Doula: Difference between revisions
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{{Short description|Non-medical companion}} |
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{{Other uses}} |
{{Other uses}} |
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{{Short description|Non-medical companion who supports a person through significant health-related experiences}} |
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[[File:Fotos produzidas pelo Senado (25184345764).jpg|alt=|thumb|300x300px|A doula (left) guiding a pregnant woman in preparation for labor. Comforting touch can help alleviate contractions during labor. The ball and childbirth position are also important.]] |
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A '''doula''' ({{IPAc-en|ˈ|d|uː|l|ə |
A '''doula''' ({{IPAc-en|ˈ|d|uː|l|ə |
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}}) is a |
}}; {{ety|grc|δούλα|female slave}}; {{IPA-el|ˈðula}}) is a non-medical professional who provides guidance for the service of others and who supports another person (the doula's client) through a significant health-related experience, such as [[childbirth]], [[miscarriage]], [[Abortion|induced abortion]] or [[stillbirth]], as well as non-reproductive experiences such as [[death|dying]].<ref>{{Cite book|title=Birth ambassadors : doulas and the re-emergence of woman-supported birth America| vauthors = Morton CH |year=2014|isbn=978-1-939807-06-9|pages=33–34| publisher = Praeclarus Press, LLC |oclc=876741292}}</ref><ref name=":42">{{Cite web|url=https://www.dona.org/what-is-a-doula/|title=What is a Doula|website=DONA International|language=en-US|access-date=2019-08-13}}</ref><ref name=":322">{{cite book |url= https://books.google.com/books?id=gdylDAAAQBAJ&pg=PR2 |title=The Doulas: Radical Care for Pregnant People |last1=Mahoney|first1=Mary|last2=Mitchell|first2=Lauren | name-list-style = vanc |date=2016-10-17|publisher=The Feminist Press at CUNY|isbn=9781558619494 }}</ref><ref name=":92">{{cite journal | vauthors = Rawlings D, Tieman J, Miller-Lewis L, Swetenham K | title = What role do Death Doulas play in end-of-life care? A systematic review | journal = Health & Social Care in the Community | volume = 27 | issue = 3 | pages = e82–e94 | date = May 2019 | pmid = 30255588 | doi = 10.1111/hsc.12660 | doi-access = free }}</ref> A doula might also provide support to the client's partner, family, and friends.<ref name=":13">{{Cite web|url=https://evidencebasedbirth.com/the-evidence-for-doulas/|title=Evidence on: Doulas|date=2017-08-14|website=[[Evidence Based Birth]]|access-date=2019-03-30}}</ref><ref>{{Cite book|title=The birth partner : a complete guide to childbirth for dads, doulas, and other labor companions| vauthors = Simkin P, Rohs K |isbn=978-1558329102|edition=5th|location=Beverly, MA, USA|oclc=1000126985|date = 2018-10-09}}</ref> |
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The doula's goal and role is to help the client feel safe and comfortable, complementing the role of the healthcare professionals who provide the client's medical care. Unlike a physician, [[midwife]], or nurse, a doula cannot administer medication or other medical treatment or give medical advice.<ref name="Kennel22" /><ref name=": |
The doula's goal and role is to help the client feel safe and comfortable, complementing the role of the healthcare professionals who provide the client's medical care. Unlike a physician, [[midwife]], or nurse, a doula cannot administer medication or other medical treatment or give medical advice.<ref name="Kennel22" /><ref name=":42"/> An individual might need to complete training to work as a doula, although training and certification processes vary throughout the world.<ref name="Kennel22" /><ref name=":322" /><ref name=":92"/><ref name=":72">{{cite journal | vauthors = Steel A, Frawley J, Adams J, Diezel H | title = Trained or professional doulas in the support and care of pregnant and birthing women: a critical integrative review | journal = Health & Social Care in the Community | volume = 23 | issue = 3 | pages = 225–41 | date = May 2015 | pmid = 24942339 | doi = 10.1111/hsc.12112 | doi-access = free }}</ref> |
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Some doulas work as volunteers; others are paid for their services by their client, medical institutions, or other private and public organizations. Doulas receive varying amounts of training, and their professionalism also varies.<ref name=": |
Some doulas work as volunteers; others are paid for their services by their client, medical institutions, or other private and public organizations. Doulas receive varying amounts of training, and their professionalism also varies.<ref name=":92"/><ref>{{cite journal|vauthors=Lantz PM, Low LK, Varkey S, Watson RL|date=2005|title=Doulas as childbirth paraprofessionals: results from a national survey|journal=Women's Health Issues|volume=15|issue=3|pages=109–16|doi=10.1016/j.whi.2005.01.002|pmid=15894196}}</ref> |
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The contributions of doulas during reproductive experiences and end-of-life care have been studied and have been shown to benefit their clients.<ref name=": |
The contributions of doulas during reproductive experiences and end-of-life care have been studied and have been shown to benefit their clients.<ref name=":92"/><ref name=":032"/><ref name=":34">{{cite journal | vauthors = Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A | title = Continuous support for women during childbirth | journal = The Cochrane Database of Systematic Reviews | volume = 7 | issue = 7 | pages = CD003766 | date = July 2017 | pmid = 28681500 | pmc = 6483123 | doi = 10.1002/14651858.CD003766.pub6 }}</ref><ref>{{cite journal | vauthors = Fukuzawa RK, Kondo KT | title = A holistic view from birth to the end of life: end-of-life doulas and new developments in end-of-life care in the West | journal = International Journal of Palliative Nursing | volume = 23 | issue = 12 | pages = 612–619 | date = December 2017 | pmid = 29272199 | doi = 10.12968/ijpn.2017.23.12.612 }}</ref> For example, a birth doula providing support during [[childbirth]] might increase likelihood of vaginal birth (rather than [[Caesarean section]]), decrease the need for pain medication during labor, and improve the perception of the birthing experience.<ref>{{cite journal | vauthors = Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A | title = Continuous support for women during childbirth | journal = The Cochrane Database of Systematic Reviews | volume = 7 | pages = CD003766 | date = July 2017 | issue = 8 | pmid = 28681500 | pmc = 6483123 | doi = 10.1002/14651858.CD003766.pub6 | collaboration = Cochrane Pregnancy and Childbirth Group }}</ref><ref name=":6"/> |
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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.<ref name=":10">{{cite journal | vauthors = Chor J, Lyman P, Tusken M, Patel A, Gilliam M | title = Women's experiences with doula support during first-trimester surgical abortion: a qualitative study | journal = Contraception | volume = 93 | issue = 3 | pages = 244–8 | date = March 2016 | pmid = 26480890 | pmc = 4766033 | doi = 10.1016/j.contraception.2015.10.006 }}</ref><ref>{{cite journal | vauthors = Altshuler AL, Whaley NS | title = The patient perspective: perceptions of the quality of the abortion experience | journal = Current Opinion in Obstetrics & Gynecology | volume = 30 | issue = 6 | pages = 407–413 | date = December 2018 | pmid = 30299320 | doi = 10.1097/GCO.0000000000000492 | s2cid = 52937963 }}</ref><ref name=": |
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.<ref name=":10">{{cite journal | vauthors = Chor J, Lyman P, Tusken M, Patel A, Gilliam M | title = Women's experiences with doula support during first-trimester surgical abortion: a qualitative study | journal = Contraception | volume = 93 | issue = 3 | pages = 244–8 | date = March 2016 | pmid = 26480890 | pmc = 4766033 | doi = 10.1016/j.contraception.2015.10.006 }}</ref><ref>{{cite journal | vauthors = Altshuler AL, Whaley NS | title = The patient perspective: perceptions of the quality of the abortion experience | journal = Current Opinion in Obstetrics & Gynecology | volume = 30 | issue = 6 | pages = 407–413 | date = December 2018 | pmid = 30299320 | doi = 10.1097/GCO.0000000000000492 | s2cid = 52937963 }}</ref><ref name=":92"/><ref name="Balas22">{{cite journal | vauthors = Balas MC, Gale M, Kagan SH | title = Delirium doulas: an innovative approach to enhance care for critically ill older adults | journal = Critical Care Nurse | volume = 24 | issue = 4 | pages = 36–46 | date = August 2004 | doi = 10.4037/ccn2004.24.4.36 | pmid = 15341233 | url = http://ccn.aacnjournals.org/content/24/4/36.long }}</ref> |
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== History and etymology == |
== History and etymology == |
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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.<ref>{{Cite web|title=Anthropologist's studies of childbirth bring new focus on women in evolution|url=http://www1.udel.edu/udaily/2009/feb/childbirth021609.html|access-date=2020-10-23|website=www1.udel.edu}}</ref> However, the contemporary role of "doula" first emerged from the grassroots [[Natural childbirth|natural birth movement]] in the United States in the 1960s when women began desiring unmedicated, low-intervention births and began to have friends and others with formal or practical knowledge about childbirth provide them with support during pregnancy.<ref name=":0">{{Cite book|title=Birth ambassadors : doulas and the re-emergence of woman-supported birth America| vauthors = Morton CH |year=2014|isbn=9781939807069|pages=51–101|oclc=876741292}}</ref> |
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.<ref>{{Cite web|title=Anthropologist's studies of childbirth bring new focus on women in evolution|url=http://www1.udel.edu/udaily/2009/feb/childbirth021609.html|access-date=2020-10-23|website=www1.udel.edu}}</ref> However, the contemporary role of "doula" first emerged from the grassroots [[Natural childbirth|natural birth movement]] in the United States in the 1960s when women began desiring unmedicated, low-intervention births and began to have friends and others with formal or practical knowledge about childbirth provide them with support during pregnancy.<ref name=":0">{{Cite book|title=Birth ambassadors : doulas and the re-emergence of woman-supported birth America| vauthors = Morton CH |year=2014|isbn=9781939807069|pages=51–101| publisher = Praeclarus Press, LLC |oclc=876741292}}</ref> |
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The term ''doula'' was first used in a 1969 [[Anthropology|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.<ref name="Dana Raphael2">{{cite news|url=https://www.nytimes.com/2016/02/21/nyregion/dana-raphael-proponent-of-breast-feeding-and-the-use-of-doulas-dies-at-90.html?_r=0|title=Dana Raphael, Proponent of Breast-Feeding and Use of Doulas, Dies at 90 |last=Roberts |first=Sam|name-list-style=vanc |date=February 19, 2016|work=[[The New York Times]]|access-date=January 17, 2017|author-link=Sam Roberts (newspaper journalist)}}</ref> 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.<ref name="Dana Raphael2" /> Raphael derived the term from [[modern Greek]] ({{lang|el|δούλα}}, [[wiktionary:doúla|doúla]] ({{IPA-el|ˈðula}}), "slave"<ref>{{Cite web|title=δούλα - Ελληνοαγγλικό Λεξικό WordReference.com|url=https://www.wordreference.com/gren/%CE%B4%CE%BF%CF%8D%CE%BB%CE%B1|access-date=2022-02-16|website=www.wordreference.com|language=el}}</ref>), as told to her by an elderly Greek woman,<ref name="Raphael-NYT Magazine2">{{cite web|url=https://www.nytimes.com/interactive/2016/12/21/magazine/the-lives-they-lived-dana-raphael.html|title=Dana Raphael Opened Up the Mysteries of Nursing|last=Jones|first=Maggie|date=December 21, 2016|work=[[NYT Magazine]]|access-date=January 17, 2017|name-list-style=vanc}}</ref> Eleni Rassias,<ref>{{cite book|title=The Tender Gift: Breastfeeding|last=Raphael|first=Dana|date=1973|name-list-style=vanc|author-link=Dana Raphael}}</ref> and described it as coming from "[[Aristotle]]'s time," an [[Ancient Greek]] word {{lang|grc| |
The term ''doula'' was first used in a 1969 [[Anthropology|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.<ref name="Dana Raphael2">{{cite news|url=https://www.nytimes.com/2016/02/21/nyregion/dana-raphael-proponent-of-breast-feeding-and-the-use-of-doulas-dies-at-90.html?_r=0|title=Dana Raphael, Proponent of Breast-Feeding and Use of Doulas, Dies at 90 |last=Roberts |first=Sam|name-list-style=vanc |date=February 19, 2016|work=[[The New York Times]]|access-date=January 17, 2017|author-link=Sam Roberts (newspaper journalist)}}</ref> 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.<ref name="Dana Raphael2" /> Raphael derived the term from [[modern Greek]] ({{lang|el|δούλα}}, [[wiktionary:doúla|doúla]] ({{IPA-el|ˈðula}}), "slave"<ref>{{Cite web|title=δούλα - Ελληνοαγγλικό Λεξικό WordReference.com|url=https://www.wordreference.com/gren/%CE%B4%CE%BF%CF%8D%CE%BB%CE%B1|access-date=2022-02-16|website=www.wordreference.com|language=el}}</ref>), as told to her by an elderly Greek woman,<ref name="Raphael-NYT Magazine2">{{cite web|url=https://www.nytimes.com/interactive/2016/12/21/magazine/the-lives-they-lived-dana-raphael.html|title=Dana Raphael Opened Up the Mysteries of Nursing|last=Jones|first=Maggie|date=December 21, 2016|work=[[NYT Magazine]]|access-date=January 17, 2017|name-list-style=vanc}}</ref> Eleni Rassias,<ref>{{cite book|title=The Tender Gift: Breastfeeding|last=Raphael|first=Dana|date=1973|name-list-style=vanc|author-link=Dana Raphael}}</ref> and described it as coming from "[[Aristotle]]'s time," an [[Ancient Greek]] word {{lang|grc|δούλα}} meaning "female slave."<ref name="Mander3">{{cite book|title=Supportive care and midwifery|vauthors=Mander R|publisher=[[John Wiley & Sons]]|year=2001|isbn=978-0632054251|pages=113–33|chapter=The doula|chapter-url=https://books.google.com/books?id=AWvQy8rtyqgC&pg=PA113}}</ref> |
