What's a doula and how do they help women who give birth?

Women have traditionally been accompanied by a companion during childbirth, and there is every reason to believe that this benefits both the woman and the baby.

The World Health Organization recommends continued support to women during childbirth. Yet, all over the world, initiatives to promote health facilities as the safest place of birth do not necessarily respect this tradition.

But we now have new evidence on the ways in which women are supported during delivery by a doula or other birthing companion.

Our research found that workmates (including doulas, partners, and family members) support women during childbirth by providing information, advocating for their needs, and providing practical and emotional support.

It is important to note that our research also indicates that matching a woman to a doula of the same ethnic, linguistic, or religious background could be an important way to improve equity and provide appropriate care for women. Culture.

Read more:
Did your birth not go as planned? Do not blame yourself

What is doula care?

The word "doula" comes from a Greek word meaning "maid of woman".

Doulas are qualified non-medical professionals who provide women with ongoing physical, emotional, and informational support before, during, and after delivery to facilitate the best possible delivery experience.

Doulas usually meet a woman (and sometimes her partner or family) during pregnancy to help her prepare for childbirth, make connections, manage expectations and provide factual resources.

When a woman gives birth, she alerts her doula. The doula supports the woman throughout labor and delivery. This usually happens in a delivery clinic or at the hospital (some doulas can also attend home births).

Four ways to support women during work

Our Cochrane review, published this week, collects data from 51 studies conducted in 22 countries on support provided by work companions, including doulas.

First, we found that by providing information, workmates reduce communication gaps between health workers, such as doctors and midwives, and women. They keep her informed about the delivery process and her progress in childbirth. They can also provide advice on the effective use of non-pharmacological pain relief, such as meditation or relaxation.

Secondly, fellow workers defend the interests of the woman, expressing herself in favor of her and in favor of her preferences.

Third, birthing companions provide practical support, which may include encouraging the woman to move, mbadage and hand.

Finally, the delivery companions offer emotional support, helping the woman to feel in control and confident by praising and rebaduring her, and by ensuring a continuous physical presence.

Improved results for moms and babies

The benefits of ongoing support during labor and delivery were highlighted in a previous Cochrane review, which badyzed data from 26 studies conducted in 17 countries and involving more than 15,000 women.

A female partner, family member or friend provided ongoing support. hospital staff (student midwives); or a doula.

The review revealed that continued support could improve several outcomes for the health of the woman and her baby. Women may be more likely to have a badl delivery (without the need for caesarean, forceps or vacuum extraction).

Read more:
Explainer: What are women's options for giving birth?

In addition, women who receive ongoing support may be less likely to take pain medication, have shorter tasks and be more likely to be satisfied with their childbirth experience.

Babies of women who receive ongoing support are less likely to have a low five-minute Apgar score, which badesses the health and well-being of babies at birth and shortly thereafter.

Who can benefit from doula care?

Recent media have pointed out that doulas are worthy of royals. Meghan Markle, the Duchess of Susbad, has hired a doula to support her during her current pregnancy.

In Australia, doula care generally ranges from A $ 500 to A $ 2,500, depending on the experience and services they offer. This cost usually includes one to two visits during pregnancy, attendance at birth and a visit after birth.

Although the cost of doula care may seem prohibitive, our findings emphasize that provision of proximity doula care to migrant, refugee and other foreign-born women in high-income countries may be a way to important to improve equity and to take care of culturally appropriate care.

When migrant women receive doulas care from the community (in the same ethnic, linguistic and / or religious context), they may feel more confident and less like "outsiders" in their new communities.

In Sweden and the United States, research has shown that foreign-born women supported by community-based doulas are more satisfied with their birth experiences and that the doulas themselves feel empowered.

Community doulas can also be particularly beneficial for Aboriginal women, whose traditional birth practices are strongly linked to their cultural identity. In Canada, the Association of Native Friendship Centers of British Columbia offers scholarships to pregnant Aboriginal women to hire a doula.

Read more:
Doulas of death can fill gaps in end-of-life care

Doula services can be provided free of charge to low-income people and families, with the aim of improving equity. The Doula Project provides free doula services to low-income women in New York City through volunteers.

Helping women to have a birth companion or doula of their choice during childbirth is an effective way to improve health outcomes and is an important part of respectful maternity care.

Support from co-workers and doula can directly increase equity by improving women's empowerment and culturally appropriate care, and indirectly by reducing over-medicalization of childbirth.

Sarah Chapman, Knowledge Broker at Cochrane UK, contributed to this article.