Often people feel like the role a doula plays can or should be done by other healthcare workers. While this would be nice, in reality it is very difficult for healthcare workers to provide good medical care and good labor support. In particular there are a few things that set a doula apart from other healthcare workers.
A doula will stay with the laboring family from the beginning of labor until the end. Sometimes that beginning is also unpredictable, but the doula will be there from the very first contraction. This is something that is just not workable with our current medical system. Many healthcare providers also see their role as more medical and don’t help much with the emotional aspects of beginning labor or afterward.
The doula is also very knowledgeable about the client she is working with. She often meets with them before and after the birth to attend to needs and planning. Because of this, she knows her client very well and comes to know what she truly needs during labor and birth. This is very different from what is provided by healthcare providers. Often the first time the woman meets her nurse is when she is admitted. She also sometimes works with a group of doctors or midwifes that makes it difficult to get to know them. Even if they have just one provider, they often are only allotted a certain amount of time to meet with them.
Another big plus that the doula brings to the birthing room is their training in labor support. Most nurses and medical providers have little formal training in labor support beyond the medical. Due to our birthing environment, most women choose epidurals and many medical providers now have little experience working with women in a non-medicated birth. Some medical providers actively seek out learning in these areas, but this is the exception rather than the rule. Because of this, a trained doula makes a great asset to the birthing team.
According to the cochrane review on continuous labor support, labor support was more effective if it was not a part of hospital staff or the woman’s social circle, or in a place where epidural analgesia was not readily available. The study pointed out some reasons that a professional doula may have better results than a midwife or nurse. Nurses and midwifes often have other patients that they are taking care of, which makes it hard to focus solely on one patient. They also have to spend a large proportion of their time managing technology and keeping records. Many nurses and midwifes may begin and end shifts in the middle of the woman’s labor which makes it difficult to provide continuous support and often they lack labor support training.
It was also noted that professional labor support showed more clinical results than just family members or friends. This could be due to the fact that friends or family may not as be familiar with birth, and they themselves may need support when working with the laboring woman.