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 DOULA

What is it?
DEFINITION AND EXPLANATION OF DOULAS
A Doula (or labor assistant) is a non-medical assistant who provides mothers and their families with physical, emotional and informational support during pregnancy, childbirth and the postpartum period. 

What is it used for? 
CONDITIONS A DOULA CAN HELP WITH
Doulas may specialize in different areas of care.

A labor doula provides:

- Advocacy and support in a variety of aspects throughout the labor and birth process
- Professional guidance from a trained and knowledgeable individual experienced in the birthing process who can assist in facilitating a smooth delivery through liaisoning and communicating with all members of the delivery
- Knowledge and education of various medical aspects of the delivery
- Mentoring and guidance in the physical and emotional changes through pregnancy
- Interventions to increase the woman’s comfort throughout pregnancy and birth
- Facilitation of the process of the parents developing a birth plan
- Methods of assistance such as massage, positioning, breathing and relaxation techniques to increase the mother’s comfort
- Emotional support and knowledge for the partner of the laboring mother
- An advocate who endeavors to help the laboring mother avoid extraneous medical interventions
- Support in breastfeeding and assistance with resolving any difficulties
- Written documentation describing the story of the pregnancy and birth
- Specialized resources devoted solely to the support of the mother and her partner

The labor doula remains with the mother throughout the labor and assists the parents as needed following the birth.
A post-partum doula provides:

- Further guidance and mentoring in assisting the mother with successful breastfeeding
- A source of assistance for the mother and family in incorporating baby into the family structure
- Specialized care of the newborn and education in the needs of an infant
- An ally who can help the father or partner bond with the baby and assist the mother
- Domestic assistance, care of other children in the household, and additional tasks as needed

Where did it come from?
HISTORY OF DOULAS
The term “doula” originated in ancient Greece and historically referred to a woman who provided personal service to another woman.  Some doulas prefer to be called “labor assistants.” 

The modern day meaning of the word “doula” was first coined by anthropologist Dana Raphael.  While in the Philippines she observed more experienced mothers mentoring and helping new mothers care for and breastfeed their babies.  Marshall Klaus and John Kennell then utilized the term to refer to individuals who support a woman throughout her pregnancy, delivery, and postpartum stage, changing the meaning to its present day usage.  

Demand for doulas has been increasing, thanks to clinical studies showing that women with doulas have 50% fewer cesarean sections, a 25% reduction in length of labor, 40% less use of the labor-inducing drug Pitocin and 60% fewer requests for epidurals. Fewer medical interventions also mean lower expenses. This is driving the creation of in-house doula programs at U.S. hospitals. 

What is it based upon?
THEORY OF USING A DOULA
Utilizing the services of a doula is not meant to replace any members of the medical team or the husband or partner; rather, the doula is an experienced professional able to meet the needs of the mother and family throughout the prenatal, birth process, and postpartum period by providing physical and emotional support as well as information, guidance and mentoring.  Given the doula’s knowledge of the stages of pregnancy, labor and delivery, and newborn care, the doula is able to assist in facilitating an easier and more emotionally rewarding birth experience.

What is it like? 
WHAT THE SERVICES OF A DOULA INCLUDE
Labor/birth support doulas can play a substantive support role in the birthing process.  Rather than performing clinical procedures, doulas use a variety of techniques to facilitate an easier labor and delivery through their training and experience in anticipating and assisting the needs of the mother.  Doulas assist the mother’s physical comfort through a variety of interventions, such as suggesting useful labor and delivery positions, massaging her, and performing reflexology.  In addition, doulas provide emotional and psychological support to the laboring mother, and serve as a liaison and advocate between the mother and medical staff.  A doula may also provide the mother and her partner with information on various medical interventions, allowing the couple to make more informed decisions.

Doulas not only assist and support the mother but also provide mentoring and guidance to the father or partner.  Whereas the father often has minimal experience anticipating the needs of the mother through the labor experience and little familiarity with the process itself, the doula has substantial expertise and can serve as an ally and coach to the father.  Doulas are also trained and skilled in incorporating the father’s needs into the birth process, and studies have shown that fathers participate more fully in the birth process when a doula is in attendance.  A doula does not supplant the father but instead facilitates his continued involvement in the labor process birth.

Labor/birth support doulas frequently do not strictly confine their services to the birth process, but offer contact before and after the birth.  Utilizing in person visits, telephone calls, and email contact, these doulas provide additional assistance and support to the mother and family.

Postpartum doulas provide services to the mother following the child’s birth.  Working primarily in the family’s residence, such doulas help smooth the transition the parents undertake as they integrate the new child into their family. These doulas help to facilitate the bond between the baby and mother, support the breast feeding process, and work with the parents to strengthen their skills in caring for the newborn. They also assist the mother with her own recovery by undertaking light housework, preparing nourishing meals for the mother, and engaging with siblings to help them adjust to the new infant.  The scope of a postpartum doula’s duties can vary widely and is determined by the doula and the family.

Who does it?
PRACTITIONER STATUS 
A variety of organizations provide doula certification; however, such certification is not legally required in the United States and Canada.