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Two physician-researchers, [[Marshall H. Klaus|Marshall Klaus]] and [[John H. Kennell|John Kennell]], who conducted [[ |
Two physician-researchers, [[Marshall H. Klaus|Marshall Klaus]] and [[John H. Kennell|John Kennell]], who conducted [[clinical trial]]s on the medical outcomes of doula-attended births, adopted the term to refer to a person providing labor support.<ref name="Kennel22">{{cite book|chapter-url=https://books.google.com/books?id=43ebxn4cK6gC&pg=PA4|title=The Doula Book: How A Trained Labor Companion Can Help You Have A Shorter, Easier, And Healthier Birth|vauthors=Klaus MH, Kennell JH, Klaus PH|publisher=[[Da Capo Press]]|year=2002|isbn=978-0738206097|chapter=Chapters 1, 2}}</ref> In 1992, [[Doulas of North America]] (later DONA International) was co-founded by Klaus, Kennell, Phyllis Klaus, Penny Simkin, and Annie Kennedy, becoming the first organization to train and certify doulas.<ref name=":022">{{cite journal | vauthors = Torres JM | title = Breast milk and labour support: lactation consultants' and doulas' strategies for navigating the medical context of maternity care | journal = Sociology of Health & Illness | volume = 35 | issue = 6 | pages = 924–38 | date = July 2013 | pmid = 23398567 | doi = 10.1111/1467-9566.12010 | url = https://deepblue.lib.umich.edu/bitstream/2027.42/99048/1/shil12010.pdf | hdl = 2027.42/99048 | doi-access = free }}</ref><ref name=":222">{{Cite web|url=https://www.dona.org/the-dona-advantage/about/history/|title=History of DONA International|website=DONA International|date=7 August 2014 |access-date=2019-04-09}}</ref> The organization with the backing of the research of Klaus and Kennell helped lend credibility and professionalize doulas.<ref>{{Cite book|url=https://books.google.com/books?id=yaHbAAAAQBAJ|title=Laboring On: Birth in Transition in the United States |last1=Simonds |first1=Wendy |last2=Rothman |first2=Barbara Katz |last3=Norman |first3=Bari Meltzer | name-list-style = vanc |date=2013-10-23|publisher=Routledge|isbn=9781135939984 }}</ref> Due to the lobbying efforts of DONA International, the term ''doula'' was accepted into the [[The American Heritage Dictionary of the English Language|American Heritage Dictionary]] and [[Oxford English Dictionary|Oxford Dictionary]] in 2003, followed by [[Merriam-Webster|Merriam Webster Dictionary]] in 2004.<ref name=":222" /> Alternative names to this role include "childbirth assistant" and "monitrice," but they did not catch on as "doula" had.<ref name=":0" /> |
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In 2008, activists in New York City began the Doula Project, to expand the role of the doula to other reproductive experiences beyond birth, grounded in [[reproductive justice]] framework.<ref name=":3222">{{Cite book|url=https://books.google.com/books?id=gdylDAAAQBAJ&pg=PR2|title=The Doulas: Radical Care for Pregnant People|last1=Mahoney|first1=Mary|last2=Mitchell|first2=Lauren | name-list-style = vanc |date=2016-10-17|publisher=The Feminist Press at CUNY|isbn=9781558619494 }}</ref><ref>{{Cite book|title=The Radical Doula Guide: A Political Primer For Full Spectrum Pregnancy and Childbirth Support|last=Pérez|first=Miriam Zoila | name-list-style = vanc |year=2012 }}</ref> The participants began working as abortion doulas and coined the term "full-spectrum doula" who support all pregnancy experiences and outcomes such as pregnancy termination, miscarriage and fetal loss.<ref name=":3222" /><ref name=":8">{{Cite journal|last=Basmajian|first=Alyssa|date=2014 | name-list-style = vanc |title=Abortion Doulas: Changing the Narrative|journal=Anthropology Now|language=en|volume=6|issue=2|pages=44–51|doi=10.1080/19492901.2014.11728432|s2cid=80163473|issn=1942-8200}}</ref> Full spectrum doula groups |
In 2008, activists in New York City began the Doula Project, to expand the role of the doula to other reproductive experiences beyond birth, grounded in [[reproductive justice]] framework.<ref name=":3222">{{Cite book|url=https://books.google.com/books?id=gdylDAAAQBAJ&pg=PR2|title=The Doulas: Radical Care for Pregnant People|last1=Mahoney|first1=Mary|last2=Mitchell|first2=Lauren | name-list-style = vanc |date=2016-10-17|publisher=The Feminist Press at CUNY|isbn=9781558619494 }}</ref><ref>{{Cite book|title=The Radical Doula Guide: A Political Primer For Full Spectrum Pregnancy and Childbirth Support|last=Pérez|first=Miriam Zoila | name-list-style = vanc |year=2012 }}</ref> The participants began working as abortion doulas and coined the term "full-spectrum doula" who support all pregnancy experiences and outcomes such as pregnancy termination, miscarriage and fetal loss.<ref name=":3222" /><ref name=":8">{{Cite journal|last=Basmajian|first=Alyssa|date=2014 | name-list-style = vanc |title=Abortion Doulas: Changing the Narrative|journal=Anthropology Now|language=en|volume=6|issue=2|pages=44–51|doi=10.1080/19492901.2014.11728432|s2cid=80163473|issn=1942-8200}}</ref> Full spectrum doula groups can be found in major cities in the United States.<ref>{{Cite web|url=http://bayareadoulaproject.org/|title=Bay Area Doula Project|language=en|access-date=2019-08-21}}</ref> |
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In 2019, [[Black maternal mortality in the United States|Black maternal health]] advocate and ''[[Parents (magazine)|Parents]]'' writer [[Christine Michel Carter]] interviewed Vice President [[Kamala Harris]] about the popularity of doulas in the Black community.<ref>{{Cite web |title=How Doulas Provide the Advocacy and Support Black Women Need |url=https://www.parents.com/pregnancy/giving-birth/doula/do-black-women-need-doulas-more-than-anyone/ |access-date=2023-06-21 |website=Parents |language=en}}</ref> As a senator, in 2019 Harris reintroduced the Maternal Care Access and Reducing Emergencies (CARE) Act which aimed to address the maternal mortality disparity faced by women of color by training providers on recognizing implicit racial bias and its impact on care. Harris stated:<blockquote>"We need to speak the uncomfortable truth that women—and especially Black women—are too often not listened to or taken seriously by the health care system, and therefore they are denied the dignity that they deserve. And we need to speak this truth because today, the United States is 1 of only 13 countries in the world where the rate of maternal mortality is worse than it was 25 years ago. That risk is even higher for Black women, who are three to four times more likely than white women to die from pregnancy-related causes. These numbers are simply outrageous."</blockquote> |
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== Types of support == |
== Types of support == |
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==== Role ==== |
==== Role ==== |
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A doula focused on birth is also known as birth companion, nonclinical birth worker, birth coach or post-birth supporter, by providing continuous care before, during, or after |
A doula focused on birth is also known as a birth companion, nonclinical birth worker, birth coach, or post-birth supporter, by providing continuous care before, during, or after in the form of information, advocacy, physical support, and emotional support.<ref name=":42"/><ref name=":6">{{cite journal |vauthors = Bohren MA, Berger BO, Munthe-Kaas H, Tunçalp Ö | title = Perceptions and experiences of labour companionship: a qualitative evidence synthesis | journal = The Cochrane Database of Systematic Reviews | volume = 3 | pages = CD012449 | date = March 2019 | issue = 7 | pmid = 30883666 | pmc = 6422112 | doi = 10.1002/14651858.CD012449.pub2 | collaboration = Cochrane Effective Practice and Organisation of Care Group }}</ref><ref name=":72"/><ref name=":032"/> A birth doula is also called a labor doula. A birth doula might accompany a pregnant woman during labor and birth in place of or in addition to a partner, family member, or friend. Unlike these other birth companions, a doula has formal training in labor support.<ref name=":42" /><ref name=":6" /> The kinds of support provided during childbirth might include physical assistance and comfort (massage, maintaining a supporting posture, or providing water), emotional support (providing company, encouragement or simply talking in a soothing tone of voice), acting as an advocate during childbirth (supporting the birthing woman's right to make decisions about their own body and baby to the medical team) and informational support (provide information about the birthing process and non-medication based forms of pain relief, and facilitating communication between their client and health providers).<ref name=":6" /><ref name=":13"/> |
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Most doula-client relationships begin a few months before the baby is due. Before the labor, the doula and the family can develop a relationship where the pregnant woman and their support person ( |
Most doula-client relationships begin a few months before the baby is due. 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.<ref name="Mander3"/> |
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==== Benefits and limitations ==== |
==== Benefits and limitations ==== |
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Continuous support during labor provided by doulas has been associated with improved outcomes for both birthing women and babies, including shorter delivery, fewer [[ |
Continuous support during labor provided by doulas has been associated with improved outcomes for both birthing women and babies, including shorter delivery, fewer [[cesarean section]]s and complications, the use of fewer [[Pharmaceutical drug|medications]] and fetal extraction tools, less time in [[neonatal intensive care unit]]s, positive psychological benefits, more satisfying birth experiences, and increased [[breastfeeding]].<ref name=":34"/><ref name=":13" /> 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. These benefits appear to be contingent on the doula providing continuous rather than intermittent assistance and knowing the specific social and cultural setting within which their services are provided.<ref>{{cite journal | vauthors = Scott KD, Berkowitz G, Klaus M | title = A comparison of intermittent and continuous support during labor: a meta-analysis | journal = American Journal of Obstetrics and Gynecology | volume = 180 | issue = 5 | pages = 1054–9 | date = May 1999 | pmid = 10329855 | doi = 10.1016/s0002-9378(99)70594-6 }}</ref> Doula care can help reduce [[Health equity|health disparities]] of those with the greatest need including those with less education, lower incomes, less preparation for childbirth and those lacking social support.<ref name=":23">{{cite journal | vauthors = Strauss N, Giessler K, McAllister E | title = How Doula Care Can Advance the Goals of the Affordable Care Act: A Snapshot From New York City | journal = The Journal of Perinatal Education | volume = 24 | issue = 1 | pages = 8–15 | date = 2015 | pmid = 26937157 | pmc = 4720857 | doi = 10.1891/1058-1243.24.1.8 }}</ref><ref>{{cite journal | vauthors = Coley SL, Zapata JY, Schwei RJ, Mihalovic GE, Matabele MN, Jacobs EA, Anderson CK | title = More Than a "Number": Perspectives of Prenatal Care Quality from Mothers of Color and Providers | journal = Women's Health Issues | volume = 28 | issue = 2 | pages = 158–164 | date = 2018 | pmid = 29208354 | pmc = 5835403 | doi = 10.1016/j.whi.2017.10.014 }}</ref><ref>{{cite journal | vauthors = Everson CL, Cheyney M, Bovbjerg ML | title = Outcomes of Care for 1,892 Doula-Supported Adolescent Births in the United States: The DONA International Data Project, 2000 to 2013 | journal = The Journal of Perinatal Education | volume = 27 | issue = 3 | pages = 135–147 | date = June 2018 | pmid = 30364259 | pmc = 6193361 | doi = 10.1891/1058-1243.27.3.135 }}</ref><ref>{{cite journal | vauthors = Spiby H, Green JM, Darwin Z, Willmot H, Knox D, McLeish J, Smith M | title = Multisite implementation of trained volunteer doula support for disadvantaged childbearing women: a mixed-methods evaluation | journal = Health Services and Delivery Research | volume = 3 | issue = 8 | pages = 1–332 | date = 2015 | pmid = 25834865 | doi = 10.3310/hsdr03080 | doi-access = free }}</ref> Research also supports the effectiveness of female friends or relatives, after minimal training, as a low-cost alternative to professional doulas.<ref name=":34" /><ref name="Campbell2">{{cite journal | vauthors = Campbell D, Scott KD, Klaus MH, Falk M | title = Female relatives or friends trained as labor doulas: outcomes at 6 to 8 weeks postpartum | journal = Birth | volume = 34 | issue = 3 | pages = 220–7 | date = September 2007 | pmid = 17718872 | doi = 10.1111/j.1523-536X.2007.00174.x | s2cid = 923119 }}</ref> |
