Originally published on metropolis.co.jp on April 2012

Giving birth is said to be a profound experience in a woman’s life, but for Olivia Arakawa, it was life-changing in more ways than one. Her experience led to her working in Japan as a doula—a provider of non-medical physical, emotional, and informational support to a woman and her partner before, during, and after birth.

“After a long and difficult labor [in the US] I realized how useful a doula would have been,” Arakawa recalls. “My husband’s support was indispensable, but this was his first go around too, and he didn’t know what to do anymore than I did.”

After maternity leave she realized she was no longer satisfied with her job and set about becoming a doula in 2010. Unlike midwives, doulas are not medically qualified and don’t perform clinical duties during birth. While training is not usually regulated, Arakawa was fortunate to study at the highly regarded Simkin Center of Allied Birth Vocations in Seattle with Penny Simkin, a founder of both the doula movement in the US and DONA International, a global association for the profession.

“I took a one-week course, attended childbirth classes and a ‘Breastfeeding for Doulas’ class. I also keep up continuous education on the latest research,” Olivia explains. “I’ve been practicing since then and recently added teaching birth classes to the mix.

Jane Kitagawa

“I’m planning on becoming a midwife, and this seemed a good starting point to gain experience and help women have smoother, calmer labors. I love my job,” she smiles. “You never get over the joy of seeing a baby born—and also that of seeing a couple become a family.”
When personal circumstances resulted in Arakawa and her family moving to Japan, she was lucky she could transfer her practice, Olive Tree Birth.

“Birth in Japan is seen as a natural and positive process, in contrast with much of the US, where it is highly medicalized and considered fraught with danger,” Arakawa comments. “Consequently, the cesarean rate here is much lower and the outcome for women and babies are better. However, not everyone is comfortable with the pain relief options available in Japan,” she says, adding that a doula can assist with such issues and gather information about pregnancy, labor and available delivery options for clients.

“What I do differs according to a woman’s needs, but includes birth education, light massage, suggesting different positions, encouragement and information, and breastfeeding assistance,” she says. According to Arakawa, a large body of research points to a reduced need for vacuum extraction, forceps delivery, and cesarean births when doulas are involved—not to mention more satisfaction for the mothers, better outcomes for the baby, and shorter labors.

Arakawa meets with expecting mothers and partners at least twice before birth to explore concerns and hopes, and get acquainted. When labor begins, Arakawa goes to the client’s house until it is time for the hospital. Then, she remains present until an hour or two after birth to make sure the new family is settled in. She meets once or twice afterward to discuss the birth and provide additional breastfeeding and parenting support as needed.

“We’re fortunate to have excellent midwives here in Japan. However, your midwife doesn’t stay the whole time you’re in labor; they have several women to look after at the same time. They change shifts too, so you don’t have continuous support. If you don’t speak Japanese fluently, there’s also a communication challenge. But I think the biggest benefit is that a doula is there for you—and only you. The midwife is a medical professional; her main goal is to get you and your baby safely through this journey. Though safety is the highest priority, it’s not the only important aspect of birth. A doula is there to help you feel satisfied with and in control of your birth experience.”

Arakawa notes that all hospitals she’s visited as a doula have welcomed her services. However, she says, Aiku (in Hiroo) allows only one person during birth, so a mother would be unable to have her partner and a doula present.

For further information on Olive Tree Birth doula services and birthing classes, see www.olivetreebirth.com