History of Doula

Having a doula or “birth supporter” is a concept that dates back as far as prehistoric times. In the 1960’s, at the height of the “natural birth movement”, this became a more widespread practice for women who desired more control over their birth outcomes.

Years ago, when women exclusively gave birth at home in the care of skilled midwives, women had their female family members support and guide them, but with the development of obstetrics and hospital births in the last century, women became estranged from the birth process, and family members lost sufficient knowledge and confidence to guide a woman.

To fulfill women’s need for birth support in modern times, the professional doula arose in the 1970s and ’80s.

 

Role of a Doula

• A Doula is a trained companion who is there to provide active support for a birthing mother and her family during both labor and the postpartum period.
• All doulas facilitate communication between women and their caregivers and encourage women to advocate for themselves and to participate in informed decision making about their care.
• Labor doulas stay with women for the entire labor, offering encouragement, suggesting techniques for increasing comfort, and helping establish breastfeeding.
• Postpartum doulas offer hands-on guidance with the baby, help with breastfeeding, emotional support as the mother heals from the birth experience and practical support including organizing the home, doing errands and cooking meals.

The key component of doula care is the nurturing and caring presence of the doula. As doulas like to say, they mother the mother.

 

What does a doula do?

Typically, doulas are privately hired by women and their families. Most women first meet a labor doula in the second or third trimester of pregnancy.

• In prenatal meetings, an expectant mother and a labor doula will discuss the mothers birth preferences and the doulas ability to meet or adapt to those needs, the mothers thoughts about drugs and interventions, and her fears and/or concerns about labor and birth. She and the doula will also explore the kinds of emotional support and comfort techniques she may find helpful.
• Doulas may offer their clients further information on pregnancy and childbirth, and may assist them with developing a birth plan.
• Unlike most medical caregivers, doulas provide continuous support to the laboring woman.
• The labor doula routinely arrives when labor begins or whenever the woman is ready for additional support.
• The doula may meet the mother at home, hours before she leaves for the hospital or birthing center.
• A doula remains with the mother continuously throughout labor and stays until a couple of hours after the birth.

 

What does a Doula NOT do?

• Doulas do not perform any medical or clinical tasks.
• They do not make any medical recommendations or clinical assessments
• Doulas do not diminish the importance of having a midwife or doctor present at a birth.
• Doulas do not take your blood pressure.
• Doulas do not take your temperature. If your water has been broken for a while or you show signs of a fever, she may suggest you take your own temperature.
• Doulas do not do vaginal exams.

 

How has the role of a Doula changed?

Doulas have been in the process of integrating into the maternity care system for the last 30 years. Research, coming mainly from underserved populations, shows that doulas have a positive influence on labor and birth outcomes, such as shortening the length of labor, lowering the rate of epidural use, and lowering the rate of cesarean surgery. Mothers supported by doulas have demonstrated more affectionate interactions with their newborns, less anxiety, and felt the doula had a positive influence on their birth experience.

During childbirth, support from Doulas is becoming more usual in healthcare in Western countries. According to a recent review about continuous labor support, published in 2018, the continuous labor support appears to offer impressive benefits and no harms to women and newborns, especially when provided by someone in a Doula role. This appears to be an important care practice for those who wish to improve the quality, outcomes, and experience of maternity care.

While most people associate doulas with the birthing process, their role has expanded to cover diverse forms of support, including physical, emotional, informational, and advocacy support for women during all phases of pregnancy and labor. Moreover, their role does not end with women. This type of care extends to the partner and other family members as well.

For more information please visit the National Library of Medicine

 

What to expect from a doula

A doula is an advocate for the birthing mother and her partner. Whether a women wants to birth in a hospital (with or without drugs or interventions), or whether she wants to birth at home with a midwife or other trained attendant, her doula will be there to help her feel involved, safe and empowered. A doula does not replace the birthing mother’s partner, or the loved one she has chosen to be with her. The doula is there to provide objective nurturing support and education, to make suggestions about comfort measures and positions, to keep the mother hydrated and focused, to provide breaks for the other members of the birth team, and to be the gatekeeper between the mother and the outside world. The doula is there to help make birthing easier.