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Preparation Before Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Daniele Di Mascio, Leen Al-Hafez
A doula is a continuous support person that a woman may choose for emotional support and advice about coping techniques and comfort measures (comforting touch, massage, warm baths/showers) [16].
COVID-19 and reproductive injustice
Published in J. Michael Ryan, COVID-19, 2020
Research demonstrates that support persons, particularly doulas, improve birth outcomes in hospital settings by minimizing unnecessary medical interventions that place women at greater risk of birthing complications (Gruber, Cupito, and Dobson 2013). Doulas also play an especially vital role in shielding women of color from obstetric racism (Oparah et al. 2018). Obstetric racism, defined by Davis (2019) as the racism experienced by women during maternal healthcare processes, comes in many forms, including “critical lapses in diagnosis, being neglectful, dismissive, or disrespectful; causing pain; and engaging in medical abuse through coercion to perform procedures or performing procedures without consent” (Davis 2019, 562). Doulas can provide a vital buffer between birthing women and providers by supporting mothers in self-advocacy (Oparah et al. 2018; Wint et al. 2019). Benefits to doula-assisted births include a decreased risk of cesarean surgeries and birthing complications, a decrease in reported birth trauma, and greater likelihood of initiating breastfeeding (Gruber, Cupito, and Dobson 2013). Doulas also serve as witnesses for women of color, often the only birth workers to report incidences of obstetric abuse during labor and delivery (Morton et al. 2018).
Birth plans
Published in Sheila Broderick, Ruth Cochrane, Trauma and Birth, 2020
Sheila Broderick, Ruth Cochrane
Some women will employ a doula as a second source of support during labour. The Greek word doula means ‘female servant’, and doulas have been present during childbirth for centuries. A doula traditionally is someone, usually a woman, with no medical training, but who would usually have had babies herself, who gives emotional support and encouragement to women in labour. Doulas first came to obstetric notice in the 1980s when research in Guatemala (Sosa et al 1980) showed that the presence of a doula in the labour room provided a number of beneficial effects for both mother and baby. The research was undertaken in a busy unit where it was normal practice for women to go through the first stage of labour unattended, to be helped by a midwife only when they started pushing in the second stage. The researchers found that women who had a doula with them during the labour had shorter labours and used less pain relief compared with women who did not have a doula.
“Doulas shouldn’t be considered visitors, we should be considered a part of [the] team”: doula care in Georgia, USA during the COVID-19 pandemic
Published in Sexual and Reproductive Health Matters, 2022
Daria Turner, Alyssa Lindsey, Priya Shah, Ayeesha Sayyad, Amber Mack, Whitney S. Rice, Elizabeth A. Mosley
Doulas are non-medical, trained professionals that provide continuous support (informational, emotional, physical) during pregnancy, labour and childbirth, and postpartum.1–5 Doula support is associated with improved maternal-child health outcomes including better birthing experiences, less likelihood of induction or augmentation with synthetic oxytocin, shorter length of labour, higher rates of vaginal births, lower rates of Cesarean delivery, lower use of pain medication, higher Apgar scores, reduced postpartum depression, and increased breastfeeding.1–4,6–12 For all pregnant people – but especially those who have experienced trauma or are living with post-traumatic stress symptoms – trauma-informed doula care can also reduce the risk of birth trauma or re-traumatisation during birth.10,13,14
A qualitative inquiry into pregnant women’s perceptions of respectful maternity care during childbirth in Ibadan Metropolis, Nigeria
Published in Sexual and Reproductive Health Matters, 2022
Oluwaseun Taiwo Esan, Salome Maswime, Duane Blaauw
The women’s perceptions of RMC focused more on the inter-personal skills of healthcare providers than their medical or technical skills. Thus, their interpretation of RMC mainly emphasised the preserving dignity domain, and wanting to be treated as individual human beings. The women also desired more love and spiritual support from their providers, even requesting prayers. It has been found that one of the reasons women often visit traditional birth attendants (TBA) in Africa is because the TBAs pet, pamper and pray for them during labour.29 This perception on the need for spiritual support for women during childbirth raises other ethical questions, considering that women and health providers alike may have different religious backgrounds and the ethical rights of both must be preserved. Health providers may need to incorporate the concept of “demonstrating love” in the form of compassion and emotional support to women in labour, as recommended in the literature.30 The use of professional doulas as birth companions in health facilities may also be encouraged as these are known to provide physical, emotional (love), and spiritual support to women during birth.31
“We have this awesome organization where it was built by women for women like us”: Supporting African American women through their pregnancies and beyond
Published in Social Work in Health Care, 2019
Laura Hmiel, Cyleste Collins, Portia Brown, Emily Cherney, Christin Farmer
One such intervention has been to give at-risk women access to birth doulas. Doulas are women who serve as ante-, peri-, and/or post-natal supports for a pregnant woman with the goal of easing her transition to motherhood. A doula’s role is non-medical in nature, and she does not take the place of the physician or midwife who manages her client’s health and that of her future child during pregnancy; instead, she is there to support the non-medical aspects of pregnancy and labor. Many studies have shown a doula’s presence before and during labor positively impacts the woman’s experience (Hodnett, Gates, Hofmeyr, & Sakala, 2005), decreases rates of intervention (Hodnett et al., 2005; Kozhimannil et al., 2016b; Kozhimannil, Hardeman, Attanasio, Blauer-Peterson, & O’Brien, 2013), and is related to positive effects on the health and development of her infant (Kozhimannil et al., 2016b; Kozhimannil, Attanasio, Hardeman, & O’Brien, 2013). Unfortunately, although women have served as doulas for one another throughout much of human history, the modern doula is rare and often prohibitively expensive when found, thus severely limiting the access of certain women to this valuable service. Research has found that many of the women who desire but do not have access to doula care are African American, uninsured (Behrman & Butler, 2006), and at risk of preterm birth.