Doulas have been practicing their trade under a variety of names for centuries.
But as the medical model of birth became the norm throughout North America during the
nineteenth and twentieth centuries, the birthing room became closed to non-medical birth
assistants as birth became more and more the sole purview of hospital staff. But during
the mid-to-late twentieth century, daughters of women who had experienced “twilight
sleep,” being strapped down on the delivery table, and breast-binding to stop lactation
began to investigate what had been left behind when women turned their maternity care
over to medical professionals. Gradually, women and their families began to see the
value of emotional support during labor and doulas were rediscovered.
The value of labor support is not only evident in the testimonies of women and
families who have benefited from labor support, it is also supported by the results of
controlled clinical trials. As reported in the DONA Position Paper, “The Doula’s
Contribution to Modern Maternity Care,” a number of studies published in the 1980’s and
1990’s showed statistically significant decreases in the rates of medical interventions
such as forceps delivery, oxytocin induction and augmentation, and Cesarean birth when
labor and birth were attended by doulas or healthcare professionals acting as doulas. In
addition, some studies suggest a significant improvement in postpartum outcomes such as
breastfeeding success and decreased rates of postpartum depression when a doula attends
In providing labor support, doulas draw from a wellspring of practical knowledge
acquired from both formal training and personal and professional experience with
childbirth. They know positions and techniques to ease pain and help speed labor
progress, they are familiar with birth terminology so they can help their clients navigate
the often confusing language... [continues]
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