Doula birth fashion criticised
Wednesday December 2nd, 2009
By Jane Collingwood
Good care of mothers giving birth may be jeopardised by the increasing
popularity of paid birth partners - known as doulas, a doctor claims today.
On the website
of the British Medical Journal, Dr Abhijoy Chakladar of Worthing Hospital,
UK, writes that paid birthing partners, or doulas, are increasingly common.
At a recent birth, he writes, "I found myself disconcerted by the doula's presence, as I was unfamiliar with her role. To whom should I direct my explanation?" He chose to speak directly to the mother, but the doula "interjected" to question him.
Because he did not qualify his answer with medical information, Dr Chakladar fears he may have compromised his care. "In retrospect, I should have confirmed everyone's roles and established ground rules," Dr Chakladar writes.
"A cynic might ask whether the doula business is actually necessary or whether it is exploiting - for profit - unspoken fears about NHS perinatal care," he writes. "I am disappointed by the real or perceived need for doulas."
Commenting on the article, Louise Silverton of the Royal College of Midwives, said: "Doulas can have a place for women who do not have any social support, which is usually provided by their family and friends."
She added: "My concern is that maternity services are struggling to provide one-to-one care."
A further study in the journal shows that premature birth rates are higher among mothers from deprived areas, despite improvements in obstetric care.
Dr Lucy Smith and colleagues from Leicester University, UK, analysed figures on 7,449 very premature infants born over a ten year period. Risk was nearly twice as high in the most deprived areas.
But they report: "Survival rates and neonatal care provision is similar for infants from all areas."
* Doulas gained support yesterday from Britain's National Childbirth Trust, which campaigns for better conditions for pregnant women.
Mary Newburn, of the NCT, said: "Doulas are women experienced in supporting women during normal childbirth and provide emotional and physical support, and may be paid for by the woman herself or via the NHS.
"The NCT believes it's important that women are given support throughout labour so they can feel calm, relaxed and reassured.
"For most, this means they would like to have some sort of birth companion with them, whether it's the father, doula, friend or all three. Clinical decision making is the not the role of the doula and doulas should enhance the communication between the woman and her professional carers.
"There is strong evidence that continuous support from a non-health professional throughout labour results in better birth experiences and fewer interventions. Having access to a doula is also particularly important for those women who do not have a partner, friend or relative who can fill this role."
Tags: Childbirth and Pregnancy | Nursing & Midwifery | UK News | Women’s Health & Gynaecology
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