As the rate of caesarean deliveries steadily rises, so is the 'trend' of pregnant women employing a birth support person – known as a doula – to prepare for and help them give birth.
Gaby Targett has had over 400 new babies in her arms, and as one of Perth's longest-serving doulas she looks back at 17 years of witnessing the joy and excitement of women giving birth.
She said the vocation of becoming a doula was quite accidental, and started when one of her girlfriends, inspired by Gaby's own positive birth experience, asked her to be with her when she delivered her son.
"When my girlfriend had her baby, she wanted me to be there and help her create that atmosphere. I really didn't know what my role was, didn't know what a doula was, I just knew that me being there would help her be calm and focused within," she said.
"It wasn't until five years after I'd been attending births that someone said 'oh, you're a doula'. I was so shocked there was a word for it and [after researching it] I discovered there was a whole movement.
"I was the only doula in Perth at that time as far as I knew."
Gaby describes a doula as a support person who gives women emotional help in their birthing experience.
Contrary to midwives, doulas have no medical role in the birthing suite, and only offer advice when explicitly asked. But she said her real focus is delivering effective child birth education before the big event.
"I used to be a doula that just turned up for the birth, but I realised after the first 10 years - which I call my 'apprentice years' - that really the focus and effort is about the work I do prior to the birth."
The concept of an experienced woman attending birth is not new, she said, and can be found in various indigenous cultures around the world. The word "doula" actually means female servant in Ancient Greek, but doulas used to also be called god sibs or montrice.
"Aboriginal women had them forever, known as charrlies," she said.
"It's not a new thing but has become in vogue because there is such a high intervention rate, and the medical model is so powerful in the hospitals that women's births have been seen as a medical procedure, not something that's a natural process".
Around 2004 there was an influx of women asking for birth support, Gaby said.
Gaby, who describes herself as "a guardian of natural birth" is passionate about helping women experience the most natural birthing experience they can have, and take away their fears and apprehensions.
She said she believes what she calls "the cascade of intervention" was a factor explaining the rising rate of caesarean deliveries in Australia.
Over the past 10 years in Australia, the caesarean rate increased from 23.3 per cent in 2000 to a peak of 31.5 per cent in 2009, according to the Australian Institute of Health and Welfare.
"Women need to know that the smallest amount of intervention can snowball. A lot of women end up with caesareans because they were induced," she said.
Gaby said that while most partners welcome her into the delivery suite to take the pressure off them, and to provide a calm and relaxed environment, she sometimes faces hostility from medical staff.
"In a lot of the private hospitals here in Perth the midwives really are hostile to me," she said.
"They see me as a threat. They even got to a point where you have to sign a consent form that you won't speak to your client, or encourage them or give them advice at any time."
Gaby found that her skills are gaining acceptance by the medical profession, and her new book, A Labour Of Love II, features a foreword written by Perth's Professor Fiona Stanley.
In the new book, the sequel to her first birthing guide A Labour Of Love, Gaby aims to "empower through knowledge to give women the birth they want".
"If you don't know what your choices are, you don't have any," she said.
"Should you need medical interventions, you can't feel disappointed if you have put everything into your mental and physical preparations. People spend more money on their cot, their prams and their baby car seats than what they do on education. Birth education is invaluable."
Topics discussed in the new book also include optimal foetal positioning, mental preparation, and techniques such as imagineering, hypnosis and several other alternative therapies like acupuncture, acupressure and homeopathy.
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