A doula is an assistant who provides various forms of non-medical and non-midwifery support (physical and emotional) in the childbirth process. Based on a particular doula’s training and background, the doula may offer support during prenatal care, during childbirth and/or during the postpartum period.
A birth doula provides support during labor.
Thus a labor doula may attend a home birth or might attend the parturient woman during labor at home and continue while in transport and then complete supporting the birth at a hospital or a birth center.
A postpartum doula typically begins providing care in the home after the birth. Such care might include cooking for the mother, breastfeeding support, newborn care assistance, errands, light housekeeping, etc.
Such care is provided from the day after the birth, providing services through the first six weeks postpartum.
In some cases, doula care can last several months or even to a year postpartum – especially in cases when mothers are suffering from postpartum depression, children with special needs require longer care, or there are multiple infants.
Etymology & History Of Usage
The word doula comes from Ancient Greek , which means “female slave.”
Because of its origin the term has negative connotations in Ancient Greece as well as in modern Greece, and for this reason, Greek women performing professional labor support choose to call themselves labor companions or birth workers.
Anthropologist Dana Raphael first used the term doula to refer to experienced mothers who assisted new mothers in breastfeeding and newborn care in the book Tender Gift: Breastfeeding (1973).
Thus the term arose initially with reference to the postpartum context, and is still used in that domain.
Medical researchers Marshall Klaus and John Kennell, who conducted the first of several randomized clinical trials on the medical outcomes of doula-attended births, adopted the term to refer to labor support as well as prenatal and postpartum support.
Types Of Doulas
Labor/birth support doulas are labor support persons who attend to the emotional and physical comfort needs of laboring women to smooth the labor process.
They do not perform clinical tasks such as heart rate checks or vaginal exams, nor do they provide advice.
Rather, they use massage, positioning suggestions, etc., to help labor to progress as well as possible. A labor/birth support doula joins a laboring woman either at her home, birth center, or hospital and remains with her until a few hours after the birth.
Some doulas also offer several prenatal visits, phone support, and one postpartum meeting to ensure the mother is well informed and supported. The terms of a labor/birth doula’s responsibilities are decided between the doula and the family.
In addition to emotional, physical and informational support, doulas work as advocates of their client’s wishes and may assist in communicating with medical staff to obtain information for the client to make informed decisions regarding medical procedures.
Postpartum doulas are hired to support the woman after birth, usually in the family’s home.
They are skilled in offering families evidence-based information and support on breastfeeding, emotional and physical recovery from childbirth, infant soothing, mother-baby bonding, and coping skills for new parents.
They may also help with light housework, coordinate freshly made nutritious meals for the mother, and help incorporate older children. The terms of a postpartum doula’s responsibilities are decided between the doula and the family.
Some hospitals and foundations offer programs for volunteer community doulas. Volunteer doulas play an important role for women at risk for complications and those facing financial barriers to additional labor support.
All doulas offer continuous encouragement and reassurance to laboring women. Volunteer doulas can encourage mother-based birth advocacy and motivate a woman to feel in control of her pregnancy.
The doula is an ally and occasional mentor for the father or partner. Their respective roles are similar, but the differences are crucial.
The father or partner typically has little actual experience in dealing with the often-subtle forces of the labor process, and may receive enormous benefit from the presence of a doula, who is familiar with the process of birth.
Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a situation, and a doula facilitates the family process.
Studies have shown that fathers usually participate more actively during labor with the presence of a doula than without one. A responsible doula supports and encourages the father in his support style rather than replaces him.