Any woman who has given birth will tell you that pregnancy is not an entirely smooth ride. There are many things that happen in that space of nine months when a woman is carrying a growing baby inside her womb.
Besides having to deal with the fact that one’s body is changing, there is the body ache, fatigue, nausea and that looming uncertainty and fear of what to expect as the birth date draws closer.
It is for these reasons that family members, relatives and friends selflessly give overwhelming love and support to expectant mothers.
But did you know there are professional women who can be hired to give this same kind of care to an expectant mother?
These are called birth doulas and they help provide physical and emotional support to both the mothers and their partners. They meet with moms well before their due date to help them prepare for birth and develop a supportive relationship; they are by your side from the time you go into labour to a few hours after you deliver.
Laura Wando is one such woman who was inspired to become a doula in order to help women who felt lost during their time of pregnancy.
“I know that in the African setting, expectant women have their mothers, aunties and sisters to support them while giving birth but the difference is that the doulas are trained personnel,” she says.
“A doula is there to support your wishes by offering practical kinds of suggestions for comfort. If you want to scream, they will encourage you to do it, that if it helps. If you want a massage, you will get it. These doulas will be there purposely for you, to support your wishes and desires for birth, and not for any other member of the family.”
Wando’s child birth experience was the other reason she was motivated to start offering these services to pregnant mothers.
After conceiving in 2008, she decided to go and give birth from the United States of America (USA) instead of Kenya where she was living at the time.
Her husband did not tag along as he stayed behind to work, a decision both had consented to.
“A friend sold me the idea of hiring a doula, a term I heard for the first time,” she says.
“This is what I did when the time drew nearer for the delivery. I needed the support of a doula because I did not have my husband by my side at the time.”
Wando who has been living in Uganda for the past six years now received a four day doula and breastfeeding training in 2012 from USA. Although the gold standard is to have gone through a recognised training programme and to be certified by an organisation, there is no standard umbrella certifying organisation because it is not a medical profession.
In Uganda, the certifying association is Shanti Uganda Society that started in 2008 with a vision to unite traditional birthing practices with modern best practices as well as provide birth education in communities affected by war, poverty and HIV/Aids in the country.
It was started by Natalie Angell-Besseling, a yoga teacher and doula with a background in international development.
No doubt, working as a doula exposes one to empowering and inspiring stories about child birth. For this reason, Wando felt the need to provide an additional service; birth photography.
“The fantastic bit was that I was already passionate about photography. I used to take pictures even before becoming a doula,” she says.
“So when some clients started making requests that they wanted to document their child birth experiences, I was prompted to learn more about photography and upgrade my equipment.”
Also, Wando joined a birth photography mentorship group called “Birth Becomes Her” which aims at celebrating birth.
Birth photography involves taking pictures of a client during the different stages of pregnancy including prenatal (before birth), labour and postpartum (after birth).
Some of the interesting bits that Wando captures include facial expressions of mother and father holding their baby for the first time.
“Just imagine taking a picture of a father with tears filling up his eyes as he holds his child. It speaks a lot about what kind of raw emotion child birth brings,” she says.
Since there are hospitals that prohibit cameras within their premises, Wando says she often advises clients to first request the administration for permission to allow her take pictures. In most cases, she is given the authorisation to proceed with taking photos.
“And it is the same thing when you want to hire a doula. I always encourage clients to talk to their doctors or midwives first to see if they are okay with it,” she says, adding, “This is in order to avoid disappointment.”
Why are the doula services not common in Uganda?
Besides the reason that many expectant mothers have overwhelming support from family members at the time they are going to give birth, Wando also believes the other reason doula services are not common in the country is because many women do not know that they exist.
“That is why the information needs to be out there. I know there are women who would want someone at their side from the time of conception to childbirth but then are not aware of these services,” she says, adding, “ I would actually love it if a Ugandan woman walked up to me one day and told me that she wants to be a doula as well.”
With a doula’s services, Wando believes expectant mothers and their partners can make better informed choices as well as have a more positive attitude towards child birth.
Away from offering doula services, Wando is also a development worker and a facilitator of the Positive Birth Movement Kampala, a mothers’ support group which aims to connect pregnant women together to share stories, expertise and positivity about childbirth.
Away from work, the 45-year-old is a wife and mother of two children aged two and seven years. She holds a Master’s degree in Public Health from Tulane University, New Orleans.
Wando’s preparation routine for expectant mothers
• “During the pre-natal visits, I ask the client about her reproductive history including the number of births she has had, emotions surrounding the birth, desires and expectations from the birth as well as their partner’s feelings towards the birth of the baby.
• Then, I help them develop a birth plan which is a list of preferences they want to have happen during labour, birth and the post-natal period. I also explain the normal physiology of labour and provide them with information and resources if needed.
• Also, I talk to them about nutrition and suggest exercises, which are meant for relaxation, posture and balance.
• Sometimes, pregnant women will complain about the discomfort they feel as they approach the due date, therefore, I suggest better sleeping and sitting patterns so that they can keep a good posture.
• In addition, I do a birth rehearsal that involves a two-hour meeting where the client, partner and I practice comfort measures including breathing techniques, guided relaxation, labour positions, among others. The exercises are meant to keep one in a relaxed state and reduce one’s perception of pain. The other forms of exercises that can help pregnant women relax include bouncing on the stability ball as well as swaying and rhythmic movement. Preferences are different for every woman. Some want touch, some want movement, some like music while others simply just want quiet.”