Doula

This word, coming from the Greek, refers to a woman who helps another woman, and in medical terminology has come to mean a person, often a woman, who is a nonmedical assistant in prenatal care, childbirth, and in looking after a baby soon after he or she has been born.

Initially, the term in Greek generally referred to a slave, with the medical anthropologist Dr. Dana Raphael being one of the first to use the term when she referred to experienced mothers among the Ilocanos in Luzon in the Philippines helping mothers who had just had their first babies. Although relatives such as grandmothers and aunts often helped people in village societies where there were extended family networks, there was also heavy use of nonrelated women. The more experienced women were able to help with breastfeeding and newborn babies. As a result, this was largely dealing with the postpartum period (i.e., after birth), but gradually came to be used to refer to people who helped before birth as well. Work by medical researchers Marshall H. Klaus, John H. Kennell, and Phyllis H. Klaus, in their book Mothering the Mother (1993) showed the importance of the doula attending birth, and as a result, the process became more common in nonvillage societies such as in cities.

Nowadays, doulas involved in labor support are trained in dealing with the emotional and physical comfort needs of women about to give birth. Some work attached to hospitals and clinics, but many, especially in third world countries, work on a semiformal or informal basis visiting expectant women, and those who have recently given birth, in their homes. Their role has often been increased to involve them with helping mothers in recovery after childbirth [Page 555]by doing housework, preparing meals, and buying food when the woman has no other social network on which she can call. On another level, they can also advise authorities if the mother is having any problems before or after birth.

Although doulas in the United States and Canada are not required to be certified, this is possible, and many have completed long courses and built up years of experience. They have also been involved in providing medical advice to mothers, drawing up exercise regimens during pregnancy, and giving advice on diet and other areas. They suggest positions that the woman can adopt during labor, which is particularly important when labor pains begin unexpectedly. They also advise the partner of the mother, can be present at birth, and help with immediate postnatal care.