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In March 2014, the [[American College of Obstetricians and Gynecologists]] (ACOG) put out a Consensus Statement titled "Safe Prevention of Primary Cesarean Delivery" in which it said, "Increasing [a woman's] access to non-medical interventions during labor, such as continuous labor support, also has been shown to reduce cesarean birth rates."<ref name="pmid245531672">{{cite journal | author = American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine | title = Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery | journal = Obstetrics and Gynecology | volume = 123 | issue = 3 | pages = 693–711 | date = March 2014 | pmid = 24553167 | doi = 10.1097/01.AOG.0000444441.04111.1d | url = http://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery }}</ref> As more research has become available on the positive benefits of trained labor support provided by someone not employed by the hospital, in 2017 ACOG officially announced the need for all birthing individuals to have access to continuous labor support outside hospital staff, and said, "Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes."<ref>{{cite journal | vauthors = Kozhimannil KB, Hardeman RR, Attanasio LB, Blauer-Peterson C, O'Brien M | title = Doula care, birth outcomes, and costs among Medicaid beneficiaries | journal = American Journal of Public Health | volume = 103 | issue = 4 | pages = e113-21 | date = April 2013 | pmid = 23409910 | pmc = 3617571 | doi = 10.2105/AJPH.2012.301201 }}</ref><ref name="pmid281218312">{{cite journal | author = Committee on Obstetric Practice; American College of Obstetricians and Gynecologists | title = Committee Opinion No. 687: Approaches to Limit Intervention During Labor and Birth | journal = Obstetrics and Gynecology | volume = 129 | issue = 2 | pages = e20–e28 | date = February 2017 | pmid = 28121831 | doi = 10.1097/AOG.0000000000001905 | url = https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Approaches-to-Limit-Intervention-During-Labor-and-Birth }}</ref> The official committee opinion put out by ACOG also offers other recommendations that allow birthing women more choice and access to more supportive care. Doulas could be utilized to help achieve many of these recommendations as they move towards better collaboration.<ref>{{cite news|url=https://www.trainingdoulas.com/general/women-access-doula-care/|title=All women should have access to doula care|last=Leavitt|first=Rachel|date=2017-06-05|work=New Beginnings Doula Training|access-date=2018-07-08|name-list-style=vanc}}</ref> |
In March 2014, the [[American College of Obstetricians and Gynecologists]] (ACOG) put out a Consensus Statement titled "Safe Prevention of Primary Cesarean Delivery" in which it said, "Increasing [a woman's] access to non-medical interventions during labor, such as continuous labor support, also has been shown to reduce cesarean birth rates."<ref name="pmid245531672">{{cite journal | author = American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine | title = Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery | journal = Obstetrics and Gynecology | volume = 123 | issue = 3 | pages = 693–711 | date = March 2014 | pmid = 24553167 | doi = 10.1097/01.AOG.0000444441.04111.1d | url = http://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery | access-date = 2015-12-21 | archive-date = 2014-03-02 | archive-url = https://web.archive.org/web/20140302063757/http://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery | url-status = dead }}</ref> As more research has become available on the positive benefits of trained labor support provided by someone not employed by the hospital, in 2017 ACOG officially announced the need for all birthing individuals to have access to continuous labor support outside hospital staff, and said, "Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes."<ref>{{cite journal | vauthors = Kozhimannil KB, Hardeman RR, Attanasio LB, Blauer-Peterson C, O'Brien M | title = Doula care, birth outcomes, and costs among Medicaid beneficiaries | journal = American Journal of Public Health | volume = 103 | issue = 4 | pages = e113-21 | date = April 2013 | pmid = 23409910 | pmc = 3617571 | doi = 10.2105/AJPH.2012.301201 }}</ref><ref name="pmid281218312">{{cite journal | author = Committee on Obstetric Practice; American College of Obstetricians and Gynecologists | title = Committee Opinion No. 687: Approaches to Limit Intervention During Labor and Birth | journal = Obstetrics and Gynecology | volume = 129 | issue = 2 | pages = e20–e28 | date = February 2017 | pmid = 28121831 | doi = 10.1097/AOG.0000000000001905 | url = https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Approaches-to-Limit-Intervention-During-Labor-and-Birth }}</ref> The official committee opinion put out by ACOG also offers other recommendations that allow birthing women more choice and access to more supportive care. Doulas could be utilized to help achieve many of these recommendations as they move towards better collaboration.<ref>{{cite news|url=https://www.trainingdoulas.com/general/women-access-doula-care/|title=All women should have access to doula care|last=Leavitt|first=Rachel|date=2017-06-05|work=New Beginnings Doula Training|access-date=2018-07-08|name-list-style=vanc}}</ref> |
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In 2017 the United Kingdom's [[Royal College of Midwives]] published a position statement on doulas, which supports the choice of the individual to hire a doula for their birth as long as the doula does not provide medical care.<ref>{{cite web|url=https://www.rcm.org.uk/sites/default/files/Doulas%20V.2_3.pdf|title=Doulas Position Statement|date=October 2017|publisher=The Royal College of Midwives|archive-url=https://web.archive.org/web/20180827142636/https://www.rcm.org.uk/sites/default/files/Doulas%20V.2_3.pdf|archive-date=27 August 2018|url-status=dead}}</ref> |
In 2017 the United Kingdom's [[Royal College of Midwives]] published a position statement on doulas, which supports the choice of the individual to hire a doula for their birth as long as the doula does not provide medical care.<ref>{{cite web|url=https://www.rcm.org.uk/sites/default/files/Doulas%20V.2_3.pdf|title=Doulas Position Statement|date=October 2017|publisher=The Royal College of Midwives|archive-url=https://web.archive.org/web/20180827142636/https://www.rcm.org.uk/sites/default/files/Doulas%20V.2_3.pdf|archive-date=27 August 2018|url-status=dead}}</ref> |
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A 2018 study examined women's perceptions of doulas in several different countries, including Egypt, Lebanon, Syria, Malawi, Sweden, Nepal, Russia, Canada, and the United States of America and found that having continuous support from a companion such as a doula was highly appreciated by most women.<ref name=":032">{{cite journal | vauthors = Lunda P, Minnie CS, Benadé P | title = Women's experiences of continuous support during childbirth: a meta-synthesis | journal = BMC Pregnancy and Childbirth | volume = 18 | issue = 1 | pages = 167 | date = May 2018 | pmid = 29764406 | pmc = 5952857 | doi = 10.1186/s12884-018-1755-8 }}</ref> However, perceptions may vary from country to country due to cultural factors, such as an emphasis on modesty and privacy, which |
A 2018 study examined women's perceptions of doulas in several different countries, including Egypt, Lebanon, Syria, Malawi, Sweden, Nepal, Russia, Canada, and the United States of America and found that having continuous support from a companion such as a doula was highly appreciated by most women.<ref name=":032">{{cite journal | vauthors = Lunda P, Minnie CS, Benadé P | title = Women's experiences of continuous support during childbirth: a meta-synthesis | journal = BMC Pregnancy and Childbirth | volume = 18 | issue = 1 | pages = 167 | date = May 2018 | pmid = 29764406 | pmc = 5952857 | doi = 10.1186/s12884-018-1755-8 | doi-access = free }}</ref> However, perceptions may vary from country to country due to cultural factors, such as an emphasis on modesty and privacy, which might affect what kind of support a woman prefers.<ref name=":032" /> |
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A 2018 study |
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. The doula profession was introduced in 1996 to mainland China and demand of their services increased since then, with women citing dissatisfaction with medical care. After China's implementation of the Second-Child Policy, doula care was strongly linked to doula support in regard to family planning.<ref>{{Cite journal|last=Dai|first=Zehui|date=October 2018|title=Chinese News Media Discourse of Doulas and Doula Care|journal=The Journal of Perinatal Education|volume=27|issue=4|pages=243–252|doi=10.1891/1058-1243.27.4.243|issn=1058-1243|pmc=6491159|pmid=31073270}}</ref> |
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Tensions between doctors, nurses and doulas have sometimes been described as a "turf battle,"<ref name=" |
Tensions between doctors, nurses, and doulas have sometimes been described as a "turf battle,"<ref name="WSJ3">{{cite news|title=As 'Doulas' Enter Delivery Rooms, Conflicts Arise: Hired to Help in Childbirth, They Sometimes Clash With Doctors and Nurses|date=2004-01-19|work=[[The Wall Street Journal]]|vauthors=Hwang S}}</ref> though it is also recognized that doulas and nurses can occupy complementary roles that provide opportunities for mutual learning and assistance.<ref name="Ballen2">{{cite journal | vauthors = Ballen LE, Fulcher AJ | s2cid = 23409222 | title = Nurses and doulas: complementary roles to provide optimal maternity care | journal = Journal of Obstetric, Gynecologic, and Neonatal Nursing | volume = 35 | issue = 2 | pages = 304–11 | year = 2006 | pmid = 16620259 | doi = 10.1111/j.1552-6909.2006.00041.x }}</ref> Some hospitals have created internal doula training programs to reduce conflict between doulas and medical staff.<ref name="WSJ3"/><ref>{{cite web|url=https://www.prodoula.com/hospital-credentialing-for-doulas-yea-or-nay/|title=Hospital "Credentialing" For Doulas? Yea or Nay?|date=2015-10-24|website=Become a Doula with ProDoula|access-date=2016-04-18}}</ref> |
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==== Training and certification ==== |
==== Training and certification ==== |
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There is no law requiring doulas to become certified, however certification can benefit professional doulas by providing structured education prior to entry into the field, access to a mentor, opportunities for networking, and client confidence.<ref>{{Cite book|url=https://books.google.com/books?id=yaHbAAAAQBAJ|title=Laboring On: Birth in Transition in the United States|last1=Simonds|first1=Wendy|last2=Rothman|first2=Barbara Katz|last3=Norman|first3=Bari Meltzer|date=2013-10-23|publisher=Routledge|isbn=9781135939984}}</ref> In [[North America]], training generally takes the form of a two- to three-day seminar, and some experience with childbirth.<ref>{{cite web|url=https://www.prodoula.com/|title=Doula Training Become A Doula|website=ProDoula|access-date=2016-04-18}}</ref> Trainees |
There is no law requiring doulas to become certified, however, certification can benefit professional doulas by providing structured education prior to entry into the field, access to a mentor, opportunities for networking, and client confidence.<ref>{{Cite book|url=https://books.google.com/books?id=yaHbAAAAQBAJ|title=Laboring On: Birth in Transition in the United States|last1=Simonds|first1=Wendy|last2=Rothman|first2=Barbara Katz|last3=Norman|first3=Bari Meltzer|date=2013-10-23|publisher=Routledge|isbn=9781135939984}}</ref> In [[North America]], training generally takes the form of a two- to the three-day seminar, and some experience with childbirth.<ref>{{cite web|url=https://www.prodoula.com/|title=Doula Training Become A Doula|website=ProDoula|access-date=2016-04-18}}</ref> 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 can occur through organizations at various levels (local, national, or international) and some require positive evaluations from medical professionals. 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.<ref name="Balas22"/> Some doulas train through distance education.<ref name="Ballen2" /> |
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There is a movement to encourage certification |
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.<ref name="Ballen2" /> Doulas not trained by a formal organization can be controversial within medical settings due to a lack of formal medical education when a discussion regarding [[medical interventions in labor]] versus pursuing [[natural childbirth]] without an [[epidural]] or [[cesarean section]] arises.<ref name="WSJ3"/> |
