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Q
Doula or Doctor?

Would you suggest that a first time mother use a doula or should she follow the mainstream procedures and give birth at the hospital with doctors present?

A
Answer (Published 9/22/2008)

"Doula" is a Greek word that originally meant "women's servant," although in today's parlance it refers to a professional who helps women through labor, childbirth and the initial stages of motherhood. The role of the doula is to facilitate a positive childbirth experience. She isn't a substitute for a doctor or a midwife: you still need one or the other for medical care during pregnancy, and one or the other will need to be present when you give birth. However, a doula can enter the picture at any stage of pregnancy or the birth process to answer your questions and provide support and reassurance.

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Studies have shown that when doulas are present, women are less likely to require pain medications, less likely to have a caesarean delivery, and more likely to report a positive childbirth experience.

I discussed the role of doulas with Tieraona Low Dog, M.D., director of the Fellowship at the Arizona Center for Integrative Medicine who studied midwifery earlier in her career. Dr. Low Dog emphasizes that you can use a doula at the hospital, as well as at home, and highly recommends having a doula present for the birth, especially if you're a first-time mother. She also advises checking to see if your hospital has nurse midwives as well as doctors on staff. If so, she says you can be in the hospital but still create a more intimate home-like delivery. If your pregnancy is low risk and you are in good health, giving birth at home can be beautiful, but Dr. Low Dog advises that you will need a qualified midwife in addition to a doula and that home birth is best if you don't live or deliver too far from a hospital should you need one. I agree.

Bear in mind that anyone can be a doula regardless of training – or lack of it. Before hiring one, be sure to ask about her education and experience and check to see if she has been certified by a reputable national organization.

Andrew Weil, M.D.

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