| Adams19
|
Pregnancy and birth in
the United States during
the COVID-19 pandemic:
The views of doulas |
This study examined the
perspectives of doulas, or
nonclinical labor support
professionals, on how pregnancy
and birth experiences and
maternal health care delivery
systems changed in the early
weeks of the COVID-19 pandemic. |
Doulas’ close relationships with pregnant
people enabled them to be an important
source of support during the COVID-19
pandemic. Added to the larger body
of work on the impacts of doula care,
this study supports widespread calls
for universally integrating doulas into
maternity care systems as a targeted
strategy to better support pregnant
and birthing people in both crisis and
noncrisis situations. |
| Akbarzadeh et al.20
|
Comparison of the
effects of doula
supportive care and
acupressure at the BL32
point on the mother’s
anxiety level and
delivery outcome |
To compare the effects of
doula supportive care and
acupressure at the BL32 point on
the mother’s anxiety level and
delivery outcome. |
The study results showed that doula
supportive care and acupressure at the
BL32 point reduced the mother’s anxiety
as well as the labor length. Therefore,
non-pharmacological methods are
recommended to be used during labor for
improving birth outcomes and creating a
positive birth experience. |
| Akhavan and Edge21
|
Foreign-Born Women’s
Experiences of
Community-Based
doulas in Sweden — A
Qualitative Study |
In this study, our aim was to
explore the experiences of doula
support among foreign-born
women in Sweden in the context
of a "Community-Based Doula"
(CBD) intervention project |
This study indicates that a doula can
provide support and a reassuring
presence before, during, and after
birth. The CBD program is committed
to training doulas to help women
have satisfying birthing and parenting
experiences. Informed by these findings,
maternity health care providers may
be able to give newly arrived refugee
women, socially isolated foreign-born
women, or both groups need maternity
support that better addresses their
needs for emotional as well as medical
support and care. |
| Byrskog et al.22
|
Community-based
bilingual doulas for
migrant women in labor
and birth-findings from
a Swedish register-based
cohort study |
The aim of this study was to
compare birth outcomes for
migrant women who received
CBD support in labor with birth
outcomes for migrant women who
experienced usual care without
CBD support, and Swedish-born
women giving birth during the
same time period and at the
same hospitals. |
CBD support appears to have the potential
to reduce analgesia use in migrant women
with vulnerability to adverse outcomes,
as in this study. It may also be that some
necessary interventions were facilitated
by the enhanced communication made
possible by the presence of a CBD. |
| Campbell et al.16
|
A randomized controlled
trial of continuous
support in labor by a
lay doula |
Aim to compare labor outcomes in
nulliparous women accompanied
by a personally chosen, additional
support person (doula group) with
outcomes in nulliparous women
who received standard care
(control group) |
In conclusion, low-income pregnant
women with the option to choose a
female friend who has received lay doula
training and will act as doula during
labor, along with other family members,
shortens the labor process |
| Chen and Lee23
|
Effectiveness of the
doula program in
Northern Taiwan |
This study investigated the
effectiveness of the doula program
after its initial introduction
in Taiwan. |
Providing continuous labor support
before, during, and after childbirth
to pregnant women requiring labor
support may reduce the C/S rate and
increase the normal spontaneous
delivery (NSD) rate, but the relevant
mechanism between the two remains to
be clarified in the future. The regression
model showed that the factors
associated with labor woman receiving
C/S included high prenatal anxiety, total
time need for doula accompaniment,
epidural use and analgesics use. The
factors of continuous doula support
and oxytocin use were associated with
receiving NSD. |
| Darwin et al.17
|
Evaluation of trained
volunteer doula services
for disadvantaged
women in five areas
in England: women’s
experiences |
This paper focuses on the
experiences of the women who
used the service; specifically,
the areas of impact and the
nature of the relationship that
may offer insights into how such
outcomes occur. |
The UK NICE guidance for the care of
Pregnant women with Complex Social
Factors (NICE, 2010) calls for models
that overcome barriers and facilitate
access to improve women’s outcomes.
