In the 21st century, a doula is a person (usually a woman) who works with women and families during pregnancy and birth, or someone who cares for the baby and family after the birth.
A doula provides education, support and advocacy, acting as an “emotional safety net” at various points in the childbearing year. The birth doula’s most significant role is to provide continuous support in labor for the client.
In February 2014 the American Congress of Obstetricians and Gynecologists said, “Continuous labor support, including support provided by doulas, is one of the most effective ways to decrease the cesarean rate,” adding that doula support improves labor and delivery outcomes.
A doula is not a medical provider, and does not have responsibility for the safety of the woman giving birth or the infant. She prepares and coaches the parents to be informed about various options for birth and for reducing the pain of labor. A doula also supports the partners of women who are birthing, by discovering the level of support they want and need.
Doulas began in the United States around the middle 1970s, drawing on observation and research by physicians, midwives and anthropologists on the benefits for the birthing woman of having a trained labor companion during labor and birth..
In the United States today, about one third of all births are by the abdominal surgery of cesarean section. Experts and activists see the important role that doulas can play in lowering the cesarean rate. The World Health Organization (WHO) suggests that countries aim for a cesarean rate of between 10% and 15%.
M. Klaus, J. Kennell, P. Klaus in The Doula Book, 3rd edition (2012) have reported research (Chapter 5) about doula care.
- Shorten the length of labor by 25%
- Reduce the use of artificial stimulation of labor by Pitocin by 40%
- Reduce the use of pain medication by 30%
- And most importantly, reduce the use of cesarean surgery by 45%.
In addition, at 6 weeks after birth, women who had a doula by their side in labor and birth had higher breastfeeding rates and less postpartum depression.
Different doulas focus on different aspects of the child-bearing year: prenatal care, preparation for labor and birth, care after birth. What all doulas offer is the calm, compassionate presence of a person trained in typical and complicated birth experiences.