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Major doula organizations that offer certification programs include Birth Arts International, Birth Works, Birthing from Within, Childbirth and Postpartum Professional Association (CAPPA), [[DONA International]], Hypnobirthing, International Childbirth Education Association (ICEA), and ProDoula.<ref>{{Cite web|url=http://transform.childbirthconnection.org/action/consumeradvocate/cbe-doula/|title=Childbirth Education and Doula Organizations {{!}} Transforming Maternity Care|access-date=2019-04-01}}</ref> Because of the lack of standardization, doula organizations provide different courses with varying requirements and anyone can refer to themselves as a doula.<ref name="NYT2">{{cite news|url=https://www.nytimes.com/2008/03/02/fashion/02doula.html|title=And the Doula Makes Four|date=2008-03-02|work=[[The New York Times]]|access-date=2012-03-22|vauthors=Paul P}}</ref> Doulamatch.net, an online referral page for doulas, has offered a list of items that students should look for as they begin looking for training. Amy Gilliland, a researcher on doula care and culture, also lists some qualities a training program should have.<ref>{{cite news|url=https://www.trainingdoulas.com/doula-training/best-doula-training/|title=What Makes the Best Doula Training Program?|last=Leavitt|first=Rachel|date=2017-06-13|work=New Beginnings Doula Training|access-date=2018-07-08|name-list-style=vanc}}</ref> Some theorists have stated that it |
Major doula organizations that offer certification programs include Birth Arts International, Birth Works, Birthing from Within, Childbirth and Postpartum Professional Association (CAPPA), [[DONA International]], Hypnobirthing, International Childbirth Education Association (ICEA), and ProDoula.<ref>{{Cite web|url=http://transform.childbirthconnection.org/action/consumeradvocate/cbe-doula/|title=Childbirth Education and Doula Organizations {{!}} Transforming Maternity Care|access-date=2019-04-01}}</ref> Because of the lack of standardization, doula organizations provide different courses with varying requirements and anyone can refer to themselves as a doula.<ref name="NYT2">{{cite news|url=https://www.nytimes.com/2008/03/02/fashion/02doula.html|title=And the Doula Makes Four|date=2008-03-02|work=[[The New York Times]]|access-date=2012-03-22|vauthors=Paul P}}</ref> Doulamatch.net, an online referral page for doulas, has offered a list of items that students should look for as they begin looking for training. Amy Gilliland, a researcher on doula care and culture, also lists some qualities a training program should have.<ref>{{cite news|url=https://www.trainingdoulas.com/doula-training/best-doula-training/|title=What Makes the Best Doula Training Program?|last=Leavitt|first=Rachel|date=2017-06-13|work=New Beginnings Doula Training|access-date=2018-07-08|name-list-style=vanc}}</ref> Some theorists have stated that it might take college-level work or more in-depth online education in order to provide some of the communication skills that might be necessary.<ref>{{cite journal | vauthors = Meadow SL | title = Defining the doula's role: fostering relational autonomy | journal = Health Expectations | volume = 18 | issue = 6 | pages = 3057–68 | date = December 2015 | pmid = 25327532 | pmc = 5810740 | doi = 10.1111/hex.12290 }}</ref> |
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==== Motivations and challenges ==== |
==== Motivations and challenges ==== |
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{{Missing information|section|description|date=August 2019}} |
{{Missing information|section|description|date=August 2019}} |
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In 2010, a survey of professional Canadian doulas found that the common motivations for doula work include "desire to support women in childbirth, personal interest, and a wish to share their own positive birth experience with others" but did not see the work as a means to create steady income.<ref name="pmid207079522">{{cite journal | vauthors = Eftekhary S, Klein MC, Xu SY | title = The life of a Canadian doula: successes, confusion, and conflict | journal = Journal of Obstetrics and Gynaecology Canada | volume = 32 | issue = 7 | pages = 642–9 | date = July 2010 | pmid = 20707952 | doi = 10.1016/S1701-2163(16)34567-4 }}</ref> Doulas of color also found motivation in providing care for their racial, ethnic and cultural communities so as to provide culturally competent care.<ref>{{cite journal | vauthors = Hardeman RR, Kozhimannil KB | title = Motivations for Entering the Doula Profession: Perspectives From Women of Color | journal = Journal of Midwifery & Women's Health | volume = 61 | issue = 6 | pages = 773–780 | date = November 2016 | pmid = 27862907 | pmc = 5143171 | doi = 10.1111/jmwh.12497 }}</ref> Volunteer doulas often saw doula work as a way to "help others, to establish a practice as an employed doula, and to have a route into nursing or midwifery."<ref name=": |
In 2010, a survey of professional Canadian doulas found that the common motivations for doula work include "desire to support women in childbirth, personal interest, and a wish to share their own positive birth experience with others" but did not see the work as a means to create steady income.<ref name="pmid207079522">{{cite journal | vauthors = Eftekhary S, Klein MC, Xu SY | title = The life of a Canadian doula: successes, confusion, and conflict | journal = Journal of Obstetrics and Gynaecology Canada | volume = 32 | issue = 7 | pages = 642–9 | date = July 2010 | pmid = 20707952 | doi = 10.1016/S1701-2163(16)34567-4 }}</ref> Doulas of color also found motivation in providing care for their racial, ethnic and cultural communities so as to provide culturally competent care.<ref>{{cite journal | vauthors = Hardeman RR, Kozhimannil KB | title = Motivations for Entering the Doula Profession: Perspectives From Women of Color | journal = Journal of Midwifery & Women's Health | volume = 61 | issue = 6 | pages = 773–780 | date = November 2016 | pmid = 27862907 | pmc = 5143171 | doi = 10.1111/jmwh.12497 }}</ref> Volunteer doulas often saw doula work as a way to "help others, to establish a practice as an employed doula, and to have a route into nursing or midwifery."<ref name=":52">{{cite journal | vauthors = Spiby H, Mcleish J, Green J, Darwin Z | title = 'The greatest feeling you get, knowing you have made a big difference': survey findings on the motivation and experiences of trained volunteer doulas in England | journal = BMC Pregnancy and Childbirth | volume = 16 | issue = 1 | pages = 289 | date = September 2016 | pmid = 27680500 | pmc = 5041283 | doi = 10.1186/s12884-016-1086-6 | doi-access = free }}</ref> From 2021 to present, Canada has specifically focused research on the cultural significance of indigenous practices in doula work.<ref>{{Cite journal |last1=Doenmez |first1=Caroline Fidan Tyler |last2=Cidro |first2=Jaime |last3=Sinclair |first3=Stephanie |last4=Hayward |first4=Ashley |last5=Wodtke |first5=Larissa |last6=Nychuk |first6=Alexandra |date=2022-01-16 |title=Heart work: Indigenous doulas responding to challenges of western systems and revitalizing Indigenous birthing care in Canada |journal=BMC Pregnancy and Childbirth |volume=22 |issue=1 |pages=41 |doi=10.1186/s12884-021-04333-z |issn=1471-2393 |pmc=8761381 |pmid=35034612 |doi-access=free }}</ref><ref>{{Cite web |last=Cidro |first=Jaime |author2=Ashley Hayward |author3=Larissa Wodtke |date=January 2022 |title=Position Paper: Indigenous Doulas as Intervention for Violence against Indigenous Women and Girls |url=https://www.ohchr.org/sites/default/files/2022-03/cidro-hayward.pdf}}</ref><ref>{{Cite journal |last1=Cidro |first1=Jaime |last2=Doenmez |first2=Caroline |last3=Sinclair |first3=Stephanie |last4=Nychuk |first4=Alexandra |last5=Wodtke |first5=Larissa |last6=Hayward |first6=Ashley |date=2021-08-26 |title=Putting them on a strong spiritual path: Indigenous doulas responding to the needs of Indigenous mothers and communities |journal=International Journal for Equity in Health |volume=20 |issue=1 |pages=189 |doi=10.1186/s12939-021-01521-3 |issn=1475-9276 |pmc=8390212 |pmid=34446010 |doi-access=free }}</ref> |
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A 2004 study of North American doulas identified challenges to doula work such as lack of support from clinicians, balancing doula work with family and other work obligations, and being on call.<ref>{{cite journal|vauthors=Lantz PM, Low LK, Watson RL|date=December 2004|title=Doulas' views on the rewards and challenges of their work.|url=https://www.proquest.com/openview/22acc6e65c0b3e4cefde94564916873b/1|journal=International Journal of Childbirth Education|volume=19|issue=4|pages=31}}</ref> Volunteer doulas also found challenges in individuals' poor understanding of the doula's role, lack of clear boundaries, and complex socio-economic issues.<ref name=": |
A 2004 study of North American doulas identified challenges to doula work such as lack of support from clinicians, balancing doula work with family and other work obligations, and being on call.<ref>{{cite journal|vauthors=Lantz PM, Low LK, Watson RL|date=December 2004|title=Doulas' views on the rewards and challenges of their work.|url=https://www.proquest.com/openview/22acc6e65c0b3e4cefde94564916873b/1|journal=International Journal of Childbirth Education|volume=19|issue=4|pages=31}}</ref> Volunteer doulas also found challenges in individuals' poor understanding of the doula's role, lack of clear boundaries, and complex socio-economic issues.<ref name=":52"/> Additionally, doulas often are challenged with the task to navigate their role in [[Medicalization|medicalized]] (hospital) births.<ref>{{Cite book| vauthors = Hunter CA |title=Understanding Doulas and Childbirth Women, Love, and Advocacy|date=2016|publisher=Palgrave Macmillan US :Imprint: Palgrave Macmillan|isbn=978-1-137-48536-6|oclc=1049995336}}</ref> Due to the social hierarchy and privilege that medical professionals have in medical settings doulas are often subordinate to doctors and physicians. Doulas have to negotiate the power dynamics between the patient and medical provider, while also establishing their legitimacy and role in the process of childbirth.<ref>Henley, M. M. (2016). ''Science and Service: Doula Work and the Legitimacy of Alternative Knowledge Systems'' [Doctoral dissertation, The University of Arizona]. The University of Arizona.</ref> They, therefore, have to be cognizant of the medical environment in which their client chooses to give birth in order to effectively advocate for their client's needs.<ref>{{Cite book|last=Mitchell, Lauren & Mahoney, Mary|title=The Doulas: Radical Care for Pregnant People|publisher=Feminist Press|year=2016|isbn=978-1-55861-941-8|location=New York|oclc=945948862}}</ref> |
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=== Antepartum === |
=== Antepartum === |
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=== Postpartum === |
=== Postpartum === |
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{{See also|Postpartum confinement}}Postpartum doulas provide educational support and practical support in the home in the first weeks and months after childbirth or after adding an infant to the family. The same doula often provides both birth and postpartum services.<ref name=":42" /> Their services include a mixture of emotional support and practical help, such as infant care, breastfeeding support, information, advocacy and referral, partner support, sibling care, and household organization/work as the family adjusts to the addition of a new baby.<ref>{{cite journal | vauthors = Gjerdingen DK, McGovern P, Pratt R, Johnson L, Crow S | s2cid = 206826557 | title = Postpartum doula and peer telephone support for postpartum depression: a pilot randomized controlled trial | journal = Journal of Primary Care & Community Health | volume = 4 | issue = 1 | pages = 36–43 | date = January 2013 | pmid = 23799688 | doi = 10.1177/2150131912451598 }}</ref> There is some evidence that postpartum doula support can increase [[breastfeeding]] and decrease [[postpartum depression]].<ref name=":13" /><ref>{{Cite web|url=http://www.nationalpartnership.org/our-work/resources/health-care/maternity/overdue-medicaid-and-private-insurance-coverage-of-doula-care-to-strengthen-maternal-and-infant-health-issue-brief.pdf|title=Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health|date=January 2016|publisher=National Partnership for Women and Families}}</ref> |
{{See also|Postpartum confinement}}Postpartum doulas provide educational support and practical support in the home in the first weeks and months after childbirth or after adding an infant to the family. The same doula often provides both birth and postpartum services.<ref name=":42" /> Their services include a mixture of emotional support and practical help, such as infant care, breastfeeding support, information, advocacy and referral, partner support, sibling care, and household organization/work as the family adjusts to the addition of a new baby.<ref>{{cite journal | vauthors = Gjerdingen DK, McGovern P, Pratt R, Johnson L, Crow S | s2cid = 206826557 | title = Postpartum doula and peer telephone support for postpartum depression: a pilot randomized controlled trial | journal = Journal of Primary Care & Community Health | volume = 4 | issue = 1 | pages = 36–43 | date = January 2013 | pmid = 23799688 | doi = 10.1177/2150131912451598 | doi-access = free }}</ref> There is some evidence that postpartum doula support can increase [[breastfeeding]] and decrease [[postpartum depression]].<ref name=":13" /><ref>{{Cite web|url=http://www.nationalpartnership.org/our-work/resources/health-care/maternity/overdue-medicaid-and-private-insurance-coverage-of-doula-care-to-strengthen-maternal-and-infant-health-issue-brief.pdf|title=Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health|date=January 2016|publisher=National Partnership for Women and Families}}</ref> |
