Stephanie Kawai: “It is vital to eliminate the fear of what the body goes through during labor”

A personal experience and her work helping to establish communities Tokyo Mothers Group and Tokyo Pregnancy Group saw the Briton Stephanie Kawai, 44, follow her instincts to become a doula. A mother of three boys and a permanent resident of Japan, her career as a doula is part of her mission to contribute to support networks for families and the international community in Japan.

1. What does a doula do? A doula is a person who provides support during pregnancy, childbirth and the postpartum period to a woman and her partner, providing information, advice, support and reassurance.

2. What kind of support do doulas offer partners? We are an additional shoulder they can lean on and give them advice or suggestions on how they can better support their partner.

3. Are there any differences from being a doula in Japan? Being a doula in Japan adds a cultural dimension, because while labor and childbirth are the same all over the world, from a physiological standpoint, the cultural differences with what to expect may surprise some.

4. What prompted you to become a doula? I was not at all prepared for my first job. It was by far the most difficult thing I have ever done in my life, both physically and mentally. After that, I started the Tokyo Mothers Group and met a doula. She told me what she had done and I thought, “My God, if I had known about you, when I was pregnant with my first son, I would have hired you in the blink of an eye.” !

Between having my second and third son, rather than returning to my previous job, I decided to follow what was clearly a passion to continue working as a doula. After leading the Tokyo Mothers Group, I knew there was a need.

5. Who are your patients? I work almost exclusively with international couples in Japan. Sometimes there can be a Japanese spouse. I have also had Japanese couples who have lived abroad seeking support.

6. How do you keep abreast of practices? I try to attend conferences online. I am now taking a course that will give me additional skills to become a birth and grief doula to support those experiencing miscarriage, stillbirth or other infant loss.

7. What traits should a doula have? I would say flexibility and adaptability – unexpected things can happen. Being calm is important.

8. How would you describe your own style? It really depends on each client, but I’m empathetic, and building relationships is a big part of that for me. Building familiarity and trust when we work together can have a big impact on the workflow.

9. What about the birth labor that interests you the most? I love to teach how to breathe for birth. Breathing makes all the difference in work, mentally and physically, so making sure my clients are prepared with breathing techniques is one of my favorite things.

10. What types of birth experiences have you supported? Oh, such a variety. Many types of hospital births in over 30 types of hospitals and clinics of all sizes in and around Tokyo, as well as Hokkaido and western Japan.

11. Still in the hospital? No, I have had the great privilege of attending home births; they were some of my favorite experiences. These deliveries are usually taken care of by a Japanese midwife. I have also been in facilities run by midwives, often called josan’in (birth houses) in Japan.

12. Is there a big difference? Having a home birth or in a midwifery office is extremely free in a way that you can’t quite get in hospitals. It’s more like they’re following the woman, rather than the woman who has to follow hospital policies.

13. Has anything changed since the pandemic? Yes, it had a big impact on childbirth in Japan. Many hospitals have restricted birth support that was previously allowed. Sometimes even the father is not allowed to attend a childbirth or visit her afterwards. Fortunately, some places still allow me to accompany the woman in person. For other places, my support has become virtual. Depending on your birth preferences, it is important to know the rules in advance.

14. Is virtual media effective? Yes, I have found that supporting someone virtually while at work, while not ideal, still works well.

15. What is your approach to working with physicians and midwives in labor? The doctors themselves aren’t there until the flare-up or unless there’s a complication, so it’s usually the midwives who are there for the typical job, and they come and go from time to time. in time to check on the wife. Whether I’m there in person or online, we really focus on our particular roles. I’m not here to replace doctors or midwives, but to provide extra support that they may not have the time or the language skills to do.

16. How are their reactions? It is indeed very positive. But, like everything, it’s about cultivating relationships. It’s really important in Japan in general. They usually come away thinking it’s a good thing their patients have someone like me to lean on for advice, help with breathing and emotional support, and to speak things in their own language. native or in a language they are comfortable with.

17. How do you help your clients navigate between informed consent and medical care? I help them understand and know how to navigate their options if something happens outside of their birth plan. I provide them with the appropriate questions to ask and inform them of the alternatives.

18. Are you a lawyer then? Yes. As a doula, I am here to support my clients and work independently for them, not for their caregivers, but I do not speak directly on their behalf. If something happens during labor that is not in line with their hoped-for preferences, I give my clients questions to ask or ask them if there are alternatives to an action plan that can help. facilitate their initial wishes.

19. How connected are you to the Japanese birthing community? There is not a huge community of childminders, but some Japanese women are helping. I would say postpartum support is a bigger goal for most of them. I have a partner doula, a lovely French woman named Celia, and I am in a few Facebook groups for Japanese doulas and I keep in touch with a few Japanese midwives.

20. Finally, what can expectant parents get from a doula? For those who are abroad and not in their home country, a doula can help you overcome some of the cultural differences around pregnancy and childbirth. It is essential to eliminate the fear of what the body is going through during labor, because there is nothing wrong with the way the body functions. We have always lived birth, like any mammal. It’s how we view childbirth that is important and can shape things, and it’s an amazing experience.

For more information, visit tokyodoulasupport.wordpress.com.