Doula
[13][14] The benefits of a doula providing other types of support have been less well studied, but might improve a client's experience with medical care or help an individual cope with health transitions.
[15][16][4][17] The concept of having a companion providing support to the birthing woman dates back to prehistoric times, evidenced by archeological findings of stone carvings and statues and anthropological studies.
[19] The term doula was first used in a 1969 anthropological study conducted by Dana Raphael, a protégée of Margaret Mead, with whom she co-founded the Human Lactation Center in Westport, Connecticut, in the 1970s.
[20] Raphael suggested it was a widespread practice that a female of the same species be part of childbirth, and in human societies this was traditionally a role occupied by a family member or friend whose presence contributed to successful long-term breastfeeding.
"[24] Two physician-researchers, Marshall Klaus and John Kennell, who conducted clinical trials on the medical outcomes of doula-attended births, adopted the term to refer to a person providing labor support.
Before the labor, the doula and the family can develop a relationship where the pregnant woman and their support person (e.g. the other parent) feel comfortable asking questions, expressing their fears and concerns, and discussing birth preferences.
[24] Continuous support during labor provided by doulas has been associated with improved outcomes for both birthing women and babies, including shorter delivery, fewer cesarean sections and complications, the use of fewer medications and fetal extraction tools, less time in neonatal intensive care units, positive psychological benefits, more satisfying birth experiences, and increased breastfeeding.
[11][5] Cross-country research on the effects of doulas on childbirth and postnatal care is complicated by the variety of settings, cultures, and medical systems of individual countries and the characteristics of patients.
[33] Doula care can help reduce health disparities of those with the greatest need including those with less education, lower incomes, less preparation for childbirth and those lacking social support.
"[40][41] The official committee opinion put out by ACOG also offers other recommendations that allow birthing women more choice and access to more supportive care.
[10] A 2018 study examining news media discourse in China noted that Chinese doulas needed to register with official departments or organizations and are closely linked with midwifery.
[49] Trainees might have hands-on practice with various techniques used during childbirth, including maternal positions and movements, relaxation and breathing exercises and other measures that could be used for comfort.
Certification may also require, in addition to attending a training course, time spent working or learning about maternity care and childbirth classes, and possibly a written exam.
[46] There is a movement to encourage certification and provide documentation of it on consumer websites such as DoulaMatch where an individual can find certified doulas, childbirth educators, yoga instructors, and other birth-related professionals.
[3] This can include support for abortion, miscarriage, stillbirth, queer family planning, adoption, and fertility as well as extending services to women, men, transgender and gender non-conforming individuals.
[3][15] Full-spectrum doulas often identify as activists as well as service providers and emphasize the human rights of their clients in the hopes of ending social stereotypes.
Doulas work in a variety of situations, including community collectives and as solo practitioners, and provide abortion support as a service in their full-spectrum practice.
[69] In the United States following the landmark decision, Dobbs v. Jackson Women's Health Organization, doulas expect to be contacted more frequently about abortion support as access becomes more limited.
[78][79] In the UK, the National Health Service and promotion of midwifery for low-risk pregnancies provide a continuity of care unavailable to North American pregnant women, but still are seeing an upswing in doulas.
[56] A 2019 study reviewed perceptions of labor companionship across mostly high income countries and found barriers that prevent the universal implementation of doula care.
These challenges are due to a multitude of factors dealing with perception (for example, providers not understanding the benefits or roles and other medical aspects being seen as more important) and logistics (chiefly, gaps in policy, difficulty of integration, and lack of training).
The services provided are often low cost, and expand in the amount of support offered compared to traditional doulas and consider physical, social spiritual and emotional needs.
[81] These doulas also actively engage policy makers by recommendations on certification and Medicaid coverage, integration into medical care, and participating on advisory boards.
[84][85] Prison doula organizations work with those incarcerated to provide prenatal care, childbirth education, birth attendance, and breast feeding support.
[84][86] While well-received, prison doula support is not widespread in the United States and most programs are local due to the lack of an established federal standard of medical care for pregnant incarcerated individuals.