It would appear that volunteer doula
services have the potential to make
a contribution to this. Of note, the
benefits reported by women did not
always involve direct support during
the labor and birth. An approach akin to
friendship and based on building trust,
listening, and enabling appears to be
fundamental; in some circumstances,
this can be strengthened by actively
supporting involvement of family,
including partners. Critically, the ending
of the close one-to-one relationship
carries the potential for feelings of loss
and distress which could undermine
the benefits experienced. The timing
and management of endings warrant
further exploration, particularly given
the potential for coinciding with a
period of heightened vulnerability
for mental health problems. Further
longitudinal research is needed to
gather women’s views and experiences
through the period of support, and
the ending, to further elucidate the
mechanisms by which positive impacts
of doula support are achieved and may
be threatened. |
| Eftekhary et al.24
|
The Life of a Canadian
doula: Successes,
Confusion, and Conflict |
Examine the backgrounds,
practices, and professional
motivations of doulas and
to understand their role and
interactions with other maternity
care providers |
This study highlighted areas of possible
conflict concerning labor and delivery
practices, as well as potential challenges in
inter-professional interactions. We are now
in a better position to identify the personal
and professional barriers that might
impede the further participation of doulas
as accepted childbirth workers |
| Falconi et al.25
|
Doula care across
the maternity care
continuum and impact
on maternal health:
Evaluation of doula
programs across three
states using propensity
score matching. |
The objectives of this study were
to: 1) evaluate the integration
of doulas with different types of
clinical providers during labor
and delivery to understand
how different combinations of
provision of care relate to maternal
health outcomes; 2) assess when,
over the care continuum (from the
first trimester through childbirth),
doulas provide the greatest benefit
to maternal health; and 3) evaluate
whether women gain differential
benefits from doulas depending
upon certain risk factors, including
race/ethnicity and certain
chronic conditions. |
Our study provides evidence on the
benefit of the integration of doula care
early in pregnancy and continuing
postnatally. Study findings also
demonstrate the success in integrating
doula into maternity care networks. Doulas
offer numerous benefits to expectant
and postpartum mothers, especially
among low-income and marginalized
minority populations. |
| Greiner et al.26
|
The Cost-Effectiveness
of Professional doula
Care for a Woman’s First
Two Births: A Decision
Analysis Model |
This study evaluated the potential
cost-effectiveness of professional
doula support during a woman’s
first birth in a theoretical
population of US women, with
all women having a second birth
without doula care. |
In conclusion, estimates from this
cost-effectiveness analysis add to the
literature supporting the integration of a
professional doula into a woman’s labor
care and signal the need for increased
doula care reimbursement. Increasing low
risk women’s access to professional doula
support holds great promise to enhance
the quality of US maternity care while
remaining cost-effective. |
| Hans et al.8
|
Promoting positive
mother–infant
relationships: a
randomized trial of
community doula
support for young
mothers |
The present study investigated
the effect of doula services on
parenting among young, low
income mothers. |
In conclusion, our findings show that the
community doula model holds promise for
enhancing positive parenting and parent
child interaction in multirisk populations
that goes beyond its traditional role in
improving the health of mothers and
infants around childbirth. At the same
time, the fading effect of the intervention
also is a cautious reminder that ongoing
efforts are needed to support intervention
effects in the lives of mothers facing
multiple risks in their parenting. |
| Hans et al.7
|
Randomized Controlled
Trial of doula-Home
Visiting Services:
Impact on Maternal and
Infant Health |
This randomized controlled trial
(RCT) examines the impact of
doula-home-visiting on birth
outcomes, postpartum maternal
and infant health, and newborn
care practices |
The doula-home-visiting intervention
was associated with positive infant-care
behaviors. Since few evidence-based
home-visiting programs have shown health
impacts in the postpartum months after
birth, incorporating doula services may
confer additional health benefits to families. |
| Haugaard et al.27
|
Norwegian multicultural
doulas’ experiences of
supporting newly
arrived migrant women
during pregnancy
and childbirth:
A qualitative study |
The aim of the study was to
examine how the multicultural
doulas experienced their work
with newly arrived migrant women
during pregnancy and childbirth. |
The findings suggested that their presence
can strengthen maternity care for
migrant women by means of providing
information, ensuring continuity, and
building a cultural bridge between the
migrant women and maternity care
in Norway. The findings of this study
suggested that migrant women with short
residence in Norway can benefit from
multicultural doula support. |
| Kozhimannil et al.28
|
Potential benefits
of increased access
to doula support
during childbirth |
The goal of this study was to
characterize women who used
doula services and those who
desired but could not access doula
support among a representative
sample of US childbearing women.
