Doulas 'complicating' birth process
Updated on 02 December 2009
Pregnant women who hire birth assistants, known as "doulas", are complicating NHS care, the British Medical Journal warns.
A report published today in the British Medical Journal says that the helpers are complicating the level of care provided.
The Royal College of Midwives say "doulas" are taking over duties that should only be carried out by trained midwives.
But the helpers maintain their role is limited to providing their clients with emotional and practical support.
Bridget Baker, from Doula UK, and Denise Linay, from the Royal College of Midwives, spoke to Channel 4 News about the issue.
Bridget Baker said that Doulas were important for those do not have pregnancy support.
"A Doula is a lay person who is a companion during a birth and pregnancy and also works with a woman post-natally to support the mother as her own mother may have done if she was around," she said.
"There are preparation courses for Doulas and in Doula UK we have a mentoring and supervision process and all our Doulas commit to a code of conduct.
"Women need women to support them during the birth. The partners if they attend the birth also need a bit of support.
"Midwives are working under tremendous pressure, there isn’t necessarily continuity of care, the midwife may change shift during the process and the Doula rarely does. We train Doulas to accept that they have boundaries and they shouldn't overstep them."
Denise Linay from the Royal College of Midwives accepted that in cases Doulas were a benefit to women but said that there needed to be more synergy.
"A lot of our members do give accounts of Doulas being supportive and actually enhancing the birth experience but unfortunately we do have situations when the Doula can be quite obstructive and quite antagonistic to the midwife by not allowing the midwife to speak directly to the woman, by challenging any advice that the midwife is giving.
"In one extreme case we heard in a home confinement the Doula wouldn't actually let the midwife into the room.
"Doulas and mothers and midwives need to work together.
"What we need to be careful about is where Doulas encroach on the midwife's territory. Ultimately we need more midwives to provide the care that Doulas are offering.
Linay told Krishnan Guru-Murthy that she did not think Doulas needed to be officially licensed.
"You only need a form of regulation when you are in a situation where you could cause harm," she said.
"I don't think Doulas should ever be placed in a place where that could happen."
