Why a doula?

Continuous Support for Women During Childbirth
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J. Continuous support for women during childbirth.
Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub3.

Continuous support in labour increased the chance of a spontaneous vaginal birth, had no harm, and women were more satisfied.

Historically women have been attended and supported by other women during labour and birth. However in many countries, as more women are giving birth in hospital rather than at home, continuous support during labour has become the exception rather than the norm. This may contribute to the dehumanization of women’s childbirth experiences. Modern obstetric care frequently subjects women to institutional routines, which may have adverse effects on the progress of labour. Supportive care during labour may involve emotional support, comfort measures, information and advocacy. These may enhance physiologic labour processes as well as women’s feelings of control and competence, and thus reduce the need for obstetric intervention. The review of studies included 21 trials, from 15 countries, involving more than 15,000 women in a wide range of settings and circumstances. The continuous support was provided either by hospital staff (such as nurses or midwives), women who were not hospital employees and had no personal relationship to the labouring woman (such as doulas or women who were provided with a modest amount of guidance), or by companions of the woman’s choice from her social network (such as her husband, partner, mother, or friend). Women who received continuous labour support were more likely to give birth ‘spontaneously’, i.e. give birth with neither caesarean nor vacuum nor forceps. In addition, women were less likely to use pain medications, were more likely to be satisfied, and had slightly shorter labours. Their babies were less likely to have low 5-minute Apgar Scores. No adverse effects were identified. We conclude that all women should have continuous support during labour. Continuous support from a person who is present solely to provide support, is not a member of the woman’s social network, is experienced in providing labour support, and has at least a modest amount of training, appears to be most beneficial. Support from a chosen family member or friend appears to increase women’s satisfaction with their childbearing experience.

“Going Beyond the Call of Doula”: A Grounded Theory Analysis of the Diverse Roles Community-Based Doulas Play in the Lives of Pregnant and Parenting Adolescent Mothers. Fall 2010 Issue of The Journal of Perinatal Education. Click here to read this ground breaking study.

“…The ethnographic findings of this study suggest that the doulas provide valuable assistance to pregnant and parenting adolescents by addressing social psychological issues and socio-economic disparities. ‘‘Diverse role-taking’’ results in doulas helping pregnant adolescents navigate more successfully through fragmented social and health service systems that are less supportive of low-income adolescents, who are often perceived to be draining scarce resources. The findings have implications for the roles of community-based doulas assigned to low income adolescents of color seeking to overcome obstacles and attain better educational and economic opportunities.”

Doula Care, Early Breastfeeding Oucomes, and Breastfeeding Status at 6 Weeks Postpartum Among Low-Income Primiparae

Nommsen-Rivers LA, Mastergeorge AM, Hansen RL, Cullum AS, Dewey KG.
JOGNN, 38, 157-173; 2009.