund, too, and there are different charities across the UK that can help. We want to work for women whatever their situation.

If doulas didn’t exist I think there’d be a lot more trauma. Women would not know what their options were and they’d be unsupported post-partum. I think it would be a lot more challenging for women without external support. I’m sad that a lot of women, though, don’t even know about doulas.

The advice I’d give myself now if I was starting as a doula, which reminds me how nervous I was on my first day when I got the call that my client was in hospital, is be calm and kind and everything else will come naturally.

I do feel very honoured to get to do this work. It feels like a calling. It’s all-consuming and you have to give yourself to it entirely, but I’m passionate about it. I’m lucky, I think it’s the best job in the world to get to support women through this time.

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