Why Invite a Doula?

"If a doula were a drug, it would be unethical not to use one."  John Kennell, Mothering the Mother

Potential Health Benefits of Using a Doula

~  60% reduction in epidural requests

~  40% reduction in pitocin use

~  50% reduction in cesarean section

~  25% reduction in labor time

~  30% reduction in additional pain drug use

~  Reduced chances of maternal fever and infection

~  Reduced maternal blessing following birth

~  Reduced incidence of postpartum depression

~  Parents have higher regard and increased sensitivity towards babies

~  Greater parental satisfaction with the birth

~  Decreased risk of postpartum depression

~  Increased breastfeeding success

"The father-to-be' s presence during labor and delivery is important to the mother and father, but it is the presence of the doula that results in significant benefits in outcome." (10)

More Benefits to the Father and Mother

~  The doula was trained and knew comfort measures (nurses may or may not)

~  The doula is there only for the mother and her partner, no other responsibilities (like monitoring, charting, helping another nurse, health of mother and baby, servicing the machines, etc)

~  Will help you assert and verbalize your goals and will  notify you if there is a deviation from your plans, wishes

~  Helps keep the birth atmosphere clam, peaceful, and sacred

~  The doula is familiar with terminology, so can help the mother and partner understand what is being said, if caregivers become too technical/medical in their explanations

~  If something does go differently than expected, all the caregivers will be very busy doing what they are supposed to do, and the busier they are the less time they will have for explanations and reassurances, the doula can give a running commentary, and still just hold a hand, provide emotional support, which may be more important now than before

~  It allows the partner to participate to his (her) comfort level, without feeling nervous about the aspects he/she may not be so comfortable about 

~  No change of shift for the doula, while nurses will most likely change at least once during mom's stay in L&D

~  Continuous presence, getting used to the voice, settling into a team with partner

~  Taking turns doing the harder parts of physical support, just offering an extra set of hands and another heart and brain

~  Allows brief breaks and breathers without deserting mom

1. Scott KD, Berkowitz G, Klaus M. A comparison of intermittent and continuous support during labor: a meta-analysis. Am J Obstet Gynecol 1999 May 180:5 1054-9.

2. Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. Continuous emotional support during labor in a US hospital. A randomized controlled trial. JAMA 1991 May 1 265:17 2197-201

3. Scott KD, Klaus PH, Klaus MH. The obstetrical and postpartum benefits of continuous support during childbirth. J Womens Health Gend Based Med 1999 Dec;8:1257-64.

4. Keenan P. Benefits of massage therapy and use of a doula during labor and childbirth. Altern Ther Health Med 2000 Jan;6:66-74.

5. Wang D, Mao X, Qian S. Clinical observation on Doula delivery. Chung Hua Fu Chan Ko Tsa Chih 1997 Nov 32:11 659-61.

6. Zhang J, Bernasko JW, Leybovich E, Fahs M, Hatch MC. Continuous labor support from labor attendant for primiparous women: a meta-analysis. Obstet Gynecol 1996 Oct 88:4 Pt 2 739-44

7. Nolan M. Supporting women in labour: the doula's role. Mod Midwife 1995 Mar 5:3 12-5.

8. Gordon NP, Walton D, McAdam E, Derman J, Gallitero G, Garrett L. Effects of providing hospital-based doulas in health maintenance organization hospitals. Obstet Gynecol 1999 Mar 93:3 422-6.

9. Langer A, Campero L, Garcia C, Reynoso S. Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers' wellbeing in a Mexican public hospital: a randomised clinical trial. Br J Obstet Gynaecol 1998 Oct 105:10 1056-63.

10. Klaus MH, Kennell JH. The doula: an essential ingredient of childbirth rediscovered. Acta Paediatr 1997 Oct 86:10 1034-6.

11. Raphael D. Support and variation, the needs of the breast-feeding woman. Acta Paediatr Jpn 1989 Aug 31:4 369-72.

12. Barron SP, Lane HW, Hannan TE, Struempler B, Williams JC. Factors influencing duration of breast feeding among low-income women. J Am Diet Assoc 1988 Dec 88:12 1557-61.

13. Campero L, García C, Díaz C, Ortiz O, Reynoso S, Langer A. ''Alone, I wouldn't have known what to do'': a qualitative study on social support during labor and delivery in Mexico. Soc Sci Med 1998 Aug 47:3 395-403.

14. Manning-Orenstein G. A birth intervention: the therapeutic effects of Doula support versus Lamaze preparation on first-time mothers' working models of caregiving. Altern Ther Health Med 1998 Jul 4:4 73-81.