Doula is not a word that everyone knows; in fact, my spell check doesn’t even recognize it. For those of you wondering what in the world a doula is, and why you might want one for your birth, I thought I’d provide some background information.
The most basic definition is that a doula is a person (usually a woman) who provides support to a mother during pregnancy, labor and birth. The role of a doula is not to supplant partners or healthcare providers, but to offer continuous emotional and physical support to a laboring mother. Whether or not they have given birth themselves, doulas are knowledgeable about labor, birth and a variety of comfort methods.
During pregnancy, a doula helps the mother formulate her birth preferences and provides information about pregnancy and birth. During labor, a doula might suggest different positions to try to alleviate discomfort or help the baby progress. She might help a mother vocalize, or together with the mother’s partner, provide massage or counter pressure during back labor. If a mother receives an epidural, a doula might help her change positions or help her get ready to push by focusing on contractions. A doula provides encouragement and supports the mother’s decisions, never making decisions for the mother. After the birth, a doula offers breastfeeding support and can help the parents settle in. When the new family is home from the hospital, a doula visits to process the birth and again offer breastfeeding support and parenting resources.
Doulas provide a special perspective. They are not healthcare providers with several patients, so they are able to provide continuous support to one client at a time. They are not family members, so they are able to provide support during times when family members might be overwhelmed by the mother’s experience.
A meta-analysis done by the Cochrane Collaboration shows that doulas improve birth outcomes. Women who utilize a doula during labor are 26% less likely to give birth by cesarean section, are 41% less likely to give birth with vacuum extraction or forceps, are 28% less likely to use any analgesia or anesthesia and are 33% less likely to be dissatisfied with or negatively rate their birth experience.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews 2003. Issue 3. Art. No. CD003766. DOI: 10.1002/14651858.CD003766.