We also explored the relationship
between doula support, desire
for doula support, and cesarean
delivery, distinguishing non
indicated cesareans. If desire for
doula services is related to higher
rates of non-indicated procedures,
this could serve to identify
opportunities to better serve at
risk women who may benefit from
access to continuous labor support |
In summary, we found that women with
doula support had lower odds of non
indicated cesareans compared to women
without doula support and compared
to women who desired but did not have
doula support. Additionally, women who
desired but did not have doula support
had a higher odds of cesarean without
definitive medical indication, compared
with those who did not desire doula care.
These results, which should be confirmed
by future prospective studies, suggest that
increasing access to doula care for at-risk
women who desire intrapartum doula
support (e.g., black, uninsured or publicly
insured women) may facilitate decreases
in rates of non-indicated cesareans. |
| Kozhimannil et al.29
|
Doula Care Supports
Near-Universal
Breastfeeding Initiation
among Diverse, Low
Income Women |
The goal of this analysis was to
study whether doula support may
be associated with breastfeeding
initiation among low-income,
diverse women. |
Our findings reinforce the positive
potential role for interprofessional
care and support for pregnant women.
Midwives and other maternity care
providers are uniquely situated to support
women in achieving their breastfeeding
goals and to work in partnership across
traditional professional boundaries to
meet women’s needs. Such practice is
consistent with the broader movement
toward more collaborative maternity care. |
| Lanning and Klaman30
|
Evaluation of an
Innovative, hospital
based volunteer
doula program |
To evaluate program growth,
doula characteristics, patient
satisfaction, and characteristics
and perceptions of labor and
delivery nurses who work with
volunteer doulas in a hospital
based volunteer doula program. |
This program evaluation includes several
measures of success. In addition to providing
information to Birth Partners’ program
leaders, these findings offer valuable
insights for clinicians in other hospitals
who are considering initiating a volunteer
doula program. The Birth Partners program
structure, process, and outcomes model can
provide a trigger and guide for discussion |
| Lima et al.5
|
Comprehension
on doula’s work
at a maternity in
Jequitinhonha Valley—
MG |
To analyze the understanding
of puerperae, doulas, and the
care team about the presence
of a doula during the pregnant
women’s parturition process. |
The proposed objective of this study was
reached because, through the reports, it
is possible to analyze the understanding
of the puerperae, the doulas, and the care
team about the presence of a doula during
labor in the maternity hospital in Vale
do Jequitinhonha, Minas Gerais. Also, it
was possible to identify the influence of a
doula’s work for the formation of academic
doulas. Doula’s work revealed meanings
inherent in a humanized and welcoming
care, thus providing a way for maternity
care teams, together with managers and
other ones involved in the processes of
assisting pregnant women, to reflect on
the relevance of the presence of doulas in
those scenarios. |
| McLeish and Redshaw31
|
A qualitative study
of volunteer doulas
working alongside
midwives at births in
England: Mothers’ and
doulas’ experiences |
To explore trained volunteer
doulas’ and mothers’ experiences
of doula support at birth and their
perceptions of how this related to
the midwife’s role. |
Volunteer doulas can play an important
role in improving women’s birth
experiences in England by offering
continuous, empowering, woman-focused
physical and emotional support in a
way that complements the more clinical
role of midwives, particularly where
there is no midwifery caseload care and
mothers are disadvantaged. While doulas
were generally very clear about the
boundaries of their role, some blurring
of these boundaries may be initiated by
midwives as well as doulas. There is a
need for greater clarity about the scope
of legitimate volunteer doula advocacy
on behalf of their clients, to maximize
effective working relationships between
midwives and doulas. |
| McLeish and Redshaw32
|
Being the best person
that they can be and the
best mum": a qualitative
study of community
volunteer doula support
for disadvantaged
mothers before and after
birth in England |
Explores how the antenatal and
postnatal role of the community
doula is experienced and
understood by the volunteer
doulas and the disadvantaged
women who they support. A
separate paper has explored the
role of these community doulas
at birth. |
In addition to their role as birth supporters,
the work of volunteer community doulas
in the antenatal and postnatal periods
is highly valued by vulnerable mothers
and can help to improve their parenting
confidence and skills. Mothers and doulas
described positive impacts on maternal
emotional wellbeing, with a reduction
in anxiety, unhappiness and stress, and
increases in self-esteem and self-efficacy.
