Doula-Supported Birth
A Modern Adaptation Of An Ancient Tradition

When she heard of my most recent change of profession, my mother asked me, “You’re becom-ing a What?” Some women doing this work use the term “professional labor support person,” but the most common name for it these days is Doula, Greek for “servant to women.” The term-inology may be unfamiliar, but the function of a Doula is as old as time.

What do Doulas do? We attend and support women in labor and birth. We provide strength (physi-cal, emotional, sometimes spiritual) from which women draw during this most difficult and powerful experience. We support the entire family, helping fathers participate in the birth of their child and showing all family members present how they can help the birthing mother.

In ancient times, women were familiar with birth; its pain and exhilaration, its noises, smells and rituals; the way it is intended to proceed and available interventions when things didn’t go smoothly. Women were fami-liar with birth because it took place among them, in the homes and compounds of the community. Children heard the sounds of birthing women and accepted them as normal. Women birthed in the presence of other women who encouraged them, brought them food and drink, massaged them, bathed them in cool baths or applied hot compresses, and who supported them with their arms and shoulders while they walked or pushed out their babies.

Until about a century ago, the vast majority of American women birthed at home, with a midwife or doctor to help deliver the baby and an experienced woman (sister, mother, neighbor, servant…) with them to provide undivided attention throughout hard labor. As birth has moved into the hospital, fewer women have had the opportunity to wit-ness a birth before they deliver their first child. Thus expectant women and couples attend birth-ing classes and read endless books and articles, trying to figure out what it will be like and how best to cope with the frightening and exciting challenge.

Thanks to my husband’s insistence that a Doula would be useful, I soon discovered what every woman who has given birth knows: that if you want to be an active participant in your birth and have as little medical inter-vention as possible, it is very important to have the continuous support of someone who has experience with birth.

In addition to making good sense in our society, the ancient tradition of Doula work has been clinically studied and found to be effective. In six international studies documented in Mothering The Mother by Marshall H. Klaus, John H. Kennell, and Phyllis Klaus (originally published in the New England Journal of Medicine, British Medical Journal, British Journal of Obstetrics and Gynaecology, and the Journal of the American Medical Association), Doulas were found to have a profound impact on the length of labor, the use of pain medications and artificial labor inducers, and the number of forceps and cesarean deliveries.

Specifically, the studies indicated that through the presence of a Doula:

• the average length of labor was reduced by slightly more than 50%;
• the use of epidural anes-thesia went from 55% to 8% of mothers;
• the number of women giving birth vaginally without the use of pain medications quadrupled;
• the need for artificial labor inducers (pitocin, etc.) was reduced by more than half;
• the use of forceps was reduced from 26% to 8% of the births studied;
• and the number of cesarean births was cut in half.

According to these same studies, the use of a Doula also improved mother’s satisfaction with the birth experience, and had a positive impact on post-partum pain, breastfeeding and infant health. This is dramatic evidence to support a return to a supported model of birth for modern mothers, particularly those birthing in a hospital environment.