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Other workers overlap in some of these services, such as maternity nurses, health visitors, newborn care specialists, lactation consultants, and, historically, [[ |
Other workers overlap in some of these services, such as maternity nurses, health visitors, newborn care specialists, lactation consultants, and, historically, [[monthly nurse]]s. |
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=== Full-spectrum === |
=== Full-spectrum === |
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==== Abortion ==== |
==== Abortion ==== |
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{{Main |
{{Main|Abortion doula}} |
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[[Abortion]] doulas provide care before, during, and after an abortion, with support varying by person and their informational, emotional, physical, and practical needs. 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. There are no certifications specifically for abortion doulas that are administered nationally or through individual states.<ref name=":5">{{Cite web |title=Abortion Doulas Prepare for Increased Criminalization |url=https://nextcity.org/features/abortion-doulas-prepare-for-increased-criminalization-roe-v-wade-falls |access-date=2022-06-29 |website=nextcity.org |language=en}}</ref> |
[[Abortion]] doulas provide care before, during, and after an abortion, with support varying by person and their informational, emotional, physical, and practical needs. 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. There are no certifications specifically for abortion doulas that are administered nationally or through individual states.<ref name=":5">{{Cite web |title=Abortion Doulas Prepare for Increased Criminalization |url=https://nextcity.org/features/abortion-doulas-prepare-for-increased-criminalization-roe-v-wade-falls |access-date=2022-06-29 |website=nextcity.org |language=en}}</ref> |
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⚫ | 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. They are taking precautions to retain online anonymity to better protect patients and themselves and navigate the threat of legal action.<ref name=":5" /> |
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==== Gender transition ==== |
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⚫ | 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. They are taking precautions to retain online anonymity to better protect patients and themselves and |
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A gender doula provides care before, during, and after the [[gender transition]] process for transgender and non-binary individuals.<ref>{{Cite web |title=Serious About Gender Exploration? There's a Doula for That. |url=https://www.yesmagazine.org/health-happiness/2024/04/15/gender-transition-doula-transgender |access-date=2024-04-20 |website=YES! Magazine |language=en-US}}</ref> Gender doulas may also serve as patient advocates for their clients against medical practitioners who may misgender or undermine the gender identity of the client. |
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=== End-of-life and critical care === |
=== End-of-life and critical care === |
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{{Main |
{{Main|Death midwife}} |
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End-of-life or [[ |
End-of-life or [[death doula]]s care for critically ill adults in [[Geriatric nursing|geriatric care]],<ref name="Balas22"/> and during death.<ref>{{cite web|url=http://www.huffingtonpost.com/debbie-slevin/doulas-for-the-dying_b_9601780.html|title=Doulas For The Dying|last=Slevin|first=Debbie|date=2016-04-10|work=Huffington Post|access-date=2016-04-11|name-list-style=vanc}}</ref> While some doulas work independently or on a volunteer basis, others might work in association with a health care service, such as a palliative care service. The roles of an end-of-life doula include not only physical tasks, such as assisting with posture or making the bed comfortable but also emotional and psychological tasks, such as providing guidance and support. |
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== Integration of doulas into formal medical care == |
== Integration of doulas into formal medical care == |
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=== Birth doulas === |
=== Birth doulas === |
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In the United States, doulas |
In the United States, doulas can be found in hospital, community-based programs as well as private practice or doula agencies. They might also be reimbursed by insurance companies or out-of-pocket by clients.<ref name="Ballen3">{{cite journal | vauthors = Ballen LE, Fulcher AJ | title = Nurses and doulas: complementary roles to provide optimal maternity care | journal = Journal of Obstetric, Gynecologic, and Neonatal Nursing | volume = 35 | issue = 2 | pages = 304–11 | year = 2006 | pmid = 16620259 | doi = 10.1111/j.1552-6909.2006.00041.x | s2cid = 23409222 }}</ref><ref>{{cite web|url=https://www.doulasa.com/career-choices-for-becoming-a-doula/|title=Career Choices for Becoming a Doula|website=Become a Doula with ProDoula|access-date=2016-04-18}}</ref><ref>{{Cite web |last=Viswanathan |first=Meera |date=February 4, 2024 |title=Impact of Doula Support During Pregnancy, Childbirth and Beyond (A Health Equity Systematic Review) |url=https://www.pcori.org/research-results/2023/impact-doula-support-during-pregnancy-childbirth-and-beyond-health-equity-systematic-review#:~:text=Support%20from%20a%20doula%20during,lower%20prevalence%20of%20poor%20five%2D |access-date=February 4, 2024 |website=Patient-Centered Outcomes Research Institute}}</ref> Since insurance companies typically do not cover the cost of hiring a doula, they are more popular among middle- and upper-class parents than amongst parents with lower incomes.<ref name="WSJ3"/><ref>{{cite web|url=http://missionlocal.org/2010/02/doulas-a-moms-best-friend-during-labor-grow-in-popularity/|title=Doulas, a Mom's Best Friend During Labor, Grow in Popularity|date=2010-02-22|publisher=Missionlocal.org|access-date=2014-02-02}}</ref> Since doula care has the potential to lower maternity costs and reduce health disparities, there is a push for coverage through Medicaid reimbursement programs. As of 2022, four states, [[Oregon]], [[Minnesota]], [[Virginia]] and [[Wisconsin]], have implemented reimbursement programs.<ref name=":23" /><ref>{{Cite web |last=McIntyre |first=Meghan |date=2022-10-10 |title=Doula services now covered under Virginia Medicaid expansion |url=https://www.virginiamercury.com/2022/10/10/doula-services-now-covered-under-virginia-medicaid-expansion/ |access-date=2023-11-30 |website=Virginia Mercury |language=en-US}}</ref> In 2019, [[New York State]] launched a doula pilot program for Medicaid reimbursement in [[Erie County, New York|Erie]] and [[Kings County, New York|Kings]] Counties.<ref>{{Cite web|url=https://www.health.ny.gov/health_care/medicaid/redesign/doulapilot/index.htm|title=New York State Doula Pilot Program|website=www.health.ny.gov|access-date=2019-03-30}}</ref> In that same year, New York State passed a bill to certify doulas to lend legitimacy to the profession and to pave the way for Medicaid reimbursement from the federal government, becoming the first state to do so. Doulas in New York, however, expressed concern about the bill, having not been involved with the bill's writing, citing that state certification would make doulas more beholden to the formal medical system, be a hit to business if certification programs are not approved by the state, and might prevent community doulas from working with low-income individuals.<ref>{{Cite web|url=http://nymag.com/intelligencer/2019/07/doula-certification-bill-in-new-york-state.html|title=A Landmark Bill Will Change the Way Doulas Do Business in New York|last=Meyerson|first=Collier|date=2019-07-19|website=Intelligencer|access-date=2019-07-31}}</ref><ref>{{Cite web|url=https://www.nysenate.gov/legislation/bills/2019/s3344/amendment/b|title=NY State Senate Bill S3344B|date=2019-06-05|website=NY State Senate|access-date=2019-07-31}}</ref> |
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In the UK, the [[National Health Service]] and promotion of midwifery for low-risk pregnancies provide a continuity of care |
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. This pattern has been suggested to result from the lack of midwives available and a move to provide doulas to individuals at greater risk for poor outcomes.<ref name=":52"/> |
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A 2019 study reviewed perceptions of labor companionship across mostly high income countries and found barriers that prevent |
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).<ref>{{cite journal | vauthors = Bohren MA, Berger BO, Munthe-Kaas H, Tunçalp Ö | title = Perceptions and experiences of labour companionship: a qualitative evidence synthesis | journal = The Cochrane Database of Systematic Reviews | volume = 3 | pages = CD012449 | date = March 2019 | issue = 7 | pmid = 30883666 | pmc = 6422112 | doi = 10.1002/14651858.cd012449.pub2 }}</ref> |
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=== Community-based doulas === |
=== Community-based doulas === |
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Community-based doulas work with underserved communities of which they are often members |
Community-based doulas work with underserved communities of which they are often members to provide a sense of cultural humility that fosters trust and strengthens relationships between the doula and their client. 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. Services include an increased amount of home visits, preparation for the birthing experience, education, guidance navigating health care systems, language support, screening for mental health, and food security needs.<ref name=":3" /> |
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Additionally, community-based doula models provide insight in the creation of policies that will support those families and underserved communities.<ref name=":3">{{cite report | vauthors = Bey A, Brill A, Porchia-Albert C, Gradilla M, Strauss N |url= https://blackmamasmatter.org/wp-content/uploads/2019/03/Advancing-Birth-Justice-CBD-Models-as-Std-of-Care-3-25-19.pdf |title=Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities |publisher=Ancient Song Doula Services, Village Birth International, Every Mother Counts |year=2019}}</ref> These doulas also actively engage policy makers by recommendations on certification and Medicaid coverage, integration into medical care, and participating on advisory boards.<ref>{{Cite web|title=Community-Based Doulas and Midwives|url=https://www.americanprogress.org/article/community-based-doulas-midwives/|access-date=2021-12-17|website=Center for American Progress|language=en}}</ref> |
Additionally, community-based doula models provide insight in the creation of policies that will support those families and underserved communities.<ref name=":3">{{cite report | vauthors = Bey A, Brill A, Porchia-Albert C, Gradilla M, Strauss N |url= https://blackmamasmatter.org/wp-content/uploads/2019/03/Advancing-Birth-Justice-CBD-Models-as-Std-of-Care-3-25-19.pdf |title=Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities |publisher=Ancient Song Doula Services, Village Birth International, Every Mother Counts |year=2019}}</ref> These doulas also actively engage policy makers by recommendations on certification and Medicaid coverage, integration into medical care, and participating on advisory boards.<ref>{{Cite web|title=Community-Based Doulas and Midwives|url=https://www.americanprogress.org/article/community-based-doulas-midwives/|access-date=2021-12-17|website=Center for American Progress|date=14 April 2020 |language=en}}</ref> |
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=== Prison doulas === |
=== Prison doulas === |
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== Further reading == |
== Further reading == |
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{{refbegin}} |
{{refbegin}} |
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* {{cite book | title = The Doula Book: How A Trained Labor Companion Can Help You Have A Shorter, Easier, And Healthier Birth | vauthors = Klaus MH, Kennell JH, Klaus PH | publisher = [[Da Capo Press]] | year = 2002 | isbn = 978-0738206097 | url = https://books.google.com/books?id=43ebxn4cK6gC}} |
* {{cite book | title = The Doula Book: How A Trained Labor Companion Can Help You Have A Shorter, Easier, And Healthier Birth | vauthors = Klaus MH, Kennell JH, Klaus PH | publisher = [[Da Capo Press]] | year = 2002 | isbn = 978-0738206097 | url = https://books.google.com/books?id=43ebxn4cK6gC }} |
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{{refend}} |
{{refend}} |
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Revision as of 06:54, 20 November 2024
