Doula

A doula is a non-medical assistant in prenatal care, childbirth and during the postpartum period.

The word doula comes from Greek, and refers to a woman who personally serves another woman. In Greece, the word has some negative connotations, denoting "slave" or "servant of God", as some doulas have inadvertently discovered through their international social networks. Anthropologist Dana Raphael first used this term to refer to experienced mothers who assisted new mothers in breastfeeding and newborn care in the Philippines. Thus the term arose initially with reference to the postpartum context, and is still used in that domain. Medical researchers Marshall Klaus and John Kennell, who conducted the first of several randomized clinical trials on the medical outcomes of doula attended births, adopted the term "doula" to refer to labor support as well as prenatal and postpartum support.

Labor support doulas are trained and experienced labor support persons who attend to the emotional and physical comfort needs of laboring women. A labor support doula joins a laboring woman either at her home to assist her before going to, or shortly after she is admitted to, the birth place, and remains with her until a few hours after the birth. In addition to emotional support, doulas work as advocates of their client’s wishes and may assist in communicating with medical staff on their behalf. Doulas differentiate themselves from medical practitioners in a variety of ways.

Postpartum doulas are trained to assist and encourage the new mother by helping with light housework, meal preparation, and breastfeeding.

A doula provides kindness and comfort to a woman who is in labor. This is an especially important job, because this friendly care-taker encourages and provides support to a woman when she is giving birth, one of the most vulnerable times in a woman's life. Although doulas provide services first time parents will appreciate, many women who have already given birth one or more times find the addition of a doula to their birth team an invaluable support.

Community doulas play an important role for women at risk for poor birth outcomes and those who face barriers to prenatal care. These doulas will combine the roles of labor support and postpartum doulas to offer continuous encouragement and reassurance to pregnant women with little social support. In order to form strong, trusting relationships in a social support network, it often benefits a pregnant teen to participate in both group discussions and receive individual attention. In this way, community doulas can encourage self-advocacy, teach parenting skills and motivate a teen to feel in control of her pregnancy.

Goals of social support models like the Community-based Doula Initiative, include preventing subsequent pregnancy and increasing the quality of the mother-infant bond directly after birth in order to increase the chances of secure mother-infant attachment throughout early childhood.

In the United States and Canada, doulas are not required to be certified, however certification is available through several different organizations. Licensing is not available for doula care providers.

A doula provides:

• Explanations of medical procedures and interventions;
• Emotional support;
• Advice during pregnancy;
• Exercise and physical suggestions to make pregnancy and childbirth more comfortable;
• Help with preparation of a birth plan;
• Facilitation of communication between members of laboring woman's birth team;
• Massage and other non-pharmacological pain relief measures, aromatherapy, any other non-medical comfort techniques she may be trained in;
• Positioning suggestions during labor and birth;
• Support the partner so that s/he can provide support and encouragement to the laboring woman;
• Help to avoid unnecessary interventions;
• Help with breastfeeding preparation and beginning;
• Some doulas offer a written record of the birth (birth story);
• Is present during entire labor and afterwards as long as is needed by parent(s).

Women supported by a doula during labor have been shown to have:

• 50% reduction in cesarean rate
• 25% shorter labor
• 60% reduction in epidural requests
• 30% reduction in analgesic use
• 40% reduction in forceps delivery

For more information on the study of the effectiveness of doula support, please see http://maternitywise.org/pdfs/continuous_support.pdf

For more information on the Community-based Doula Initiative, please see http://www.chicagohealthconnection.org/our_work/doula/

External links

For information regarding doula training or finding a doula, contact:

• http://www.doula.org.uk/
• http://www.dona.org
• http://www.cappa.net
• http://www.alace.org
• http://www.globalbirth.org
• http://www.positivebirth.org/
• http://www.naturalbeginningsonline.com/
• http://maresdoules.org
• http://www.midwiferytoday.com/friends/motherlove/
• http://www.lamaze-childbirth.org
• http://www.birthingfromwithin.com
• http://www.canadiandoulas.com
• http://www.icea.org

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