WHY SHOULD YOU HIRE A DOULA?
Numerous clinical studies* have found that a doula’s presence at birth...
...tends to result in shorter labors with fewer complications
...reduces negative feelings about one’s childbirth experience
...reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
...reduces the mother’s request for pain medication and/or epidurals
Research shows parents who receive support can:
Feel more secure and cared for
Are more successful in adapting to new family dynamics
Have greater success with breastfeeding
Have greater self-confidence
Have less postpartum depression
Have lower incidence of abuse
Studies have shown that the presence of a doula improves birth in the following ways:
--> 50% reduction in the cesarean rate
--> 25% shorter labor
--> 60% reduction in epidural requests
--> 40% reduction in oxytocin use
--> 30% reduction in analgesia use
--> 40% reduction in forceps delivery
*Sources- Birth Doulas Make a Difference
(www.dona.org)
The value of providing laboring women with continuous emotional support, physical comfort, and encouragement has been recognized worldwide.
Given the clear benefits and no known risks associated with intrapartum support, every effort should be made to ensure all labouring 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 labour 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 that 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 a 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 D.C. 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 non-technical 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 the 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.
Additional Research Sources
Continuous Support for Women During Childbirth, new Cochrane Review through the Childbirth Connection (Formerly Maternity Center Association), July 2003
Listening to Mothers: Report of the First National U.S. Survey of Women's Childbearing Experiences,Childbirth Connection (Formerly Maternity Center Association), October 24, 2002
Caregiver Support for Women During Childbirth: Does the Presence of a Labor-Support Person Affect Maternal-Child Outcomes?, American Family Physician, October 1, 2002
Lying in, Canadian Medical Association Journal, September 17, 2002
Social Support By Doulas During Labor And The Early Postpartum Period, Hospital Physician, September 2001 (pdf)
Care of Women in U.S. Hospitals, 2000, Agency for Healthcare Research and Quality, October 2002