A doula (/ˈduːlə/; from Ancient Greek δούλα 'female slave'; Greek pronunciation: [ˈðula]) is a non-medical professional who provides guidance for the service of others and who supports another person (the doula's client) through a significant health-related experience, such as childbirth, miscarriage, induced abortion or stillbirth, as well as non-reproductive experiences such as dying.[1][2][3][4] A doula might also provide support to the client's partner, family, and friends.[5][6]
The doula's goal and role is to help the client feel safe and comfortable, complementing the role of the healthcare professionals who provide the client's medical care. Unlike a physician, midwife, or nurse, a doula cannot administer medication or other medical treatment or give medical advice.[7][2] An individual might need to complete training to work as a doula, although training and certification processes vary throughout the world.[7][3][4][8]
Some doulas work as volunteers; others are paid for their services by their client, medical institutions, or other private and public organizations. Doulas receive varying amounts of training, and their professionalism also varies.[4][9]
The contributions of doulas during reproductive experiences and end-of-life care have been studied and have been shown to benefit their clients.[4][10][11][12] For example, a birth doula providing support during childbirth might increase likelihood of vaginal birth (rather than Caesarean section), decrease the need for pain medication during labor, and improve the perception of the birthing experience.[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]
History and etymology
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.[18] However, the contemporary role of "doula" first emerged from the grassroots natural birth movement in the United States in the 1960s when women began desiring unmedicated, low-intervention births and began to have friends and others with formal or practical knowledge about childbirth provide them with support during pregnancy.[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.[20] Raphael derived the term from modern Greek (δούλα, doúla (Greek pronunciation: [ˈðula]), "slave"[21]), as told to her by an elderly Greek woman,[22] Eleni Rassias,[23] and described it as coming from "Aristotle's time," an Ancient Greek word δούλα meaning "female slave."[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.[7] In 1992, Doulas of North America (later DONA International) was co-founded by Klaus, Kennell, Phyllis Klaus, Penny Simkin, and Annie Kennedy, becoming the first organization to train and certify doulas.[25][26] The organization with the backing of the research of Klaus and Kennell helped lend credibility and professionalize doulas.[27] Due to the lobbying efforts of DONA International, the term doula was accepted into the American Heritage Dictionary and Oxford Dictionary in 2003, followed by Merriam Webster Dictionary in 2004.[26] Alternative names to this role include "childbirth assistant" and "monitrice," but they did not catch on as "doula" had.[19]
In 2008, activists in New York City began the Doula Project, to expand the role of the doula to other reproductive experiences beyond birth, grounded in reproductive justice framework.[28][29] The participants began working as abortion doulas and coined the term "full-spectrum doula" who support all pregnancy experiences and outcomes such as pregnancy termination, miscarriage and fetal loss.[28][30] Full spectrum doula groups can be found in major cities in the United States.[31]
In 2019, Black maternal health advocate and Parents writer Christine Michel Carter interviewed Vice President Kamala Harris about the popularity of doulas in the Black community.[32] As a senator, in 2019 Harris reintroduced the Maternal Care Access and Reducing Emergencies (CARE) Act which aimed to address the maternal mortality disparity faced by women of color by training providers on recognizing implicit racial bias and its impact on care. Harris stated:
"We need to speak the uncomfortable truth that women—and especially Black women—are too often not listened to or taken seriously by the health care system, and therefore they are denied the dignity that they deserve. And we need to speak this truth because today, the United States is 1 of only 13 countries in the world where the rate of maternal mortality is worse than it was 25 years ago. That risk is even higher for Black women, who are three to four times more likely than white women to die from pregnancy-related causes. These numbers are simply outrageous."
Types of support
Birth
Role
A doula focused on birth is also known as a birth companion, nonclinical birth worker, birth coach, or post-birth supporter, by providing continuous care before, during, or after in the form of information, advocacy, physical support, and emotional support.[2][14][8][10] A birth doula is also called a labor doula. A birth doula might accompany a pregnant woman during labor and birth in place of or in addition to a partner, family member, or friend. Unlike these other birth companions, a doula has formal training in labor support.[2][14] The kinds of support provided during childbirth might include physical assistance and comfort (massage, maintaining a supporting posture, or providing water), emotional support (providing company, encouragement or simply talking in a soothing tone of voice), acting as an advocate during childbirth (supporting the birthing woman's right to make decisions about their own body and baby to the medical team) and informational support (provide information about the birthing process and non-medication based forms of pain relief, and facilitating communication between their client and health providers).[14][5]
Most doula-client relationships begin a few months before the baby is due. 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]
Benefits and limitations
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. These benefits appear to be contingent on the doula providing continuous rather than intermittent assistance and knowing the specific social and cultural setting within which their services are provided.[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.[34][35][36][37] Research also supports the effectiveness of female friends or relatives, after minimal training, as a low-cost alternative to professional doulas.[11][38]
In March 2014, the American College of Obstetricians and Gynecologists (ACOG) put out a Consensus Statement titled "Safe Prevention of Primary Cesarean Delivery" in which it said, "Increasing [a woman's] access to non-medical interventions during labor, such as continuous labor support, also has been shown to reduce cesarean birth rates."[39] As more research has become available on the positive benefits of trained labor support provided by someone not employed by the hospital, in 2017 ACOG officially announced the need for all birthing individuals to have access to continuous labor support outside hospital staff, and said, "Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes."[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. Doulas could be utilized to help achieve many of these recommendations as they move towards better collaboration.[42]
In 2017 the United Kingdom's Royal College of Midwives published a position statement on doulas, which supports the choice of the individual to hire a doula for their birth as long as the doula does not provide medical care.[43]
A 2018 study examined women's perceptions of doulas in several different countries, including Egypt, Lebanon, Syria, Malawi, Sweden, Nepal, Russia, Canada, and the United States of America and found that having continuous support from a companion such as a doula was highly appreciated by most women.[10] However, perceptions may vary from country to country due to cultural factors, such as an emphasis on modesty and privacy, which might affect what kind of support a woman prefers.[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. The doula profession was introduced in 1996 to mainland China and demand of their services increased since then, with women citing dissatisfaction with medical care. After China's implementation of the Second-Child Policy, doula care was strongly linked to doula support in regard to family planning.[44]
Tensions between doctors, nurses, and doulas have sometimes been described as a "turf battle,"[45] though it is also recognized that doulas and nurses can occupy complementary roles that provide opportunities for mutual learning and assistance.[46] Some hospitals have created internal doula training programs to reduce conflict between doulas and medical staff.[45][47]
Training and certification
There is no law requiring doulas to become certified, however, certification can benefit professional doulas by providing structured education prior to entry into the field, access to a mentor, opportunities for networking, and client confidence.[48] In North America, training generally takes the form of a two- to the three-day seminar, and some experience with childbirth.[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 can occur through organizations at various levels (local, national, or international) and some require positive evaluations from medical professionals. 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.[17] Some doulas train through distance education.[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.[46] Doulas not trained by a formal organization can be controversial within medical settings due to a lack of formal medical education when a discussion regarding medical interventions in labor versus pursuing natural childbirth without an epidural or cesarean section arises.[45]
Major doula organizations that offer certification programs include Birth Arts International, Birth Works, Birthing from Within, Childbirth and Postpartum Professional Association (CAPPA), DONA International, Hypnobirthing, International Childbirth Education Association (ICEA), and ProDoula.[50] Because of the lack of standardization, doula organizations provide different courses with varying requirements and anyone can refer to themselves as a doula.[51] Doulamatch.net, an online referral page for doulas, has offered a list of items that students should look for as they begin looking for training. Amy Gilliland, a researcher on doula care and culture, also lists some qualities a training program should have.[52] Some theorists have stated that it might take college-level work or more in-depth online education in order to provide some of the communication skills that might be necessary.[53]
Motivations and challenges
This section is missing information about description.(August 2019) |
In 2010, a survey of professional Canadian doulas found that the common motivations for doula work include "desire to support women in childbirth, personal interest, and a wish to share their own positive birth experience with others" but did not see the work as a means to create steady income.[54] Doulas of color also found motivation in providing care for their racial, ethnic and cultural communities so as to provide culturally competent care.[55] Volunteer doulas often saw doula work as a way to "help others, to establish a practice as an employed doula, and to have a route into nursing or midwifery."[56] From 2021 to present, Canada has specifically focused research on the cultural significance of indigenous practices in doula work.[57][58][59]
A 2004 study of North American doulas identified challenges to doula work such as lack of support from clinicians, balancing doula work with family and other work obligations, and being on call.[60] Volunteer doulas also found challenges in individuals' poor understanding of the doula's role, lack of clear boundaries, and complex socio-economic issues.[56] Additionally, doulas often are challenged with the task to navigate their role in medicalized (hospital) births.[61] Due to the social hierarchy and privilege that medical professionals have in medical settings doulas are often subordinate to doctors and physicians. Doulas have to negotiate the power dynamics between the patient and medical provider, while also establishing their legitimacy and role in the process of childbirth.[62] They, therefore, have to be cognizant of the medical environment in which their client chooses to give birth in order to effectively advocate for their client's needs.[63]
Antepartum
An antepartum doula provides help and support to someone who has been put on bed rest or is experiencing a high-risk pregnancy. Emotional, physical and practical support can be provided by an antepartum doula in this circumstance.[64]
Postpartum
Postpartum doulas provide educational support and practical support in the home in the first weeks and months after childbirth or after adding an infant to the family. The same doula often provides both birth and postpartum services.[2] Their services include a mixture of emotional support and practical help, such as infant care, breastfeeding support, information, advocacy and referral, partner support, sibling care, and household organization/work as the family adjusts to the addition of a new baby.[65] There is some evidence that postpartum doula support can increase breastfeeding and decrease postpartum depression.[5][66]
Other workers overlap in some of these services, such as maternity nurses, health visitors, newborn care specialists, lactation consultants, and, historically, monthly nurses.
