Barcelona Mum

Interview with Juliette Allard

Juliette Allard is a fully qualified Doula, working in Barcelona and surrounding areas. She comes highly recommended by many local mums. If you have any questions for Juliette she would love to hear from you!
juliette@mamadoula.org 656639455

Could you define for our readers the definition of a doula and the services a doula offers women?
A doula is a person who is trained in supporting women as they give birth. She is familiar with the processes involved in normal, physiological birth and knows what to expect during a normal labour (she should be a mum as well with a personal positive experience of birth). She is trained to provide physical and emotional comfort, reassurance and encouragement, natural pain management techniques (for example massage, active birth postures, and relaxation/breathing tools), and suggestions for helping labour to progress. She is trained to inform the parents and help them to take their own decisions. A doula should be a neutral knowledgeable person, one who understand parents needs and medical procedures. Some doulas also work with parents after the birth to help them adjust to life with their new baby. A doula is not a medical professional and as such she doesn't deliver babies, or perform clinical tasks such as fetal monitoring, a doula is there for the parents, the doctors or midwife for the baby. To have a doula with you in the delivery room you must have the approval of the OB or the midwife.

What percentage of your clients are from the international community?
Most of the mums to be I help during their pregnancy are foreign, I would say 80% of them (that includes German, American, English, Canadian, Belgian, French…) and 20% Spanish but not catalan (as I dont speak catalan). I’m French so I’m attracting more International people who need help with translation

Why do they choose to work with a doula?
Parents need to be guided in their maternal language  meaning future parents are looking for someone who is able to understand their situation 100%, understand the fact they are foregneirs, lost in translation, and also lost in the maternity medical world translation. They are looking for someone who knows the  Catalan system, who knows about birth and who speaks the same language. A doula will be their birth friend and coach. The prenatal visits are always in the parents house as that is more comfortable for them.

How do people go about finding a doula, and how do they know if they are fully qualified?
Hiring a doula is so so personal, the mum to be has to feel very comfortable with the doula, and the first meeting is free of charge, the parents express their needs, and ask some question about the doula experience, and the doula will know if she feels ok to accompany the parents too. The first meeting is to see if the team could work together. Normally a doula receives a complete training in childbirth education, and she has to have had a birth experience too. In Barcelona you have the Mares doules 9 months training, and a new one is started in Madrid. In October a DONA training  is starting for 4 days (it is an American training). Personally I did my certification with the very open minded Canadian doula training “Mère et Monde “ a very intensive one, 2 weeks, plus some internship with them and a midwife of my choice (to assist and build experience in active birth, but also be there for c-section as a wellness support). I did the kalsa way training with Gurmukh and the very famous Doula in Los Angeles, Anna Verwaal, plus the paramana doula course with Michel Odent in France. I will never stop having training because is a very important part of this job, being an information source for the mum to be. But the most most important thing is what the mum to be feels about her Doula, if she feels confident and relaxed  having this person in her intimacy.

Are there any associations for doulas in Catalunya?
In catalunya you don’t have a real Doulas association, because this service is not recognized at the moment. But some groups do exist, like www.doulasbarcelona.org a web site that provide a list of doulas in Barcelona or catalunya, so people can pick the doula of their choice. You have also www.maresdoules.org but this is mostly Imma Sarrias` website, she is one of the pioneers in Barcelona.

When you first got involved in childbirth support, what did you aspire to provide for women and has this changed?
I always try to answer first her questions, and after that I give information with scientific proof, to let her make her own decisions. Always be there to comfort her in her decision, never projecting my vision of what will be my ideal birth, just let her know that I will be always by her side to help her live the experience of birth in as positive a way as possible. That is not always easy, because sometimes I really train women to go for a natural birth because I really know they have the capacity for it and they are super prepared but they still go to a private clinic or hospital and there the reality makes their birth wishes changes, but at least they get good understanding and good support during all the process. Some of them just decide to do it at home, and 100% are really so proud, happy….amazed, there are no word to say thanks. I’m not doing anything, just support and info, All the work is done by the mum!!!!!! Actually I’m creating a herbal tea especially for pregnancy and breastfeeding, to help the mum to be take care of herself thanks to Mother Earth!!!!!. The recipe is one our grand mothers and midwives have used for ever.

What advice would you give to women from the International Community who are preparing to have a baby in Catalunya?
Be very active at looking for information and look for the right place to give birth early in the pregnancy, 9 months go very fast. The midwives are very busy so better to meet and hire one early before their schedule is too full and you have no option. If you want a natural birth and if your choice is the public hospital, the best one is actually San Pau in Barcelona or Santa catarina in Girona so ask for a referall from the Cap Salud if that is not your designated hospital. If you take care of your preparation early on you have more time to relax and get ready for the big event!
 
How do you feel about using pain medication during labour?
I have no judgment, everyone has his/her own resistance to pain, even for me that would not always be a good solution, epidural can help sometimes too. But  that will not be a natural birth because the woman loses movement, freedom and body sensations. The real secret is not that labour is painful it is that women are strong when we leave them managing their own pain and position!!!!!!
 
What labour coping techniques do you like to use?
I like to always remember Michel Odent`s advice, which is to give the maximum feeling of intimacy to the mum and provide the feeling of safety and security and soft light and warmness in the room. And giving her 100% of my attention, presence, discretion. That may sound a bit hippy but this journey is so magical that Love is very very important to provide to the couple also, to preserve their intimate love bubble, you have to love them unconditionally too.
  
