In Print: Information on Doula Support
Given the clear benefits and no known risks associated with intrapartum
support, every effort should be made to ensure that all laboring 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.
A doula provides support consisting of praise, reassurance, measures to
improve the comfort of the mother, physical contact such as rubbing the
mother's back and holding her hands, explanation of what is going on during
labor and delivery and a constant friendly presence. Such tasks can also be
fulfilled by a nurse or midwife, but they often need to perform
technical/medical procedures than can distract their attention from the
mother. Care in Normal Birth: a Practical Guide. Report of a Technical
Working Group. World Health Organization, 1996.
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.
Professionals have paid much attention to innovative technology and the
many new options for monitoring and managing labor. While the technology is
important, it can become so prominent that clinicians ignore both the natural
aspects of labor and the nontechnical needs of women in labor. . Changes that
support the patient in labor and reinforce the natural, physiologic process
?includes providing one-to-one psychological support for patients using
nursing staff or doulas. Reducing Cesarean Section Rates while Maintaining
Maternal and Infant Outcomes. Bruce L. Flamm et al. Institute for Healthcare
Improvement, Boston, 1997.
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.
It's natural for people to want support and companionship during any
stressful or challenging experience. [Often women] were less concerned about
whether having doulas shortened labors, and more interested in the added
confidence and comfort they felt because of the support they received. Pregnancy
and Birth: The Best Evidence. Joyce Barrett and Teresa Ptiman. 1999.