For the best continuity of care, ideally this service is provided by the same person, usually a mother herself, with positive experiences of her own, and with the related training, which she then transmits to the mother under her care, as necessary.
“Birth support is not simply a matter of acquiring a set of techniques. The research describes birth companions variously as providing comfort measures, emotional support, reassurance, encouragement, praise and touch.”
Doula support is NOT medically oriented. That remains to be a midwife's job. While her role is to support the mother and her partner, a Doula works hand in hand with the midwife during the birth. For the best outcome in psychological and emotional support, the Doula needs to know the mother and her family well before the birth. She does not share her time of attending births with more than one mother at a time. She does not work on a shift basis, but stays with the couple throughout the birthing hours. Numerous studies have been conducted, all of which show the many benefits that are associated with Doula support for the couple. The results are remarkably consistent. Systematic reviews of randomised trials show that continuous labour support purely on an emotional level is associated with:
- lower use of analgesia and fewer epidurals
- lower rates of oxytocin use
- a reduction in the length of labour
- fewer instrumental deliveries
- fewer Cesarean sections
- more 5min Apgar scores greater than 7
- labour better than expected by the mother
- fewer unsatisfactory relationship between the midwife and the father
- less perineal trauma
- mothers more likely to be breastfeeding at 6 weeks
- better motherly instinct towards baby
- less chance of mother (and father) suffering from postnatal depression
There were no negative outcomes associated with emotional support as provided by a Doula in labour.
Michel Odent, a world known obstetrician has spent many years studying a Doula's overall effect on the birth. He highly promoted the Doula profession. It is no surprise that The Informed Choice leaflet which is supported by the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, says: “The constant presence of a supportive birth companion is one of the most effective forms of care in childbirth introduced in the last 25 years.”
We say with regret that in spite of these positive results, Doulas within the public hospitals in Malta have never been recognised for the benefits they offer. For some strange reason, Doula support has never been allowed during the birth, unfortunately when the mother needs it most.
Doula service is provided in several ways outside the hospital by our school. A combination of 2 professions which consists of a qualified and experienced Childbirth Educator and Doula provide the prenatal and postnatal Doula support as necessary. Please see sections in Courses for our intensive Pregnancy preparation classes; Support for Breastfeeding and Home Visits for the first weeks postpartum, and Parent Club and other courses for later parenting.