Throughout human history, women have attended and assisted other women during childbirth. Drawings, paintings, and sculptures from different cultures and different historical periods show women in labor supported by other women. While doulas are considered a new addition to the maternity care team, doulas are actually recreating an ancient practice in a modern context.

A birth doula is a woman who provides emotional support, suggests comfort measures, and facilitates communication for women in childbirth. Birth doulas are trained and experienced in recognizing the special emotional, psychological and physical needs of women during childbearing. Mounting evidence suggests that having a woman present whose sole function is to provide emotional support and reassurance to the laboring woman has benefits for mothers, babies, and families.

Controlled studies have demonstrated that having a doula present reduces the rate of interventions during labor, improves outcomes for the newborn, improves the bonding of mother and baby, and helps partners participate more fully in the labor and birth experience. For example, different studies have shown that having a trained doula present can reduce the need for an epidural (49.5%, Kennell ’91), lower the rate of Cesarean birth by 9.8% (Kennell’93 & ’94), reduce newborn stays in NICU (9%, Kennell ’93 & ’94), and improve mother’s satisfaction with the birth experience as well as her self image (Gordon ’98).*

Women in labor have special emotional needs that, until recently, were not recognized by the medical establishment. In today’s obstetric practices, these needs are not usually met by doctors, midwives, or nurses, who, because of their committments to the health of both mother and baby, have other important duties during labor and birth. A birth doula helps meet a mother’s emotional and psychological needs by providing her with reassurance, comfort measures, and information. The doula also helps the mother’s partner to meet these needs. Our culture does not provide many opportunities to understand and appreciate the awesome power of childbirth, having a doula present during labor and birth can help parents appreciate the experience and give them the confidence to face the challenges of parenthood. A doula’s support can help the mother have a safe and healthy birth experience that is meaningful and satisfying to her and her partner.

The doula’s role often begins before labor starts by providing the mother with information about the process of labor and birth, comfort measures and techniques for coping with each of the stages of labor, and information about her options based on her preferences and what is available in the community. The doula can also help the woman (and her partner, if applicable) to create a birth plan that fits her needs.

The word doula is a new to modern obstetric practice, however the concept is ancient. Given the numerous benefits of having a doula, every effort should be made to ensure that doulas become standard care for all laboring women.

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