Delivering extra care and support (From Bradford Telegraph and Argus)

Delivering extra care and support

9:51am Wednesday 23rd December 2009

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The shortage of midwives in the NHS has been a controversial topic for some years, with reports of tragic deaths and studies highlighting a lack of midwife care in labour.

The subject has now been turned into entertainment with actress and Britain’s Got Talent judge Amanda Holden, who underwent intensive on-the-job midwifery training on a busy labour ward in Out Of My Depth, shown on ITV last week.

Last December, the T&A reported the opening of a new birthing business. Mother Nurture Doulas was set up by Rachel Cline of Calverley, Julia Kijanski of Bingley and Emma Tomlinson of Idle.

‘Doulas’ are carers who, for a fee, offer pregnant women continuous support immediately before and after childbirth.

Since then, doulas have come under attack as meddling mercenaries, playing on the fears of expectant mothers. Only this month, a hospital anaesthetist in the British Medical Journal accused them of interfering in clinical decisions and damaging the care given to mothers and babies.

Emma Tomlinson, whose first child was born in a water-birth in Leeds General Infirmary two-and-a-half years ago, says: “There is a lack of continuity of care in the NHS. The target is for another 3,000 to 4,000 midwives by 2012, but the Royal College of Midwives are sceptical about that.

“Since we started, we have been constantly busy. We ask mums to meet several doulas before they choose because they need to find the right one for them.

“We offer two ante-natal sessions with the parents; constant phone and e-mail contact, and then doulas are on call two weeks before and two weeks after the due date; and they visit once or twice afterwards to make sure things are right.

“Giving birth is an intimate experience. Midwives can go off-shift and somebody new comes in, which can be a big deal. Doulas don’t leave you,” Emma says.

“In this area, the cost is around £200 for a trainee doula, up to £500. An independent midwife offering complete care through birth and six to eight weeks afterwards would cost £3,000,” she adds.

But has what one woman blogger described emotively as “the medicalisation of childbirth” become an ideological battle between hospital-based deliveries, in which drugs are used, and forms of natural childbirth, in which they are not?

Bridget Baker co-chairs Doula UK, an organisation started in 2001. It has about 460 doulas offering mentoring, support and supervision.

Doulas may have midwifery experience, but they aren’t medically trained and are not there to compete with midwives.

Bridget adds: “We are not there to deliver the baby. Mothers deliver babies, midwives catch them, doulas create a safe atmosphere.”

Ruth Weston runs her own business, Shipley-based Aquabirth, which manufactures and hires out birthing pools to hospitals and private clients. She also chairs West Yorkshire’s Maternity Services Commission which embraces both public and private sectors.

Ruth describes the Goodwin Doula Project, a voluntary service which started in Hull and may start in Manningham and Little Horton this spring.

“They are highly-trained and well-supervised women who offer young mums emotional and social support of the kind that a neighbour or a granny provided 30 or 40 years ago.

“They encourage breast-feeding, which cuts down the hospitalisation of babies and cot death by ten to 15 per cent, and help with post-natal depression which is a big killer of women in the UK.

“There is a shortage of midwives, but I don’t think we’ve ever had enough to provide the intensive support women need.”

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