A birth doula (pronounced doo-la) is the name of a skilled non-medical birth attendant that provides non-clinical physical, emotional, and psychological support to birthing mothers, birthing people, and their partners. The term doula, derived from the Greek word δούλη meaning female slave, and was coined by an anthropologist Dana Raphael, who observed that attendance of female helpers has been a widespread cultural practice in human societies. The term was adopted and applied to female labor coaches by Marshall Klaus and John Kennell who conducted clinical trials on the outcome of births attended by non-medical person providing labor support.
Research conducted on the clinical outcomes of labor assisted by doula support has shown the following (excerpted form Cochrane Summeries- an trusted source for peer reviewed clinical data):
“Continuous support in labour increased the chance of a spontaneous vaginal birth, had no harm, and women were more satisfied.
Historically women have been attended and supported by other women during labour and birth. However in many countries, as more women are giving birth in hospital rather than at home, continuous support during labour has become the exception rather than the norm. This may contribute to the dehumanisation of women’s childbirth experiences. Modern obstetric care frequently subjects women to institutional routines, which may have adverse effects on the progress of labour. Supportive care during labour may involve emotional support, comfort measures, information and advocacy. These may enhance physiologic labour processes as well as women’s feelings of control and competence, and thus reduce the need for obstetric intervention. The review of studies included 23 trials (22 providing data), from 16 countries, involving more than 15,000 women in a wide range of settings and circumstances. The continuous support was provided either by hospital staff (such as nurses or midwives), women who were not hospital employees and had no personal relationship to the labouring woman (such as doulas or women who were provided with a modest amount of guidance), or by companions of the woman’s choice from her social network (such as her husband, partner, mother, or friend). Women who received continuous labour support were more likely to give birth ‘spontaneously’, i.e. give birth with neither caesarean nor vacuum nor forceps. In addition, women were less likely to use pain medications, were more likely to be satisfied, and had slightly shorter labours. Their babies were less likely to have low five-minute Apgar scores. No adverse effects were identified. We conclude that all women should have continuous support during labour. Continuous support from a person who is present solely to provide support, is not a member of the woman’s social network, is experienced in providing labour support, and has at least a modest amount of training, appears to be most beneficial. In comparison with having no companion during labour, support from a chosen family member or friend appears to increase women’s satisfaction with their childbearing experience.”
My Doula Practice:
I found my calling to work with birthing families as a young woman after the amazing opportunity to photograph the birth of a child. Soon after, I became a mother myself and found a great passion for learning about the process of birth- and the need for birthing women and persons to have the support of an experienced, knowledgable, and compassionate person.
In my years as a doula, I have learned many humbling lessons. One lesson has been the revelation that the role of a doula must be organic, changing, and moving as the needs of a family unfold- This has become the center of my practice. In supporting families, I seek to adapt to their changing needs, to assist in the journey becoming parents to a child (for the first or any other time) in a way the honors the unique circumstances of each family’s process.
I have heard many doulas say that they want to empower women in birth and their partners- but I deeply believe that families, with the right support, will empower themselves. I assist families in finding the path- whether that means guiding them toward information on evidence based birth practice, or helping a family identify what values they want to nurture in their family during the perinatal period. I believe that the path to birth, as in life, may not be easy- but that in our journey, we find our true selves…
“You enter the forest
at the darkest point,
where there is no path.
Where there is a way or path,
it is someone else’s path.
You are not on your own path.
If you follow someone else’s way,
you are not going to realize
― Joseph Campbell,