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."
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