Much ado about doulas

October 19, 1999
Web posted at: 4:42 PM EDT (2042 GMT)

In this story: What is a doula? The evidence in favor of doulas The bottom line RELATEDS

By Ann Douglas

(WebMD) -- You've no doubt heard the buzz about doulas -- professionally trained support people who help women to weather the physical and emotional challenges of labor and the postpartum period. What you may not realize, however, is just how popular they are becoming: While doulas were virtually unheard of a decade ago, they attended approximately 40,000 births in 1998.

There's good reason for all this interest in doulas. A number of studies indicate that women who use the services of doulas are less likely to require a Cesarean, to need pain medication during labor or to require a forceps delivery. What's more, these studies have shown that women who use the services of doulas tend to experience shorter labors and to feel more satisfied with their birth experiences than women who don't use the services of doulas.

What is a doula?

There are two basic types of doulas: Birthing doulas help couples to draft a birth plan and then offer support during labor and the first few hours after the birth. Postpartum doulas provide a reassuring mix of motherly advice and hands-on assistance with everything from breastfeeding to cooking during the days and week following the birth. However, neither type of doula should be confused with a midwife, who is a trained caregiver. A doula is essentially a support person and is not equipped to deal with the medical aspects of birth. Most do not attend doctor's appointments with you or accompany you to Lamaze classes -- unless, of course, special arrangements are made.

The evidence in favor of doulas

Women who have benefitted from doula care speak very highly of the experience. Lauren Lipton, a New York writer who recently gave birth to her first child, found her postpartum doula to be a calming influence in the midst of the hurricane that is new motherhood. "She became sort of my substitute mom, cooking big Italian comfort meals, buying me nursing bras, and generally talking me through what was one of the roughest times I have ever experienced," she says.

The studies have helped to confirm findings that doulas, such as Sabrina Cuddy of Redwood City, California, have observed in their own practices. "I have found that women who have doulas feel better about their birth and their baby," she notes. "Just by being present, the doula gives parents confidence to get through labor. She is someone who will make sure the laboring woman isn't left alone when her partner needs to use the bathroom or eat. She can give massage, get ice chips or hot packs, recommend a variety of positions to reduce pain or speed labor and most importantly, she can protect the space the mother is laboring in. Protecting the space means that only invited guests come into the room, that the lighting, temperature, sound, etc. are all helping the woman to relax and give birth."

Here are some other significant findings on the research front:

The bottom line

While the services of a doula don't come cheap -- the going rate is between 300 dollars and 600 dollars, depending on where you live and whether you're looking for postpartum support as well as labor support -- you may not have to cover these costs out of your own pocket. Certain HMOs have started to cover the services of doulas, and a growing number of hospitals are making doulas available to their clients as part of their prenatal-care program.

RELATEDS AT :

Lamaze and other childbirth preparation methods
Options during and after childbirth

---

RELATED SITES:

Doulas of North America
National Association of Postpartum Care Services

Note: Pages will open in a new browser window

External sites are not endorsed by CNN Interactive.

---

LATEST HEALTH STORIES:

China SARS numbers pass 5,000
Report: Form of HIV in humans by 1940
Fewer infections for back-sleeping babies
Pneumonia vaccine may help heart, too