Full-spectrum
Full-spectrum doulas extend the role of a birth attendant and provide support for all reproductive experiences which connect the role to the larger reproductive justice movement.[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][67][68] Abortion doulas focus on providing support to clients having an induced abortion. They provide emotional, physical, and informational support virtually or in person.[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.[3]
Abortion
Abortion doulas provide care before, during, and after an abortion, with support varying by person and their informational, emotional, physical, and practical needs. 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. There are no certifications specifically for abortion doulas that are administered nationally or through individual states.[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. They are taking precautions to retain online anonymity to better protect patients and themselves and navigate the threat of legal action.[69]
Gender transition
A gender doula provides care before, during, and after the gender transition process for transgender and non-binary individuals.[70] Gender doulas may also serve as patient advocates for their clients against medical practitioners who may misgender or undermine the gender identity of the client.
End-of-life and critical care
End-of-life or death doulas care for critically ill adults in geriatric care,[17] and during death.[71] While some doulas work independently or on a volunteer basis, others might work in association with a health care service, such as a palliative care service. The roles of an end-of-life doula include not only physical tasks, such as assisting with posture or making the bed comfortable but also emotional and psychological tasks, such as providing guidance and support.
Integration of doulas into formal medical care
Birth doulas
In the United States, doulas can be found in hospital, community-based programs as well as private practice or doula agencies. They might also be reimbursed by insurance companies or out-of-pocket by clients.[72][73][74] Since insurance companies typically do not cover the cost of hiring a doula, they are more popular among middle- and upper-class parents than amongst parents with lower incomes.[45][75] Since doula care has the potential to lower maternity costs and reduce health disparities, there is a push for coverage through Medicaid reimbursement programs. As of 2022, four states, Oregon, Minnesota, Virginia and Wisconsin, have implemented reimbursement programs.[34][76] In 2019, New York State launched a doula pilot program for Medicaid reimbursement in Erie and Kings Counties.[77] In that same year, New York State passed a bill to certify doulas to lend legitimacy to the profession and to pave the way for Medicaid reimbursement from the federal government, becoming the first state to do so. Doulas in New York, however, expressed concern about the bill, having not been involved with the bill's writing, citing that state certification would make doulas more beholden to the formal medical system, be a hit to business if certification programs are not approved by the state, and might prevent community doulas from working with low-income individuals.[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. This pattern has been suggested to result from the lack of midwives available and a move to provide doulas to individuals at greater risk for poor outcomes.[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).[80]
Community-based doulas
Community-based doulas work with underserved communities of which they are often members to provide a sense of cultural humility that fosters trust and strengthens relationships between the doula and their client. 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. Services include an increased amount of home visits, preparation for the birthing experience, education, guidance navigating health care systems, language support, screening for mental health, and food security needs.[81]
Additionally, community-based doula models provide insight in the creation of policies that will support those families and underserved communities.[81] These doulas also actively engage policy makers by recommendations on certification and Medicaid coverage, integration into medical care, and participating on advisory boards.[82]
Prison doulas
Since the 1980s, women incarcerated in the US has increased nearly 800 percent, of which an estimated 12,000 pregnant women are incarcerated annually. Pregnant prisoners are allowed to be shackled in more than 20 states and are forced to return to jail within 24 hours without their infants.[83] The environmental factors of the penal system are shown to increase the risks associated with poor perinatal outcomes and have long-term health risks for the women and their children.[84] The implementation of prison doulas rose out of the movement to end shackling for pregnant and laboring women from the prison abolition, human rights, reproductive justice, and birth justice movements in the early 2000s.[84][85] Prison doula organizations work with those incarcerated to provide prenatal care, childbirth education, birth attendance, and breast feeding support. By providing doula services to jails, prisons, recovery centers, and county hospitals, doulas work to improve birth experiences and bonding as well as to challenge the dehumanizing penal environment.[85] In studies of women who received doula services while incarcerated, the women reported increased happiness around their pregnancy; greater feelings of empowerment; a sense of normalcy around birth; and support during separation from their infant.[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.[83] In 2018, Washington was the first state to provide access to midwifery and doula services for incarcerated women for prenatal care, delivery, and postpartum care. However, the bill does not establish means of funding the services, and does not establish guidelines for care.[87]
References
- ^ Morton CH (2014). Birth ambassadors : doulas and the re-emergence of woman-supported birth America. Praeclarus Press, LLC. pp. 33–34. ISBN 978-1-939807-06-9. OCLC 876741292.
- ^ a b c d e "What is a Doula". DONA International. Retrieved 2019-08-13.
- ^ a b c d e f Mahoney M, Mitchell L (2016-10-17). The Doulas: Radical Care for Pregnant People. The Feminist Press at CUNY. ISBN 9781558619494.
- ^ a b c d e Rawlings D, Tieman J, Miller-Lewis L, Swetenham K (May 2019). "What role do Death Doulas play in end-of-life care? A systematic review". Health & Social Care in the Community. 27 (3): e82–e94. doi:10.1111/hsc.12660. PMID 30255588.
- ^ a b c d "Evidence on: Doulas". Evidence Based Birth. 2017-08-14. Retrieved 2019-03-30.
- ^ Simkin P, Rohs K (2018-10-09). The birth partner : a complete guide to childbirth for dads, doulas, and other labor companions (5th ed.). Beverly, MA, USA. ISBN 978-1558329102. OCLC 1000126985.
{{cite book}}
: CS1 maint: location missing publisher (link) - ^ a b c Klaus MH, Kennell JH, Klaus PH (2002). "Chapters 1, 2". The Doula Book: How A Trained Labor Companion Can Help You Have A Shorter, Easier, And Healthier Birth. Da Capo Press. ISBN 978-0738206097.
- ^ a b Steel A, Frawley J, Adams J, Diezel H (May 2015). "Trained or professional doulas in the support and care of pregnant and birthing women: a critical integrative review". Health & Social Care in the Community. 23 (3): 225–41. doi:10.1111/hsc.12112. PMID 24942339.
- ^ Lantz PM, Low LK, Varkey S, Watson RL (2005). "Doulas as childbirth paraprofessionals: results from a national survey". Women's Health Issues. 15 (3): 109–16. doi:10.1016/j.whi.2005.01.002. PMID 15894196.
- ^ a b c d Lunda P, Minnie CS, Benadé P (May 2018). "Women's experiences of continuous support during childbirth: a meta-synthesis". BMC Pregnancy and Childbirth. 18 (1): 167. doi:10.1186/s12884-018-1755-8. PMC 5952857. PMID 29764406.
- ^ a b c Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A (July 2017). "Continuous support for women during childbirth". The Cochrane Database of Systematic Reviews. 7 (7): CD003766. doi:10.1002/14651858.CD003766.pub6. PMC 6483123. PMID 28681500.
- ^ Fukuzawa RK, Kondo KT (December 2017). "A holistic view from birth to the end of life: end-of-life doulas and new developments in end-of-life care in the West". International Journal of Palliative Nursing. 23 (12): 612–619. doi:10.12968/ijpn.2017.23.12.612. PMID 29272199.
- ^ Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A, et al. (Cochrane Pregnancy and Childbirth Group) (July 2017). "Continuous support for women during childbirth". The Cochrane Database of Systematic Reviews. 7 (8): CD003766. doi:10.1002/14651858.CD003766.pub6. PMC 6483123. PMID 28681500.
- ^ a b c d Bohren MA, Berger BO, Munthe-Kaas H, Tunçalp Ö, et al. (Cochrane Effective Practice and Organisation of Care Group) (March 2019). "Perceptions and experiences of labour companionship: a qualitative evidence synthesis". The Cochrane Database of Systematic Reviews. 3 (7): CD012449. doi:10.1002/14651858.CD012449.pub2. PMC 6422112. PMID 30883666.
- ^ a b Chor J, Lyman P, Tusken M, Patel A, Gilliam M (March 2016). "Women's experiences with doula support during first-trimester surgical abortion: a qualitative study". Contraception. 93 (3): 244–8. doi:10.1016/j.contraception.2015.10.006. PMC 4766033. PMID 26480890.
- ^ Altshuler AL, Whaley NS (December 2018). "The patient perspective: perceptions of the quality of the abortion experience". Current Opinion in Obstetrics & Gynecology. 30 (6): 407–413. doi:10.1097/GCO.0000000000000492. PMID 30299320. S2CID 52937963.
- ^ a b c Balas MC, Gale M, Kagan SH (August 2004). "Delirium doulas: an innovative approach to enhance care for critically ill older adults". Critical Care Nurse. 24 (4): 36–46. doi:10.4037/ccn2004.24.4.36. PMID 15341233.
- ^ "Anthropologist's studies of childbirth bring new focus on women in evolution". www1.udel.edu. Retrieved 2020-10-23.
- ^ a b Morton CH (2014). Birth ambassadors : doulas and the re-emergence of woman-supported birth America. Praeclarus Press, LLC. pp. 51–101. ISBN 9781939807069. OCLC 876741292.
- ^ a b Roberts S (February 19, 2016). "Dana Raphael, Proponent of Breast-Feeding and Use of Doulas, Dies at 90". The New York Times. Retrieved January 17, 2017.
- ^ "δούλα - Ελληνοαγγλικό Λεξικό WordReference.com". www.wordreference.com (in Greek). Retrieved 2022-02-16.
- ^ Jones M (December 21, 2016). "Dana Raphael Opened Up the Mysteries of Nursing". NYT Magazine. Retrieved January 17, 2017.
- ^ Raphael D (1973). The Tender Gift: Breastfeeding.
- ^ a b Mander R (2001). "The doula". Supportive care and midwifery. John Wiley & Sons. pp. 113–33. ISBN 978-0632054251.
- ^ Torres JM (July 2013). "Breast milk and labour support: lactation consultants' and doulas' strategies for navigating the medical context of maternity care" (PDF). Sociology of Health & Illness. 35 (6): 924–38. doi:10.1111/1467-9566.12010. hdl:2027.42/99048. PMID 23398567.
- ^ a b "History of DONA International". DONA International. 7 August 2014. Retrieved 2019-04-09.
- ^ Simonds W, Rothman BK, Norman BM (2013-10-23). Laboring On: Birth in Transition in the United States. Routledge. ISBN 9781135939984.
- ^ a b Mahoney M, Mitchell L (2016-10-17). The Doulas: Radical Care for Pregnant People. The Feminist Press at CUNY. ISBN 9781558619494.
- ^ Pérez MZ (2012). The Radical Doula Guide: A Political Primer For Full Spectrum Pregnancy and Childbirth Support.
- ^ Basmajian A (2014). "Abortion Doulas: Changing the Narrative". Anthropology Now. 6 (2): 44–51. doi:10.1080/19492901.2014.11728432. ISSN 1942-8200. S2CID 80163473.
- ^ "Bay Area Doula Project". Retrieved 2019-08-21.
- ^ "How Doulas Provide the Advocacy and Support Black Women Need". Parents. Retrieved 2023-06-21.
- ^ Scott KD, Berkowitz G, Klaus M (May 1999). "A comparison of intermittent and continuous support during labor: a meta-analysis". American Journal of Obstetrics and Gynecology. 180 (5): 1054–9. doi:10.1016/s0002-9378(99)70594-6. PMID 10329855.
- ^ a b Strauss N, Giessler K, McAllister E (2015). "How Doula Care Can Advance the Goals of the Affordable Care Act: A Snapshot From New York City". The Journal of Perinatal Education. 24 (1): 8–15. doi:10.1891/1058-1243.24.1.8. PMC 4720857. PMID 26937157.
- ^ Coley SL, Zapata JY, Schwei RJ, Mihalovic GE, Matabele MN, Jacobs EA, Anderson CK (2018). "More Than a "Number": Perspectives of Prenatal Care Quality from Mothers of Color and Providers". Women's Health Issues. 28 (2): 158–164. doi:10.1016/j.whi.2017.10.014. PMC 5835403. PMID 29208354.
