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Doula: A woman trained and experienced in childbirth who provides
continuous physical, emotional, and informational support to a woman during
labor, birth and the immediate postpartum period. Postpartum doulas care
for new families in the first weeks after birth providing household help,
advice with newborn care and feeding, and emotional support.
Effects on birth outcomes: Eleven studies showed the following effects of
doula support: shorter labors, fewer complications, reduced cesarean rates,
less need for oxytocin to speed up labor, reduced use of forceps, fewer
requests for pain medication and epidurals.
Effects on the mother: greater satisfaction with childbirth, more positive
assessments of their babies, less postpartum depression
Effects on the baby: shorter hospital stays and fewer admissions to special
care nurseries, babies breastfeed more easily, mothers are more
affectionate with their babies postpartum
Effects on the healthcare system: dramatically reduced cost of obstetrical
care, women are pleased with the personalized care doulas offer
Given the clear benefits and no known risks associated with intrapartum
support, every effort should be made to ensure that all labouring women
receive support, not only from those close to them but also from specially
trained caregivers. This support should include continuous presence, the
provision of hands-on comfort, and encouragement. -Hodnett, E. D. "Support
from caregivers during childbirth." (Cochrane Review) in Cochrane Library,
Issue 2. Oxford Update Software, 1998. Updated quarterly.
Facing unprecedented pressures to reduce expenses, many hospitals are
targeting the largest single budget item--labor costs . . . . [An]
unintended consequence of nursing cutbacks may be an increased cesarean
rate; the inability of pared down nursing staff to provide continuous
coverage to laboring mothers [has been] shown to increase the chance of
cesarean . . . .
Doulas clearly improve clinical and service quality; they provide an
absolutely safe way to reduce cesareans and other invasive birthing
interventions. -Coming to Term: Innovations in Safely Reducing Cesarean
Rates. Medical Leadership Council, Washington DC. 1996.
The continuous availability of a caregiver to provide psychological support
and comfort should be a key component of all intrapartum care programs
which should be designed for the effective prevention and treatment of
dystocia (non-progressive labor). Guidelines on Dystocia. Society of
Obstetricians and Gynaecologists of Canada, 1995.
(information provided by Nicette Jukelevics, DONA Public Relations
Committee Chair. To find out more about DONA, visit their web page at
http://www.dona.com, email at
ASKDONA@aol.com or call 206-324-5440.)
Reprinted from Midwifery Today E-News (Issue No. 1:22 May 28, 1999)
To subscribe to the E-News write: enews@midwiferytoday.com For all other
matters contact Midwifery Today:PO Box 2672-940, Eugene OR 97402
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