Throughout our coverage of developments in maternal and infant health, policies and initiatives, we have continuously referred to doulas as a key part of a pregnant woman’s support team. In fact, we even testified before the Ohio Senate Health, Human Services and Medicaid Committee on why we believe doulas should be eligible for Medicaid reimbursement so that they become more accessible to low-income women and their families. What we have yet to be explicit about, however, is outlining who doulas are and what role they play.
…doulas often help families create a birth plan, provide information about techniques that can help reduce stress, pain and trauma as well as provide laboring positions
A doula is a labor professional trained to provide non-medical, emotional and physical support throughout a woman’s pregnancy, childbirth and postpartum. While a doula may work alongside medical staff to create a comfortable environment, a doula’s primary role in the medical setting is to serve as an advocate for the family he or she works for.
What does a doula do?
While there are no official doula duties, doulas often help families create a birth plan, provide information about techniques that can help reduce stress, pain and trauma as well as provide laboring positions and respond to questions and concerns that may arise.
Families, particularly families of color, choose to work with doulas because of the proven healthy birth outcomes. As we have demonstrated previously, Black women in Ohio are currently two and a half times more likely to die of a pregnancy-related death than white women. This fact gets more urgent with age as Black women age 30 and older, are 4 to 5 times more likely to die in childbirth than white women. [1] Black women are also 36 percent more likely to have a C-section than women of any other race [2], however prenatal doula care has been shown to reduce C-section rates through things like early labor support and encouraging the baby to be well positioned for vaginal birth. [3]
We believe doulas should be eligible for Medicaid reimbursement so that they become more accessible to low-income women and their families
Not only has the inclusion of doulas into the normal course of care during and after childbirth been shown to improve outcomes for mothers and infants while reducing costs associated with care, evidence demonstrates that expectant mothers with a doula had better birth outcomes than mothers who didn’t have doulas. [4]
Becoming a doula
There are currently many organizations that offer doula training and certification nationally and internationally. These include, but are not limited to The International Childbirth Education Association, DONA International and BirthWorks International. In many cases, these organizations allow families seeking a certified doula to access and search their databases by ZIP code so families can choose a good fit from the comfort of their own homes.
Unlike doctors and certified nurse midwives, there is no legal training requirement for doulas, so curriculum and pathways vary by organization.
Unlike doctors and certified nurse midwives, there is no legal training requirement for doulas, so curriculum and pathways vary by organization. Most certification requires participants to train on a variety of topics including breastfeeding, reproduction, labor, healthy lifestyles and complications as well as participate in hands-on support and develop a resource list for communities.
Doulas and the care they provide ultimately have a positive impact on birth experiences because of their dedication to ensuring women and their families get the best, most positive experience possible as they seek to expand their families.
- https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386542/
- https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12218
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/
