Doula: A woman trained and
experienced in childbirth who provides continuous physical,
emotional, and informational support to a woman during labor,
birth and the immediate postpartum period. Postpartum doulas care
for new families in the first weeks after birth providing
household help, advice with newborn care and feeding, and
emotional support.
Effects on birth outcomes: Eleven
studies showed the following effects of doula support: shorter
labors, fewer complications, reduced cesarean rates, less need
for oxytocin to speed up labor, reduced use of forceps, fewer
requests for pain medication and epidurals.
Effects on the mother: greater
satisfaction with childbirth, more positive assessments of their
babies, less postpartum depression
Effects on the baby: shorter
hospital stays and fewer admissions to special care nurseries,
babies breastfeed more easily, mothers are more affectionate with
their babies postpartum
Effects on the healthcare system:
dramatically reduced cost of obstetrical care, women are pleased
with the personalized care doulas offer
Given the clear benefits and no
known risks associated with intrapartum support, every effort
should be made to ensure that all labouring women receive
support, not only from those close to them but also from
specially trained caregivers. This support should include
continuous presence, the provision of hands-on comfort, and
encouragement. -Hodnett, E. D. "Support from caregivers
during childbirth." (Cochrane Review) in Cochrane Library,
Issue 2. Oxford Update Software, 1998. Updated quarterly.
Facing unprecedented pressures to
reduce expenses, many hospitals are targeting the largest single
budget item--labor costs . . . . [An] unintended consequence of
nursing cutbacks may be an increased cesarean rate; the inability
of pared down nursing staff to provide continuous coverage to
laboring mothers [has been] shown to increase the chance of
cesarean . . . .
Doulas clearly improve clinical
and service quality; they provide an absolutely safe way to
reduce cesareans and other invasive birthing interventions.
-Coming to Term: Innovations in Safely Reducing Cesarean Rates.
Medical Leadership Council, Washington DC. 1996.
The continuous availability of a
caregiver to provide psychological support and comfort should be
a key component of all intrapartum care programs which should be
designed for the effective prevention and treatment of dystocia
(non-progressive labor). Guidelines on Dystocia. Society of
Obstetricians and Gynaecologists of Canada, 1995.
(information provided by Nicette
Jukelevics, DONA Public Relations Committee Chair. To find out
more about DONA, visit their web page at http://www.dona.com,
email at ASKDONA@aol.com or call 206-324-5440.)
Reprinted from Midwifery Today
E-News (Issue No. 1:22 May 28, 1999) To subscribe to the E-News
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