After graduating with a bachelor’s degree in community development from Daystar University in 2012, Susan Lumosi, 28, travelled to Canada, where she worked as a children’s counsellor for a year.
In 2014, she returned to Kenya to work with an automobile company. A year later, she quit because of what she felt was a hostile work environment.
Jobless, Susan took time to figure out the next step to take. One day, she visited her friend who was pregnant, and she did her best to provide the emotional support and company she needed. What she did not know was that this experience would lead to what she does today.
In 2015, she took up a job with Church World Service Refugee Settlement Centre (CWS-RSC), a refugee resettlement programme that assists African immigrants to settle in the United States, but a change in immigrant policy early this year led to a sharp decline in the number of people being admitted to the US, forcing the company to downsize.
Susan and tens of her co-workers lost their jobs.
“My friend, who has since given birth, is the one that suggested I become a doula, or a labour support specialist, arguing that I would be good at it,” says Susan. A doula gives advice and childbirth-related information to mothers before, during and after the birth of their babies.
“While a new-born should bring happiness to the mother and her family, sometimes delivery is a traumatic experience, especially for first-time mothers who do not get the necessary emotional support and physical comfort during labour and after delivery. My job is to ensure that mothers-to-be don’t go through these discouraging delivery experiences; my job is to make childbirth a memorable experience for mothers.”
“I discuss with the mother her birth plans and wishes, and what expectations she has about the birth. If the mother has not attended any lamaze or childbirth classes, I offer her guidance and advice on the best lying or sitting positions to counter pressure from her growing belly. I also help her to maintain mental focus and teach her breathing techniques. I also massage her back to ease pressure and to provide comfort,” adds Susan.
In recent years, the services of doulas are becoming popular in the country, especially in Nairobi.
“Most modern young mothers are conscious about the emotional and psychological implications of unsupported deliveries. Pregnancy is an isolating phase of a woman’s life, and expectant women hire doulas to support and keep them company during pregnancy. There are also those that experience severe levels of pain and longer labour, and require continuous support and constant assurance that they will pull through – this is where a doula comes in.”
Unlike before, when the services of one were a traditional art learnt through experience, today, doulas are formally trained and certified. Susan has been trained and certified by Elizabeth Project International as a labour support specialist and a breastfeeding counsellor.
“They visit Kenya twice every year to train doulas; the training, which takes a week, is usually advertised on their website where those interested can register for the classes.”
TAKES A CERTAIN KIND OF PERSON
Male doulas, she says, are rare.
“Labour support is a very intimate affair. It involves sharing very raw emotions and concerns. A doula must therefore be patient with the mother, a quality that most women have, besides, most would be uncomfortable to have in the labour room a man who is not their husband or doctor.”
There are mainly three types of doulas.
“A birth or labour doula assists the mother as she goes through labour. An antepartum or a pregnancy doula helps a mother a few weeks before childbirth, usually between 36 to 40 weeks, while a postpartum doula helps a mother, and sometimes even her family, shortly after delivery of the baby. The support provided is the same.”
According to a survey conducted by Cochrane Database of Systematic Reviews, having a doula increases the chances of a safe and successful delivery.
“Continuous labour support enhances the chances of a vaginal birth while decreasing childbirth through caesarean section. The support of a doula also minimises the use of pain medication and medication to stimulate the labour process. It also encourages shorter labour while lowering the risk of postpartum depression,” explains Susan.
Although married but without children herself, Susan sometimes faces biases in her practice, particularly with older mothers, with some questioning her expertise due to her age.
“Some dismiss me on face value, arguing that if I haven’t given birth yet, I am unlikely to understand the experience of childbirth; I may not be a mum yet, but I have information that is evidence-based. I have also assisted in successful deliveries many times. When I demonstrate my capability, they become more trusting and confident in my expertise,” she says.
The roles of doulas and midwives in childbirth are often confused. A doula, Susan explains, offers strictly non-clinical services; she can only interpret the doctor’s instructions to a mother in the labour room, even if she has a professional background in medicine.
Certified midwives however are allowed to offer medical advice, to diagnose and intervene during delivery.
Susan charges between Sh30, 000 to Sh80,000 per client, depending on the mother’s financial strength, the length of service and the scope of services she requires.
“I usually have three or four mothers at any given time. I support them from three weeks to delivery and a week after giving birth. It isn’t possible to have many clients at the same time because you must give the expectant women all the attention they need,” Susan explains.
Her business mostly targets first-time and second-time mothers.
Susan desires to see the role of doulas in Kenya recognised as a formal job as opposed to an informal service.
“We ought to incorporate doula services in the package of childbirth. Public hospitals should have a team of labour support specialists who help mothers during labour and childbirth. There should also be insurance policies that cover these services,” she argues.
She recently partnered with Nurturing Touch Wellness Centre, a Nairobi-based facility that offers prenatal, labour, and postnatal birth-related wellness services. She is also is a member of a network of doulas in Nairobi.
“We share information and our experiences of the job, encourage each other and seek to grow together. As a practitioner in any trade who is looking for valuable mentorship or partnership, always identify someone who has walked the journey longer than you. This way, you are able to hack the job more quickly,” is her advise.
Find out more about what Susan does on www.sueabby.com and on social media: Facebook: Sueabby Nairobi Doula and @sueabby_nairobidoula on Instagram.