- ^ Everson CL, Cheyney M, Bovbjerg ML (June 2018). "Outcomes of Care for 1,892 Doula-Supported Adolescent Births in the United States: The DONA International Data Project, 2000 to 2013". The Journal of Perinatal Education. 27 (3): 135–147. doi:10.1891/1058-1243.27.3.135. PMC 6193361. PMID 30364259.
- ^ Spiby H, Green JM, Darwin Z, Willmot H, Knox D, McLeish J, Smith M (2015). "Multisite implementation of trained volunteer doula support for disadvantaged childbearing women: a mixed-methods evaluation". Health Services and Delivery Research. 3 (8): 1–332. doi:10.3310/hsdr03080. PMID 25834865.
- ^ Campbell D, Scott KD, Klaus MH, Falk M (September 2007). "Female relatives or friends trained as labor doulas: outcomes at 6 to 8 weeks postpartum". Birth. 34 (3): 220–7. doi:10.1111/j.1523-536X.2007.00174.x. PMID 17718872. S2CID 923119.
- ^ American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine (March 2014). "Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery". Obstetrics and Gynecology. 123 (3): 693–711. doi:10.1097/01.AOG.0000444441.04111.1d. PMID 24553167. Archived from the original on 2014-03-02. Retrieved 2015-12-21.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ Kozhimannil KB, Hardeman RR, Attanasio LB, Blauer-Peterson C, O'Brien M (April 2013). "Doula care, birth outcomes, and costs among Medicaid beneficiaries". American Journal of Public Health. 103 (4): e113-21. doi:10.2105/AJPH.2012.301201. PMC 3617571. PMID 23409910.
- ^ Committee on Obstetric Practice; American College of Obstetricians and Gynecologists (February 2017). "Committee Opinion No. 687: Approaches to Limit Intervention During Labor and Birth". Obstetrics and Gynecology. 129 (2): e20–e28. doi:10.1097/AOG.0000000000001905. PMID 28121831.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ Leavitt R (2017-06-05). "All women should have access to doula care". New Beginnings Doula Training. Retrieved 2018-07-08.
- ^ "Doulas Position Statement" (PDF). The Royal College of Midwives. October 2017. Archived from the original (PDF) on 27 August 2018.
- ^ Dai, Zehui (October 2018). "Chinese News Media Discourse of Doulas and Doula Care". The Journal of Perinatal Education. 27 (4): 243–252. doi:10.1891/1058-1243.27.4.243. ISSN 1058-1243. PMC 6491159. PMID 31073270.
- ^ a b c d Hwang S (2004-01-19). "As 'Doulas' Enter Delivery Rooms, Conflicts Arise: Hired to Help in Childbirth, They Sometimes Clash With Doctors and Nurses". The Wall Street Journal.
- ^ a b c Ballen LE, Fulcher AJ (2006). "Nurses and doulas: complementary roles to provide optimal maternity care". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 35 (2): 304–11. doi:10.1111/j.1552-6909.2006.00041.x. PMID 16620259. S2CID 23409222.
- ^ "Hospital "Credentialing" For Doulas? Yea or Nay?". Become a Doula with ProDoula. 2015-10-24. Retrieved 2016-04-18.
- ^ Simonds, Wendy; Rothman, Barbara Katz; Norman, Bari Meltzer (2013-10-23). Laboring On: Birth in Transition in the United States. Routledge. ISBN 9781135939984.
- ^ "Doula Training Become A Doula". ProDoula. Retrieved 2016-04-18.
- ^ "Childbirth Education and Doula Organizations | Transforming Maternity Care". Retrieved 2019-04-01.
- ^ Paul P (2008-03-02). "And the Doula Makes Four". The New York Times. Retrieved 2012-03-22.
- ^ Leavitt R (2017-06-13). "What Makes the Best Doula Training Program?". New Beginnings Doula Training. Retrieved 2018-07-08.
- ^ Meadow SL (December 2015). "Defining the doula's role: fostering relational autonomy". Health Expectations. 18 (6): 3057–68. doi:10.1111/hex.12290. PMC 5810740. PMID 25327532.
- ^ Eftekhary S, Klein MC, Xu SY (July 2010). "The life of a Canadian doula: successes, confusion, and conflict". Journal of Obstetrics and Gynaecology Canada. 32 (7): 642–9. doi:10.1016/S1701-2163(16)34567-4. PMID 20707952.
- ^ Hardeman RR, Kozhimannil KB (November 2016). "Motivations for Entering the Doula Profession: Perspectives From Women of Color". Journal of Midwifery & Women's Health. 61 (6): 773–780. doi:10.1111/jmwh.12497. PMC 5143171. PMID 27862907.
- ^ a b c Spiby H, Mcleish J, Green J, Darwin Z (September 2016). "'The greatest feeling you get, knowing you have made a big difference': survey findings on the motivation and experiences of trained volunteer doulas in England". BMC Pregnancy and Childbirth. 16 (1): 289. doi:10.1186/s12884-016-1086-6. PMC 5041283. PMID 27680500.
- ^ Doenmez, Caroline Fidan Tyler; Cidro, Jaime; Sinclair, Stephanie; Hayward, Ashley; Wodtke, Larissa; Nychuk, Alexandra (2022-01-16). "Heart work: Indigenous doulas responding to challenges of western systems and revitalizing Indigenous birthing care in Canada". BMC Pregnancy and Childbirth. 22 (1): 41. doi:10.1186/s12884-021-04333-z. ISSN 1471-2393. PMC 8761381. PMID 35034612.
- ^ Cidro, Jaime; Ashley Hayward; Larissa Wodtke (January 2022). "Position Paper: Indigenous Doulas as Intervention for Violence against Indigenous Women and Girls" (PDF).
- ^ Cidro, Jaime; Doenmez, Caroline; Sinclair, Stephanie; Nychuk, Alexandra; Wodtke, Larissa; Hayward, Ashley (2021-08-26). "Putting them on a strong spiritual path: Indigenous doulas responding to the needs of Indigenous mothers and communities". International Journal for Equity in Health. 20 (1): 189. doi:10.1186/s12939-021-01521-3. ISSN 1475-9276. PMC 8390212. PMID 34446010.
- ^ Lantz PM, Low LK, Watson RL (December 2004). "Doulas' views on the rewards and challenges of their work". International Journal of Childbirth Education. 19 (4): 31.
- ^ Hunter CA (2016). Understanding Doulas and Childbirth Women, Love, and Advocacy. Palgrave Macmillan US :Imprint: Palgrave Macmillan. ISBN 978-1-137-48536-6. OCLC 1049995336.
- ^ Henley, M. M. (2016). Science and Service: Doula Work and the Legitimacy of Alternative Knowledge Systems [Doctoral dissertation, The University of Arizona]. The University of Arizona.
- ^ Mitchell, Lauren & Mahoney, Mary (2016). The Doulas: Radical Care for Pregnant People. New York: Feminist Press. ISBN 978-1-55861-941-8. OCLC 945948862.
{{cite book}}
: CS1 maint: multiple names: authors list (link) - ^ "What is a Doula?". American Pregnancy Association. 2019-04-26. Retrieved 2021-02-24.
- ^ Gjerdingen DK, McGovern P, Pratt R, Johnson L, Crow S (January 2013). "Postpartum doula and peer telephone support for postpartum depression: a pilot randomized controlled trial". Journal of Primary Care & Community Health. 4 (1): 36–43. doi:10.1177/2150131912451598. PMID 23799688. S2CID 206826557.
- ^ "Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health" (PDF). National Partnership for Women and Families. January 2016.
- ^ Chor J, Goyal V, Roston A, Keith L, Patel A (April 2012). "Doulas as facilitators: the expanded role of doulas into abortion care". The Journal of Family Planning and Reproductive Health Care. 38 (2): 123–4. doi:10.1136/jfprhc-2011-100278. PMID 22454010.
- ^ "A Call for "Full Spectrum" Doulas". Birth Arts International. 2015-08-19. Retrieved 2019-03-30.
- ^ a b "Abortion Doulas Prepare for Increased Criminalization". nextcity.org. Retrieved 2022-06-29.
- ^ "Serious About Gender Exploration? There's a Doula for That". YES! Magazine. Retrieved 2024-04-20.
- ^ Slevin D (2016-04-10). "Doulas For The Dying". Huffington Post. Retrieved 2016-04-11.
- ^ Ballen LE, Fulcher AJ (2006). "Nurses and doulas: complementary roles to provide optimal maternity care". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 35 (2): 304–11. doi:10.1111/j.1552-6909.2006.00041.x. PMID 16620259. S2CID 23409222.
- ^ "Career Choices for Becoming a Doula". Become a Doula with ProDoula. Retrieved 2016-04-18.
- ^ Viswanathan, Meera (February 4, 2024). "Impact of Doula Support During Pregnancy, Childbirth and Beyond (A Health Equity Systematic Review)". Patient-Centered Outcomes Research Institute. Retrieved February 4, 2024.
- ^ "Doulas, a Mom's Best Friend During Labor, Grow in Popularity". Missionlocal.org. 2010-02-22. Retrieved 2014-02-02.
- ^ McIntyre, Meghan (2022-10-10). "Doula services now covered under Virginia Medicaid expansion". Virginia Mercury. Retrieved 2023-11-30.
- ^ "New York State Doula Pilot Program". www.health.ny.gov. Retrieved 2019-03-30.
- ^ Meyerson, Collier (2019-07-19). "A Landmark Bill Will Change the Way Doulas Do Business in New York". Intelligencer. Retrieved 2019-07-31.
- ^ "NY State Senate Bill S3344B". NY State Senate. 2019-06-05. Retrieved 2019-07-31.
- ^ Bohren MA, Berger BO, Munthe-Kaas H, Tunçalp Ö (March 2019). "Perceptions and experiences of labour companionship: a qualitative evidence synthesis". The Cochrane Database of Systematic Reviews. 3 (7): CD012449. doi:10.1002/14651858.cd012449.pub2. PMC 6422112. PMID 30883666.
- ^ a b Bey A, Brill A, Porchia-Albert C, Gradilla M, Strauss N (2019). Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities (PDF) (Report). Ancient Song Doula Services, Village Birth International, Every Mother Counts.
- ^ "Community-Based Doulas and Midwives". Center for American Progress. 14 April 2020. Retrieved 2021-12-17.
- ^ a b Conway S (2019-12-20). "Chicago Is Making the Case for Releasing Pregnant Inmates". The Atlantic. Retrieved 2019-12-24.
- ^ a b c Shlafer RJ, Hellerstedt WL, Secor-Turner M, Gerrity E, Baker R (July 2015). "Doulas' Perspectives about Providing Support to Incarcerated Women: A Feasibility Study". Public Health Nursing. 32 (4): 316–26. doi:10.1111/phn.12137. PMC 4281502. PMID 24980835.
- ^ a b Oparah JC, Bonaparte AD (2015-12-22). Birthing Justice: Black Women, Pregnancy, and Childbirth. Routledge. ISBN 978-1-317-27720-0.
- ^ Schroeder C, Bell J (January 2005). "Doula birth support for incarcerated pregnant women". Public Health Nursing. 22 (1): 53–8. doi:10.1111/j.0737-1209.2005.22108.x. PMID 15670325.
- ^ "Washington State Legislature". app.leg.wa.gov. Retrieved 2019-12-20.
Further reading
- Klaus MH, Kennell JH, Klaus PH (2002). The Doula Book: How A Trained Labor Companion Can Help You Have A Shorter, Easier, And Healthier Birth. Da Capo Press. ISBN 978-0738206097.
External links
- Video on doulas from the University of Wisconsin School of Medicine and Public Health
- Dana Raphael. "The Evolving Role of the Doula". The Human Lactation Center. Archived from the original on January 18, 2017. Retrieved January 17, 2017.