What is your opinion of the pre- and post-birth services for women in Catalunya?
Most of the time the prenatal class are a waste of time and money for the parents. Better read books and get information from the internet. The classes are managed by an old-fashioned midwife who will not be at the birth anyway (private course or from the social security), and most of the time, doesn’t know, the OB routine or the protocol of the clinic and only trains people to accept the epidural and the medical routine as a normal way to give birth. There is no postpartum recuperation after delivery, so better to go to see a good midwife or a chiropractor or osteopath to help the body to recover his balance.
 
There has been concern about the number of Caesareans performed in Catalunya – do you think the concern is justified?
Yes the concern is more than justified, as they put the mum in a situation that they are a total spectator of the birth process, passive lying on the dilatation bed and at the end they perform a c-section anyway, and the woman is there alone in the table, witnessing the operation-birth of her baby, totally helpless. And I’m not talking about the schedule c-section. For me a woman who wants a c-section, is a person who don’t know about it, because it is a major operation and the recovery is longer than a normal birth and you have to take care of a baby right a way!!!! That is not easy.
In private clinics it is 40 % of the birth, the other 60% do not include natural births, it will be most of the time a vaginal birth with epidural and her friend the episiotomie!!!!!

What percentage of mothers opt for a natural and/or home births?
A majority of mums to be forsee a normal birth, but fears during the pregnancy and the wrong OB will make nearly all give up on their wishes for a natural birth because most of the time in private clinics the mother will be forced to take the epidural. Statistics show that in public hospitals it is close to 10-15% of women who succeeed in having a totally natural and active delivery (no drugs, but yes monitoring and sometime no freedom during pushing time). A woman needs to be very sure of herself and her partner very supportive to really succeed in having a natural birth. I would say the percentage of homebirths in Catalunya is 1 to 2%, covered by very few midwives, this % is starting to grow, as women start to be very afraid of the hospital routine and prefer a maternal figure to a cold doctor.
 
If a mother opts for a home birth do you deliver the baby or do you work alongside a midwife? If so do you have specific midwifes with whom you work?
As I’m not a medical person, yes I always work with a midwife, I’m there to support and mother the mum and the midwife is there for the baby and assuring the mum that everything is ok. Personally I work with Marisa Dragó, who is an independent midwife, who also does birth preparation (she is catalán and also speaks french and I’m her translator if the mum is an English speaker. She has more than 25 years of homebirth experiences, and she follows the F.Leboyer and M.Odent birth method). I could recommend also Marenostrum, but they are overbooked always (they were trained in England), their birth preparation is one of the best (only in Spanish)

How do you work alongside medical staff during labour if a mother opts for a hospital birth?
I respect her decision, because that is her choice, her life , her childbirth experience, and if she feels safe in the hospital or private clinic that’s the most important thing. Not everyone will feel secure and ready for a homebirth, not with the wrong idea of normal births that society projects. So I try my best to be supportive to the couple explaining any medical act if they ask for it and I respect the medical decisions. I’m not there to fight against doctors, I’m there to give the mum a positive experience, a nice memory of the special moment. I’m not qualified to tell a doctor what they are supposed to do, I’m the one who can help the mum understand a medical intervention. I’m not always able to be present in the delivery room as a doula, but yes as a translator, or their yoga teacher to help them relax. Private clinics are the most against Doula services.

Are you familiar with most maternity hospitals in Barcelona? Have you had a good experience working with them and are there any you would recommend for mothers?
I’m very familiar with most of the big clinics or hospitals, but most of them don’t accept doulas so the parents have to lie to have me with them in the delivery room. To be honest I will only recommend for the moment the hospital San Pau, where the medical team try to get the natural birth label, they accept the doulas and a birth plan, and really try to respect the wishes of the parents as much as they can. The well known “la Maternidad” is too rigid with their protocol and that makes it difficult for the mum during labor. It could be very challenging to give birth naturally as that always depends on the medical team shift. I have a very bad impression of private clinics, all very mechanical (monitoring, epidural with episiotomie most of the time), and they always separate mum and baby for no medical reason. They have always a very old fashion protocol that is totally against the OMS recomandation. If the parents started to ask why, they would not have any valid answer. All the private clinic´s protocol is to protect the clinic not the mothers. But the St Jordi although it is very small is open to allowing some midwives to deliver natural births. This clinic could be a good alternative, like a birth center. This clinic is also in every private insurance. One thing is the OB birth philosophy and vision, and the other is the clinic protocol, so I would recommend to the parents to really check everything.

How do you help mothers after the birth? Do you feel there is adequate support for mothers in terms of caring for the baby and breastfeeding?
 Yes of course I help them after birth to feel more confident with their newborn, and reassure them with breastfeeding if they want to. Depends always on the needs of the new parents, I can do a post partum massage to drain the toxins out of their body, I can cook, clean, do grocery too… it depends. For breastfeeding, I believe that in addition to the midwife, or doula, the Breastfeeding Groups Support are very positive too so I will always give them the number of Alba lactancia or grupo Gemma, and of course the leche League if they have a real problem. We need the support of others mums experiences sometimes and these group are perfect because they are neutral, not judgmental (not always like our mum´s advice or friends), they are a real blessing, a space where the new mum could feel, listen, understand and could afterwards make her own decision, because after all these group are only about sharing experiences and the new mum is the only one who knows her baby. Helping is not doing in her place, but helping could be reassuring or reinforcing a mum in her capacity to be a good mum and the right one for her baby.