A dedicated follower of fashion

Apparently, according to the UK media, doulas are becoming ‘fashionable’. A recent article referred to us as ‘the latest fashion accessory’ and I’ve actually tracked down one piece with the rather nifty title: ‘Mothers with Moola Must Have a Doula’.

There is a part of me that does a little dance of joy, clicks my heels together and shouts ‘wahey!’ when I hear this. I mean, if there’s a choice of having a really unpopular job or one that’s fashionable who wouldn’t choose the in vogue one?

Yet something about the word keeps irking me. ‘Fashionable’, I keep asking myself, ‘what’s wrong with the word when applied to what I do?’. Aside from my penchant for 90’s indie music and legs that run screaming from skinny jeans, I think the irk-factor lies in what springs to mind when someone uses the word ‘fashion’. Apologies Ms Wintour but it does tend to give off as sense of transience, luxury, here today gone tomorrow-ness and whimsy. It’s generally applied to bags or shoes or a fad for cake decorating/cross-stitch/knitting amongst trendy twenty-somethings living in Dalston and making jam whilst hungover.

I, however, am NOT a fashion item! I can’t make jam and my DVF dress has a small porridgey handprint on it. As a doula I’m prepared to climb on the roof of Vogue House and declaim that I am actually highly unfashionable. My role has been around, in one form or another, since early civilisation and it isn’t going anywhere. I’m not a passing trend or something the middle-classes are trying on for size soon to be discarded.

Though I have previously claimed otherwise (particularly at Christmas), objects of fashion are rarely necessary. They don’t often dramatically change your life and they aren’t proven to be tangibly beneficial. Indeed some items are actually rather damaging (spandex? jumpsuits? cropped tops?).*

However every study that has looked at the work of birth doulas has recorded concrete benefits of their support. Take this latest Cochrane review of 21 separate studies of women who had continuous support during their labour. The data collected from over 15,000 trial participants demonstrated the following:

  • Women allocated to continuous support were more likely to have a spontaneous vaginal birth and less likely to have intrapartum analgesia [pain relief during labour]  or to report dissatisfaction.
  • In addition their labours were shorter, they were less likely to have a caesarean or instrumental vaginal birth, regional analgesia, or a baby with a low 5-minute Apgar score.
  • Subgroup analyses suggested that continuous support was most effective when provided by a woman who was neither part of the hospital staff nor the woman’s social network, and in settings in which epidural analgesia was not routinely available.
  • AUTHORS’ CONCLUSIONS: Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.

I’m yet to meet a handbag (even a Marc Jacobs one) that can claim it statistically improves both the outcomes of birth for mother and baby and crucially the mother’s postnatal satisfaction with this momentous experience. If someone can invent one I’ll have my name down first on the list in Selfridges. Until then we are all going to have to accept that doulas just aren’t fashionable. You can’t make us in to an overnight sensation because we’ve been around for aeons.

With the weight of evidential proof behind what women have known for centuries we aren’t going the way of crimping** any time soon.

* if my husband is reading this please ignore this sentence in the context of future spending justification
** apologies if crimping is actually fashionable again

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The Hackney Doula

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