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What is a postpartum doula?

The origin and story behind doula support

The concept of women supporting other women during pregnancy, birth and early motherhood has existed long before the term doula was popularised in the 1970's. Going back in history, we know that women have always cared for and assisted other women during childbirth and motherhood. Before obstetric care was developed and childbirth was medicalised, women would labour and birth at home with the support of female relatives, friends and traditional midwifes. This way of birthing is known as the social childbirth philosophy. After birth, mothers would continue to receive care from her female support network for a period of "lying-in" dedicated to rest, healing and recovery.

Where does the word doula come from?

The word doula originates from the greek word meaning "woman servant" and was coined by Dana Raphael in 1976 to describe woman who would help mothers with breastfeeding after birth. Since then, the term doula evolved to define experienced women who provide support during pregnancy, labour and postpartum.

Modern definition of doula

The medicalisation of childbirth and the increasing rate of intervention resulted in a resurgence of women supporting women during labour and birth. Doulas gained popularity in the 1980's when cesarian rates were on the rise and they are now commonly known and recognised experienced caregivers in the field of pregnancy, birth and postpartum care. Since then, the scope of practice of doulas has expanded to include a much wider range of care.

DONA International defines a doula as "a trained professional who provides continuous physical, emotional and informational support to their client before, during and shortly after childbirth to help them achieve the healthiest, most satisfying experience possible."

Today, women seek the support of a doula for various reasons including to provide guidance and support during labour, to avoid medical interventions or pain relief, to support their birth partners and to fill the gap in pregnancy and postpartum care.

What is the role of a postpartum doula?

Although doulas are commonly known for their support in pregnancy and childbirth, there is still little awareness around the role of doulas after birth. In many cultures around the world, there is a specific rest period after the birth of a baby, where the mother is cared for and nourished by a support network usually involving dedicated female relatives or traditional carers. A paper published in 2007 named “Traditional postpartum practices and rituals: a qualitative systematic review,” showed similar postpartum practices across different cultures around the world. The researchers found "across the twenty countries, each culture’s postpartum practice included a specified rest period, a prescribed diet, and organised support from family members." There were six common major themes identified across all cultures including organised support, rest period, specific diet, hygiene and physical warmth practices, infant care and breastfeeding and rituals.

Postpartum care isn't new and is still widely practiced in traditional cultures around the world. This is where the role of doulas is known to incorporate postpartum care practices and can be specifically dedicated to caring and supporting the mother during a defined period of time after birth. A postpartum doula can help implement organised support for the mother, cook specific meals prescribed for the postpartum period, incorporate warmth practices, provide breastfeeding and newborn care support as well as facilitate rituals to honour the rite of passage into motherhood.

There is increasing awareness around the role postpartum doulas play in a mother's recovery from birth and transition into motherhood. The long-lasting benefits of a well supported postpartum period is being documented in a range of studies and highlights the importance of dedicated care during the postpartum period.

In March 2022, WHO published its first ever global guidelines to support women and newborns in the postnatal period. These recommendations support the role professionals play during the postnatal period and the impact they can have on a woman and her baby's health and wellbeing.

The need for quality maternity and newborn care does not stop once a baby is born. Indeed, the birth of a baby is a life-changing moment, one that is bound by love, hope and excitement, but it can also cause unprecedented stress and anxiety. Parents need strong health care and support systems, especially women, whose needs are too often neglected when the baby comes.” - Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at WHO



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