Impact of doulas on healthy birth outcomes.
J Perinat Educ. 2013;22(1):49-58
Authors: Gruber KJ, Cupito SH, Dobson CF
Birth outcomes of two groups of socially disadvantaged mothers at risk for adverse birth outcomes, one receiving prebirth assistance from a certified doula and the other representing a sample of birthing mothers who elected to not work with a doula, were compared. All of the mothers were participants in a prenatal health and childbirth education program. Expectant mothers matched with a doula had better birth outcomes. Doula-assisted mothers were four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding. Communication with and encouragement from a doula throughout the pregnancy may have increased the mother's self-efficacy regarding her ability to impact her own pregnancy outcomes.
PMID: 24381478 [PubMed]
After praise and encouragement: emotional support strategies used by birth doulas in the USA and Canada.
Midwifery. 2011 Aug;27(4):525-31
Authors: Gilliland AL
OBJECTIVE: to describe in detail the emotional support techniques employed by birth doulas during labour.
DESIGN: grounded theory methodology was utilised in collecting and analysing interviews given by doulas and mothers who had doula care. By using both informants, a clearer picture of what constitutes emotional support by doulas emerged.
PARTICIPANTS: 10 mothers from three different states in the Midwestern USA and 30 doulas from 10 different states and two Canadian provinces were interviewed. Two doulas worked in hospital-based programmes whereas the others had independent practices. Doulas usually attended births in hospitals where medical attendants spent little focused time with the mother.
FINDINGS: nine different strategies were distinguished. Four strategies (reassurance, encouragement, praise, explaining) were similar to those attributed to nurses in published research. Five were original and described as only being used by doulas (mirroring, acceptance, reinforcing, reframing, debriefing).
CONCLUSIONS: emotional support by professional birth doulas is more complex and sophisticated than previously surmised. Mothers experienced these strategies as extremely meaningful and significant with their ability to cope and influencing the course of their labour.
IMPLICATIONS FOR PRACTICE: the doula's role in providing emotional support is distinct from the obstetric nurse and midwife. Professional doulas utilise intricate and complex emotional support skills when providing continuous support for women in labour. Application of these skills may provide an explanation for the positive 'doula effect' on obstetric and neonatal outcomes in certain settings.
PMID: 20850916 [PubMed - indexed for MEDLINE]
Nurses and doulas: complementary roles to provide optimal maternity care.
J Obstet Gynecol Neonatal Nurs. 2006 Mar-Apr;35(2):304-11
Authors: Ballen LE, Fulcher AJ
Staff in maternity-care facilities are seeing an increase in doulas, nonmedical childbirth assistants, who are trained to provide continuous physical, emotional, and informational labor support. The long-term medical and psychosocial benefits are well documented. In this article, misconceptions about the doula's role are corrected, and suggestions are offered on ways to improve communication between health care providers and doulas. Together, nurses and doulas can provide birthing women with a safe and satisfying birth.
PMID: 16620259 [PubMed - indexed for MEDLINE]