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I often describe the role of a doula by first describing Maslow’s hierarchy of needs.  This is a concept that is taught in my course.  It can be depicted like a pyramid with physiologic needs and safety at the bottom of that pyramid, but three other layers on top.  These include love/belonging, esteem, and self actualization.  All of these needs are considered to be important to our happiness in life.

In our current system, we have done a good job at paying attention to the physiologic and safety needs, but we have forgotten the whole rest of the pyramid that ultimately is necessary for complete health.  That bottom part of the pyramid can also take up all the time and effort of a health care provider, depending on the situation.  Because of this, doulas form an important part of the health care team as they work to provide the care at the top of the pyramid which then provides complete comprehensive care.

It is important to pay attention to our clients social/physiological health during birth.

Depression During Pregnancy and Beyond 

Depression is one of those areas that we need to pay more attention to.  In pregnancy it has been associated with poor weight gain, pre-eclampsia and premature labor.  Thus is it is important that we look for it and learn how to treat it.

Because doulas work so closely with their clients it is often the case that they can pick up on signs of depression before others might.  While we don’t diagnose the disease, we definitely have some tools up our belt to help decrease it’s severity and hopefully increase the possibilities of a better outcome at birth.


Just recently a new report came out discussing the benefits for pregnant women to utilize something called mindfulness yoga, which combines yoga with a technique called mindfulness that helps to decrease anxiety and depression.   Again, this is something that is taught fully in my course, but I thought I’d give you a preview.

There are two reasons that I think this technique may be important.

1) More research is showing health concerns with the use of antidepressants during pregnancy,

2) Mindfulness yoga provides a good way to help the mother prepare for birth by helping her to develop an effective relaxation technique.

I am putting together a series of videos on yoga positioning and exercises, so stay tuned.


Simpson KL, Weaver, KJ, de Villers-Sidani E, et al. Perinatal antidepressant exposure alters cortical network function in rodents.  Proc Natl Acad Sci USA 2011;108(45):18465-70.

Muzik M, Hamilton SE, Rosenblum KS, et al.  Mindfulness yoga during pregnancy for psychiatrically at-risk women: preliminary results from a pilot feasibility study.  Complement Ther Clin Practice. 2012;18:In press.

Follow Rachel Leavitt:

Rachel has worked as a register nurse (BSN from University of Utah) since 2004 with a work history in Labor and Delivery, NICU and Postpartum Care. She is also the founder of New Beginnings Doula Training which she organized in 2011. When she's not busy being a mother and grandmother, she can be found reading research papers related to some aspect of childbirth.

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