The role of a doula has come into existence from a need. This need has risen from the changes that have occurred in our culture and society. In history it used to be that women would have other women supporting them through labor, using their personal knowledge and trust in the labor process to aid labor. Since birth became medicalized the role of the supporting women disappeared. Medical advancement has played an important role in improving maternal and new born outcome. However, that has pushed aside a much needed aspect of birth; that of having a person knowledgeable and experienced in birth who is there by the parents side the entire time a woman is in labor, providing the essential nurturing, caring, and supportive component to labor and birth. That vital type of support is something that is not always available in hospital births, seeing as doctors come when it is time to deliver the baby and nurses don’t stay by a woman’s side during the entire labor. However, a doula is there for support from pre-labor, through labor, and into postpartum.
As stated doula support starts before a woman is even in labor. It is essential that parents have the information necessary to make informed decisions and that they know their rights as patients. A doula can be pivotal in providing information and encouraging parents to educate themselves about their birth choices. This is the basis for what will shape a woman’s birth experience. In addition, once a woman is in labor, a doula’s knowledge about the labor process is crucial for support and in helping parents make informed decisions, as well as help them feel reassured about what they are going through.
A woman’s ideal birth experience can vary from woman to woman. However, current research shows doulas can help women have a positive birth experience by reducing c-section rates, shortening labor, and reducing: epidural requests, pitocin use, analgesia use, and forceps or vacuum deliveries. Doulas help in reducing those procedures by using their knowledge about techniques and positions that aid the natural and positive development and progress of childbirth, in addition to providing continuous emotional support to the mother and partner. Reducing those interventions is important because they all affect a woman’s and baby’s birth experience both emotionally and physically, mother baby bonding, and successful breastfeeding. “Women who have used a doula are more satisfied with their birth experience, feel more confident in their ability to mother, bond faster with their newborn, are less likely to have post-partum depression, and are more likely to breastfeed” Klaus, Kennel, and Klaus 2001.
Giving birth puts women in a very vulnerable state in which it is hard to always communicate with the caregiver. Doulas are able to serve parents in moments when support is needed the most. In carefully discussing the parents’ wishes and birth plan before birth a doula becomes very familiar with their wishes and is then able to guide the parents in making their whishes known and respected. In no time does a doula take the parents’ decision making power away from them, on the contrary, the doula makes sure that the decisions are always that of the parents’ and that those decisions are clearly communicated and respected. This makes the laboring woman feel safe and empowered.
A doula also provides valuable emotional and physical support by offering the woman comforting techniques or by helping the partner offer that support. Such support can include: encouragement, guided imagery, focus, breathing, massage, and position changes. This gives women the ability to go through the labor process more comfortably and confidently. Having a doula present also relieves pressure and offers support to the birth partner, so that the partner can be more relaxed, feel more confident in their role, and provide more adequate support to the woman in labor.
In order for a doula to serve a woman adequately it is not only important that women know what a doula’s role should be but also what a doula can’t and should not do. Most "Standards of Practice" state that a certified doula should not perform clinical or medical tasks such as taking blood pressure or temperature, fetal heart tone checks, vaginal examinations, or postpartum clinical care. This becomes a question of ethical standards which require that a doula maintain high standards of personal conduct in the capacity or identity as a labor support provider.
Choosing a doula to serve during pre-labor, labor, and birth is one of the most important things a woman can do to ensure a positive birth outcome. A doula can do this by educating, supporting and comforting her and her partner throughout the entire birth process. This in turn provides the best scenario to welcome a baby into this world, providing a strong foundation for a healthy, happy life ahead.