Fourteen randomized trials have demonstrated that continuous caregiver support during
childbirth can lead to shorter labors and decrease the need for intervention. In response,
there has been a significant increase in the number and use of doulas as paraprofessionals
who provide social and emotional support to women during labor/birth for a fee. We
conducted a mailed survey of a nationally representative sample of certified and certification-in-process
doulas in the United States (n = 626, 64.4% response rate) to gather some descriptive information on their sociodemographic
backgrounds, practice characteristics, and beliefs/attitudes on a number of salient
issues. The survey results suggest that, in 2003, doulas were primarily white, well-educated
married women with children. The majority of certified doulas worked in solo practice
and provided childbirth support services on average to nine clients per year. Very
few doulas were earning more than $5,000 per year from this work, and only 10% of
certified doulas reported receiving third-party reimbursement for their services.
Thus, while almost all doulas found their work emotionally satisfying, only one in
three saw their work as financially rewarding. Doulas also reported challenges in
getting support/respect from clinicians and in balancing doula work and family life.
In addition, one in four doulas reported that they were preparing for a career in
midwifery. Doulas can play an important and unique role in the childbirth process
and reap many personal rewards engaging in this type of work. However, a number of
financial, personal, and professional challenges present significant obstacles to
the growth of doulas as childbirth paraprofessionals in the United States.
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References
- The system of professions. University of Chicago Press, Chicago1988
- Births, marriages, divorces, and deaths.National Vital Statistics Review. 2002; 50 (Anonymous): 1-2
- Immaculate deception II. Celestial Arts, Berkeley, CA1994
- Birth as an American rite of passage. University of California Press, Berkeley, CA1992
- Listening to mothers. Maternity Center Association, New York2002
- Mail and telephone surveys. John Wiley & Sons, New York1978
- A guide to effective care in pregnancy and childbirth. third edition. Oxford University Press, Oxford2000
- An introduction to qualitative research. Sage Publications Ltd, Thousand Oaks, CA1998
- The medicalization and demedicalization of American society.in: Conrad P. Kern R. The sociology of health and illness. third edition. St. Martin’s Press, New York1990: 409-413
- Obstetric risks versus research realities. Greenwood Publishing Group, Westport, CT1995
- Effects of providing hospital-based doulas in health maintenance organization hospitals.Obstetrics and Gynecology. 1999; 93: 422-426
- Continuous support for women during childbirth (Cochrane Review). 2003 (The Cochrane Library, Issue 3, Oxford: Update Software)
- Effects of continuous intrapartum professional support on childbirth outcomes.Research in Nursing Health. 1989; 12: 289-297
Hwang, S. (2004). As doulas enter delivery rooms, conflicts arise. The Wall Street Journal, January 20. Kennell, J., Klaus, M., McGrath, S., et al. (1991). Continuous emotional support during labor in a US Hospital. Journal of the American Medical Association, 265, 2197–2201.
- The doula.Acta Paediatrica. 1997; 86: 1034-1036
- Mothering the mother. Addison-Wesley Publishing, Boston1993
- The growth of medical authority.in: Leavitt J.W. Women and health in America. (2nd ed.). University of Wisconsin Press, Madison, WI1999: 636-658
- Social support by doulas during labor and the early postpartum period.Hospital Physician. 2001; (September): 57-65
- Doula care. Department of Sociology, University of California at Los Angeles, 2002 (Dissertation for Degree of Doctor of Philosophy)
- Reducing pain and enhancing progress in labor.Birth. 1995; 22: 161-171
- Qualitative analysis for social scientists. Cambridge University Press, Cambridge1987
- Maternity home care assistants in the Netherlands.in: van Teijlingen E. Lowis G. McCaffery P. Porter M. Midwifery and the medicalization of childbirth comparative perspectives. Nova Science Publishers, New York2000: 163-172
- Active management of labour.British Medical Journal. 1994; 309: 366-369
- Notes on the decline of midwives and the rise of medical obstetricians.in: Conrad P. The sociology of health and illness critical perspectives. 7th ed. Worth Publishers, New York2004: 176-188
- Continuous labor support from labor attendant for primiparious women.Obstetrics and Gynecology. 1996; 88: 739-744
Biography
Paula M. Lantz, Associate Professor of Health Management and Policy at the University of Michigan School of Public Health, conducts policy-focused research on women’s health services and social inequalities in health.
Biography
Lisa Kane Low, Assistant Research Scientist in the School of Nursing and lecturer in Women’s Studies at the University of Michigan, is interested in women and adolescent’s experiences of childbirth and their association with processes of care during labor.
Biography
Sanjani Varkey, MPH, is interested in epidemiological perspectives on women’s health issues and global health.
Biography
Robyn L. Watson, is a doctoral student in Health Services Organization and Policy, University of Michigan, and is interested in research on the health care experiences of low-income minority women.
Article info
Publication history
Accepted:
January 3,
2005
Received in revised form:
December 6,
2004
Received:
July 28,
2004
Identification
Copyright
© 2005 Jacobs Institute of Women’s Health. Published by Elsevier Inc. All rights reserved.
