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Research : The Benefits of working with a Doula.

MIDIRS Midwifery DigestJune 2009 edition, the UK’s leading midwifery journal revealed that out of 735 births attended by a doula in 2008

  • Primiparous women (first time mums) 48%

  • Natural births (with no induction, medicated pain relief, augmentation and instrumental deliveries) 45%

  • Caesarean section 15% (versus 24.3% nationally)

  • Epidurals 20% (versus over 30% nationally)

  • Inductions 10% (versus 20% nationally)

  • Vaginal birth after a caesarean section success rate 70%

  • Labour in a pool 23%

  • Successful home births (no transfer) 19%

  • Physiological 3rd stage 28%

  • Breastfed at birth 86% (versus 76% nationally)

  • Doula was single birth partner 11%

The survey also included data from postnatal doulas:
88% of women who had a postnatal doula were still breastfeeding at 6 weeks and 67% were still breastfeeding at 6 months (This compares with 21% at six weeks and 7% at three months according to the Infant Feeding Survey of 2005 (Bolling et al 2007).)

(The) survey confirmed what has already been published in the medical press; that the support of another woman who is not associated with a hospital and who is working solely for the parents has a positive effect on the birth outcome.  Women and their partners who chose a doula had a much lower chance of caesarean section, use of epidural and induction.  These women had a greater opportunity to have less medicalised labours, at home and/or in a birthing pool.  The higher levels of breastfeeding also demonstrate that the one-to-one continuous support these families are getting helps them achieve this.

The role of the doula as a constant and informed support for both labour and in the early postnatal days gets ever more convincing in the current clinical setting.  The shortage of midwives, alongside a greater acknowledgement that there is a need to recapture birth as an event associated with normality rather than an obstetric condition, leaves a gap in the support and philosophical context of what care should be available to the woman with a healthy pregnancy.

Having a doula is an informed choice made by a woman; a doula will help her decide what sort of birthing experience she would like and will support her through labour.  A doula will not have a medical role or give medical advice at any stage and they should not be viewed as being in conflict with those health care professionals also present during labour and birth.  The role of the doula is to support the labouring woman and her partner practically and emotionally, helping them achieve a smooth transition into parenthood with as much support as possible, based on a framework of knowledge of what is normal and achievable and centred in individualised care.  Where the presence of the doula contributes to higher levels of natural births (low interventions) and breastfeeding rates, these should all be seen as a positive for the NHS where it promotes healthier lifestyles, reduced use of costly resources and more effective use of existing ones.

(Source: © Goedkoop V. MIDIRS Midwifery Digest, vol 19, no 2, June 2009, pp 217-218)

"Mothering the Mother" Klaus, Kennell & Klaus, 1993 state that having a doula present

  • Shortens first-time labour by an average of 2 hours

  • Helps fathers participate with confidence

The doula: an essential ingredient of childbirth rediscovered”. Klaus MH, Kennell JH. University of California at San Francisco, USA. -Acta Paediatr 1997.

At 6 weeks after delivery in one study a greater proportion of doula-supported women were breastfeeding, reported greater self-esteem, less depression, a higher regard for their babies and their ability to care for them compared to the control mothers.