What’s a doula anyway?
The word “Doula” means “a woman who serves.” A doula acts as the guardian of each woman’s birth story, providing physical and emotional support to both the birthing woman and her partner. As women provide care for other women in something as uniquely feminine as pregnancy and childbirth something powerful happens. The birthing woman is comforted and calmed through the presence and care of this experienced birth guide who knows that what she is experiencing is normal and appropriate.
“The doula is a professional trained in childbirth who provides emotional, physical, and educational support to a mother who is expecting, is experiencing labor, or has recently given birth. Their purpose is to help women have a safe, memorable and empowering birthing experience.”
– americanpregnancy.org/labor and birth
“Asking your husband to be your sole guide through labor is like asking him to lead the way on a climb of Mount Everest. He may be smart and trustworthy, you may love him, but in the Himalayas you’d both be a lot better off with a Sherpa.”
Pam England
Role of a doula from the mouth of a mother. . .
Sarah, birthing mother
“Monica is an excellent doula in every capacity. My husband and I loved our birth experience with her and look forward to future deliveries with her by our sides! Monica was our advocate. She knew what questions to ask and what techniques to suggest. She supported the care from my OB and partnered with the hospital staff to promote the best outcomes.
She was our guide. Monica is trained in Hypnobabies and GentleBirth and brings personal experience to the table as well. She asked what birth experience we wanted and then directed us to the right resources. She encouraged me to text her anytime and would often send articles and videos that I would find inspiring.
Monica was my cheerleader from start to finish. She supported exactly the birth I desired, and gave me the tools to achieve that. She never failed to tell me I was doing a good job. In labor, she cheered me on and lead my husband to do the same. She taught him ways to help me manage contractions and together they kept me going. She never took control, letting me call all the shots. She also never let me give up but reminded me I could always change my mind.
Finally, Monica was my champion. Labor was fast and furious and she never got a break. But she never let her tiredness show. She stayed with us late into the night to make sure we were settled and well. Her positivity and confidence throughout pregnancy and labor was exactly what I needed. She was my rock in the rough moments and helped me find that same strength in myself!”
Research Comparing Birth Outcomes With and Without Doula Support
| Study | No Doula Support | Doula Support |
|---|---|---|
| Guatemala (Sosa, 1980) | Length of labor: 19.3 hours | Length of labor: 8.7 hours |
| Use of Pitocin: 16% | Use of Pitocin: 2% | |
| Cesarean Rates: 27% | Cesarean Rates: 19% | |
| Guatemala (Klaus, 1986) | Length of labor: 15.5 hours | Length of labor: 7.7 hours |
| Use of Pitocin: 13% | Use of Pitocin: 2% | |
| Cesarean Rates: 17% | Cesarean Rates: 7% | |
| Houston (Kennell, 1991) | Length of labor: 9.4 hours * | Length of labor: 7.4 hours |
| Use of Pitocin: 44% | Use of Pitocin: 17% | |
| Cesarean Rates: 18% | Cesarean Rates: 8% |
Kennell, J., Klaus, M., McGrath, S., Robertson, S., & Hinkley, C. (1991). Continuous emotional support during labor in a US hospital: a randomized controlled trial. Jama, 265(17), 2197-2201.
Klaus, M. H., Kennell, J. H., Robertson, S. S., & Sosa, R. (1986). Effects of social support during parturition on maternal and infant morbidity. Br Med J (Clin Res Ed), 293(6547), 585-587.
Sosa, R., Kennell, J., Klaus, M., Robertson, S., & Urrutia, J. (1980). The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. New England Journal of Medicine, 303(11), 597-600.
* You will see that there was much less difference in length of labor between the two groups in the Texas study. In the hospital where this study was done births were actively managed, meaning they would give laboring women Pitocin to ensure labor progression on a pre-determined schedule, so the length of labor was significantly shorter for the birthing women without doula support than it likely would have been without labor augmentation.
Use of Pain Medications
| Measures | Planned Narcotics | Doula Supporting | Planned Epidural |
|---|---|---|---|
| Development of Fever in Mother | 23.5% | 12.3% | 29.6% |
| Cesarean rate | 11.6% | 3.1% | 16.8% |
| Epidural use | 26.8% | 6.3% | 87.7% |
| Instrumental Birth (Forceps/vacuum) | 24.8% | 12.2% | 17.2% |
McGrath, S., Kennell, J., Suresh, M., Moise, K., & Hinkley, C. (1999). Doula support vs epidural analgesia: impact on cesarean rates. Pediatric Research, 45, 16A-16A.
Breastfeeding Outcomes
| Measure | No Doula Support | With Doula Support |
|---|---|---|
| Breastfeeding 6 weeks postpartum | 29% | 51% |
| Breastfeeding on demand | 47% | 81% |
| Feeding problems | 63% | 16% |
Hofmeyr, G. J., Nikodem, V. C., WOLMAN, W. L., Chalmers, B. E., & Kramer, T. (1991). Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding. BJOG: An International Journal of Obstetrics & Gynaecology, 98(8), 756-764.