Doulas

Doulas are making a difference in families worldwide

When it comes to having a baby, a mother-to-be will have her own vision of the kind of birthing experience she wants. And many women are choosing to include a doula, a midwife—or both—as part of their plan for pregnancy, labor and delivery, and the crucial early months of learning to care for newborn.

Like nurse-midwives, doulas have significant experience in the delivery room. Doulas specialize in providing mothers with the emotional support and physical comforts they need through the course of pregnancy, labor and delivery.

DONA International explains the important role doulas play in helping women carry out their birthing plans and in facilitating the most positive experience of childbirth possible.

 

According to the Cochrane Database, continuous support from a person who is present solely to provide support appears to be most beneficial. This person, or birth doula, has been the subject of over 23 studies from 16 countries and more than 15,000 women in a variety of settings. The Birth Doula provides emotional, informational and some physical support to the expectant woman (and sometimes, her partner) during the prenatal period, during labor and birth and in the early hours postpartum.

The statistical data supporting birth doula care is stunning. Women who have (doula) labor support are 28% less likely to have a cesarean section, 31% less likely to have medical augmentation to speed up their labor, 9%less likely to use any pain medication and 34% less likely to rate their childbirth experience negatively.  Thus, women who have had birth doula support feel more satisfied with their birth experience, the informed decisions that they were able to make, and feel more empowered and confident as new parents. This has a tremendous impact on early parenting and the relationship with their newborn.

Access to birth doula services for pregnant women who are at risk of poor birth outcomes, regardless of geographic location, may help to disrupt the pervasive influence of social determinants as predisposing factors for health during pregnancy and childbirth.

In one study, expectant women who had doulas during the prenatal period have been shown to have four times less low birth weight babies, two times less likely to experience birth complications involving themselves or their baby, and significantly more likely to initiate breastfeeding.
 It is clear that the additional education received through antenatal doula care, the supportive environment with doula care, and on-the-spot informational support a doula care provide during labor have far reaching potentials in improving pregnancy outcomes. When pregnancy outcomes improve, then the health of the entire society can improve

Read more: Hodnett, E. D., S. Gates, et al. (2012).“Continuous support for women during childbirth.” Cochrane database of systematic reviews: CD003766.

 

In ‘The Journal of Perinatal Education –  A Lamaze International Publication’ a  study published in 2013 concludes that ” Doulas can empower women to achieve the best birth outcomes possible, and all outcomes—for births, infants, and mothers—seem to be affected more positively if support is provided by a doula in addition to the medical personnel. The doula focuses on individualized support before, during, and after birth; whereas nurses often are attending to several women in labor and responsible for many clinical and administrative tasks besides direct labor support.

Research indicates that the expectation of nurse support by expectant women may be far greater than what is actually provided (Tumblin & Simkin, 2001). Hospitals could address this disparity by including a system of doula support.

The inclusion of doulas in the prenatal period, at a point when behavioral changes can most impact birth outcomes, is most effective. Therefore, if obstetricians and other birthing professionals could include a plan of doula support in the prenatal period, adverse birth outcomes associated with a lack of social support or for women in general could be reduced. This would benefit the women and babies, medical practitioners, hospitals, and the greater community in reducing the financial and personal costs of adverse birth outcomes.

Offering doulas as part of a menu of choices in the prenatal period would be a way to empower women to be actively involved in preparing for birth and developing self-efficacy in maternal health behaviors. Women offered evidenced-based health information, support in improving their prenatal health behaviors, and the kinds of support provided by doulas are likely to make more informed choices throughout the pregnancy regarding their health and that of their baby”

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