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 1:22, May 28, 1999)
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