Mothers felt more knowledgeable and
skillful, were supported to make effective
use of maternity services, and were enabled
to build social ties in their community. |
| Neel et al.33
|
Hospital-based maternity
care practitioners’
perceptions of doulas |
Describe best practices of
integrating doulas into hospital
based maternity care teams to
facilitate access to this evidence
based service for improving
maternal health outcomes. |
Doulas can help address the US maternal
health crisis by improving birth outcomes,
especially among women most at risk.
However, negative practitioner attitudes
about doulas may interfere with the
effectiveness of interprofessional teams.
Adequate staff training in the doula
model of care, explicit role definition, and
increasing practitioner exposure |
| O’Rourke et al.34
|
How and when doula
support increases
confidence in
women experiencing
socioeconomic adversity:
Findings from a realist
evaluation of an
Australian volunteer
doula program |
This study aimed to test the theory
in realist interviews with clients,
focus groups with doulas, and with
routinely collected pre-post data. |
This first realist evaluation of a volunteer
doula support program has found how
and when a doula’s recognition of a
woman, in a support relationship, can
increase the woman’s confidence in
the short-term, in a sustained way with
broader psychological wellbeing, or not
at all. |
| Richards and Lanning35
|
Volunteer doulas’
experiences supporting
cesarean births: A
qualitative analysis for
preliminary program
evaluation |
The aim of this scoping study
was to explore the experiences
of volunteer doulas who provide
support to women during
cesarean birth, as a preliminary
method of program evaluation
and to act as a foundation for
the study of holistic cesarean
birth experiences. |
Doulas volunteering within this program
highly valued their perceived role in the
care of women experiencing cesarean
birth, including reports of increasing
evidence-based practices such as SSC and
early breastfeeding initiation in the OR.
These doulas reported successfully working
around the physically challenging OR
environment and alongside the cesarean
interprofessional team. Relationships
among doulas and other OR staff should
be examined, and the value of doula
presence in the OR recognized, to facilitate
an interprofessional approach to family
centered care. The authors invite others
to build on this preliminary program
evaluation; future research should include
interviews of clients receiving doula care
in the OR and other professional members
of the OR team. A broader perspective
of experiences and opinions may help
to expedite the successful integration of
doulas in the care of women giving birth
by cesarean, potentially improving physical
and emotional outcomes for women and
their newborns |
| Robati et al.36
|
Effects of the Presence
of the doula on Pregnant
Women’s Anxiety and
Pain During Delivery:
A Randomized
Controlled Trial |
Evaluate the impact of a doula’s
presence on anxiety and pain
in pregnant women during the
delivery process |
Generally, it is concluded that the presence
of a trained doula by pregnant women’s
side during labor can improve the mental
outcomes of delivery and decrease the
women’s anxiety and pain. It is suggested
that the study should be replicated with
a larger sample and in different health
centers of Iran. It is also recommended
that maternity centers should implement
this low-cost and proper intervention
during the delivery process. |
| Schytt et al.10
|
Community-based
bilingual doula support
during labor and birth
to improve migrant
women’s intrapartum
care experiences and
emotional well
being-Findings from a
randomized controlled
trial in Stockholm,
Sweden |
To evaluate the effectiveness of
community-based bilingual doula
(CBD) support for improving the
intrapartum care experiences and
postnatal wellbeing of migrant
women giving birth in Sweden. |
Community-based doula support during
labor and birth for migrant women neither
increased women’s ratings of their care for
labor and birth nor their emotional well
being 2 months postpartum compared
with receiving standard care only. Further
studies on the effectiveness of CBD
powered to evaluate obstetric outcomes
are needed |
| Schytt et al.37
|
The community-based
bilingual doula — A
new actor filling gaps in
labor care for migrant
women. Findings
from a qualitative
study of midwives’
and obstetricians’
experiences |
The aim of this study was
to explore midwives’ and
obstetricians’ views of community
based bilingual doula support for
migrant women during labor and
birth, and their own experience of
collaborating with CBDs. |
