Do have a doula

When mum is looking after a new baby, who's going to look after mum if her family can't step in? Harriet Green found a perfect solution

Three weeks before the birth of my first baby, I started to panic. It wasn't the birth itself that bothered me - though that did focus my mind, I assure you. No, the thing that worried me most was the follow-up. Most of the women I met in childbirth classes seemed confident that they could cope with a new baby. But although I looked forward to making the acquaintance of my little daughter - as she turned out to be - I had also become convinced that lack of sleep and frequent crying jags would send me bonkers. I needed help.

Traditionally, women facing similar circumstances have turned to their mothers. But that's not always an option these days. As women are giving birth later in life, their own mothers are much older too, and those grandmothers don't always feel as energetic as they might have done a decade earlier. What's more, many grandmothers are likely to hold down full-time jobs themselves. Then there's the problem of distance: many families are scattered across the country. My mother lives in Somerset and I'm in London. She is wonderfully supportive, but simply not in a position to offer long-term, day-to-day help.

What could I do? One option was to hire a maternity nurse, but these women have a reputation for formality and bossiness, and they nearly always stay in your house. I did not relish such intrusion. One of my friends had hired a maternity nurse and regretted it immediately. She felt the nurse - though generally pleasant - got in the way when she and her husband should have been getting to know their new baby. Anyway, it had always struck me that hiring a maternity nurse was ill-conceived: the nurse looks after the baby while the new mother looks after the nurse with endless tea and coffee and meals. I wanted to look after my own baby. What I needed was someone to look after me.

So I looked into other possibilities and it became clear that what I really needed was a "doula" (from the ancient Greek, meaning "handmaiden"). British Doulas, the best-known agency in Britain, told me that all doulas are mothers themselves, so they know first-hand how difficult the early weeks can be. They've also done formal City & Guilds training. You can choose between "birth doulas", who support mothers during labour, and "post-birth doulas", who help at home, in the days and weeks that follow, for between £10 and £15 an hour.

British Doulas has roughly 200 doulas on its books, ranging in age from their twenties to their seventies.

One recent client was novelist Claire Calman. She called in a doula a couple of weeks after she had returned home from hospital, and the benefits were immediately obvious. "As soon as Mary turned up, we went from chaos to sanity in an hour. She ordered me to bed and, by the time I'd come downstairs, she'd made supper, tidied the kitchen and shoved the washing in the machine. She was very good with my baby and had a great sense of humour."

Jean Birtles, the agency's founder - who imported the idea from America - points out that "childbirth is a time when women are at their most vulnerable". Post-birth doulas enable them to concentrate entirely on their new babies, rather than feel oppressed by the unmanageable workload of new motherhood. "Doulas will do a little washing and ironing, make a freshly prepared lunch for the mother who may be breastfeeding, prepare supper for the evening and provide emotional support," she says.

And unlike your own mother, a doula will do these things the way you want them, without making annoying comments about where you're going wrong.

So I booked a doula, and as soon as Pru Guthrie stepped inside the house, two weeks after Nancy was born, I knew I'd made the right decision. Pru is the mother of two teenage children and one of the most considerate, patient and cheerful people I have ever met. These qualities have previously served her well when she worked as a veterinary nurse and in a school. Hard though it may be for some women to understand - and I would have been one of them before I met her - she actually gets a kick out of helping new mothers. "It's a real privilege to be part of such a special time in a woman's life," she says. "It's lovely to be able to make the first few weeks easier for them. And I've always loved babies." Altogether, Pru was with me for six weeks and I've never felt so well looked after. She made sure I was comfortable, that I drank enough water and had proper meals - all essential when you're breastfeeding. In the mornings, while I caught up on much needed sleep, Pru would let herself in, so that when I wandered downstairs with little Nancy, the coffee was already bubbling in the pot and she was there to welcome us with a cheerful smile.

The kitchen was spotless, the bottles sterilised, the dishwasher emptied and essentials were never allowed to run out: she arrived every day with fresh supplies. Her cooking was delicious: every evening, my husband returned from work to find supper waiting in the oven. Consequently, we could enjoy our evenings together without bothering about what to eat or, worse, going without.

Daytime visitors benefited too. Pru made coffee or lunch for everybody, so friends could actually enjoy visiting Nancy and me, rather than leave the house hungry and thirsty.

If I needed sleep, or to pop out on my own, Pru would look after Nancy. I soon realised that she had a lot more experience than I did - not only from having her own children, but also second-hand experience gleaned from her previous assignments as a doula - so I was always grateful for practical help.

Three weeks after the birth I had to cross London for a hospital check-up. I struggled alone for a while to get Nancy dressed and into the car seat, while she turned red with rage. This became so stressful that I abandoned the trip - and phoned my husband, who'd left work early and was half-way to the hospital - to tell him so. But Pru gently stepped in to help, even accompanying me part of the way, despite her shift having come to an end, and I got there without too much of a problem.

Best of all, Pru became a great friend. I was used to working in a busy office in Soho and had never spent much time at home during the day, so it was lovely having her company. If I felt glum or grumpy, she picked up the pieces.

Of course, not all doulas are this good. Claire Calman urges mothers-to-be to make sure they find exactly the right person. As with any employee who comes into your home, it's crucial to find one whose personality is compatible with your own. After Calman's doula left to start her next booking, Calman enthusiastically called in a replacement, only to find the experience not nearly so successful. "When you are so desperate for help, you think it'll be fine. She was sweet, but very vague."

Not surprisingly, the best doulas get booked up fast. Demand has outstripped supply, and Birtles says: "We really need experienced mothers to come forward for training."

She believes that six weeks' assistance is enough for most mothers. Well, I may be a lightweight, but four months after Nancy's birth I still miss Pru terribly. In fact, I've tempted her to return for the last weeks of my maternity leave. And I don't mind if she stays for the months and years after that.

How to be a helping hand

To work as a doula, you have to be a mother yourself. Only that way, according to British Doulas, can you really understand the problems facing a new mother. For that reason, the job is ideally suited to women who want to return to work after a long period of looking after their own families.

"Some of our doulas have been nurses, midwives, health visitors or nannies," says founder Jean Birtles. "But many others have had no medically professional or academic experience. However, as mothers (and often grandmothers), they do have most of the relevant life experience."

All the same, it takes a particular character to be a doula. "You should be sympathetic and a good listener. You should also understand the issues that new families face, and be able to work without being intrusive, prescriptive or promoting dependence."

British Doulas, tel: 020 7244 6053, or see www.britishdoulas.co.uk

Harriet Green is features director of Harpers & Queen

Useful links

• Doulas of North America
• Doula Information - Childbirth.org
• FAQ - Chilbirth.org