Mothers-to-be turn to doulas in midwife shortage

They take their name from the Greek word for slave, have no medical training and do everything from massage to shopping, but they are playing a vital role in childbirth for growing numbers of women.

Doulas – otherwise known as labour coaches, birthing assistants or help women – act as companions for new mothers-to-be during what can prove to be their baby's long, stressful and painful arrival in the world.

In 2004 about 700 women hired a doula to be with them during their labour. Last year that number had risen to 2,500. Similarly, the number of doulas belonging to the network Doula UK, which represents many of those who offer their services to women, has risen from 28 in 2003 to more than 450. The chronic shortage of NHS midwives, women's anxiety that they may not receive one-to-one care while in labour in hospital, and a desire to have as natural a birth as possible help to explain the trend. Many using doulas are first-time mothers, especially those who are older, orthodox Jews, single women or those who have no relatives living nearby and can afford to hire help.



Doulas say they do little more than give advice, support and encouragement to women whose predecessors would have had their mother, aunt, sister or grandmother fulfil that role. But they also help the mother-to-be to stay as calm and relaxed as possible by advising on breathing, performing massage and listening as she shares her fears, thoughts and feelings.

Research has shown that the presence of a doula can help to shorten a woman's labour, reduce the amount of pain relief she is given, make a caesarean section less likely and give fathers more confidence in supporting the mother. Most women say they find their doula a soothing, beneficial presence during what can be a traumatic experience.

Midwives are divided as to whether doulas threaten or complement their key role. "My concern is that women are perhaps using doulas because the maternity services are struggling to provide one-to-one care and that midwives, who are not just trained clinical experts but are also skilled in emotional support, are currently finding it hard to provide continuity of care," said Mervi Jokinen of the Royal College of Midwives. "It is also sad that some women may feel anxious that their concerns will not be heard by health professionals and therefore look to an external advocate such as a doula."