Community-based bilingual doula support
was viewed as improving migrant women’s
well-being during labor and birth and as
increasing the possibilities for midwives
and obstetricians to provide good and
safe care, particularly because language
support from the CBD significantly
improved communication in the labor
room. Some ambivalence was apparent
however, about the CBD’s education, role
and boundaries. |
| Schytt et al.38
|
Community-based doula
support for migrant
women during labor and
birth: study protocol for
a randomized controlled
trial in Stockholm,
Sweden |
This study protocol describes the
design, rationale and methods of
a randomized controlled trial that
aims to evaluate the effectiveness
of CBD support for improving the
intrapartum care experiences and
postnatal well-being of migrant
women giving birth in Sweden. |
This study has the potential to inform
further development of the CBD model
and to contribute to what is known
internationally about the effectiveness of
bilingual doula support in improving the
care of migrant women during childbirth. |
| Shlafer et al.39
|
Doulas’ Perspectives
about Providing Support
to Incarcerated
Women: A Feasibility
Study |
To document the logistical feasibility of a doula program for pregnant incarcerated women and to assess doulas’ perceptions of
their achievements. |
The intervention was logistically feasible,
suggesting that doulas can adapt their
practice for incarcerated women. Doulas
may need specific training to prepare
themselves for institutional restrictions
that may conflict with the traditional roles
of doula care. It may be important for
doulas to understand the level of personal
and professional resources they may have
to expend to support incarcerated women
if they are separated from their infants
soon after delivery. |
| Smid et al.40
|
Bringing Two Worlds
Together: Exploring the
Integration of Traditional
Midwives as doulas in
Mexican Public Hospitals |
Objectives were to introduce the
previously unknown role of doula
to both traditional midwives (TMs)
and public health personnel and
to better understand the perceived
benefits and challenges of
incorporating TMs acting as doulas
formally into the public health
care system |
To bring these two worlds together, the
results of this study show that successful
implementation would require careful
planning and directed collaborative
training for both TMs and clinic staff.
The training must address the structural,
sociocultural, and professional barriers
we have described and provide a clear
definition about the role and scope of
doula care. |
| Ström et al.18
|
Experiences of
working as a cultural
doula in Sweden: An
interview study. |
The aim was to explore cultural
doulas’ experiences of giving
support to foreign-born
women during pregnancy and
after childbirth. |
The cultural doulas felt proud when they
experienced their work as meaningful
and important. It was clear to them that
their support and guidance had a positive
impact on the women’s reproductive
health as well as their integration into
Swedish society. Cultural doulas could
play an important role in building equal
maternal healthcare in Sweden. |
| Spiby et al.6
|
The greatest feeling you
get, knowing you have
made a big difference:
survey findings on
the motivation and
experiences of trained
volunteer doulas in
England |
This research aimed to understand
the motivation and experiences
of volunteer doulas who have
been trained to support women
during pregnancy, birth and the
postnatal period. |
Training and volunteering as an unpaid
doula can be a rewarding experience,
in terms of both personal development
and future employment prospects and
the ability to test out work in health and
social care. |
| Stevens et al.41
|
Midwives and doulas
perspectives of the role
of the doula in Australia:
A qualitative study |
To explore midwives and doulas
perspectives on the role of the
doula in Australia |
This research is the first research
undertaken that aims to understand the
role of a doula in Australia. Doulas are
employed by women to primarily "fill the
gap" in, "the broken maternity system" in
Australia. When doulas provide continuity
of care, midwives feel that doulas are
"taking our role" because they are meant
to be "with women." Despite the conflict,
both midwives and doulas see the
potential for collaboration. The benefits of
continuity of care are strongly supported
by research, and it is anticipated that
this option will be more available to
women with the Australian Government’s
maternity service reforms. |
Social role of doulas in Brazil and in the world: a scope review
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