DONA International is an organization that certifies birth and postpartum doulas. Its vision is “A doula for every person who wants one.” Founded in 1992 as Doulas of North America, it became an international organization in 2004. Since its inception, over 13,000 birth and postpartum professionals have been certified through the DONA International process that has its roots in the evidence-based model of care.
The organization grew out of research that was done in the 1960s and 1970s by neonatologist Dr. Marshall Klaus and pediatrician Dr. John H. Kennell that supported mother-infant bonding. The doctors purported “there is a period shortly after birth that is uniquely important for mother-to-infant attachment in the human being.” Bonding during this “sensitive period” was thought to result in improved parenting and better neurobehavioral and cognitive outcomes for baby.
The research done by Dr. Klaus and Dr. Kennell did not stop there. They also found evidence of improved obstetric outcomes for women who received continuous support during labor and delivery from another woman who was experienced in the birthing process. This support then translated into better emotional health for the mother and a better bonding experience with baby.
What is a doula?
From the Greek meaning ‘woman who serves,’ a doula is a birth or postpartum professional that offers support, reassurance, comfort, information, and encouragement to a woman and her partner during and, in the case of a postpartum doula, after labor and delivery. She will also relay information and communicate with the medical team. Unlike a midwife, a doula offers purely non-clinical services. She does not manage clinical care or perform vaginal exams, fetal heart rate monitoring, or maternal blood pressure monitoring. Nor does she offer medical advice.
A doula is there to make sure the laboring woman has the birthing experience she desires. Although some research has shown a decreased use of pain medication for women with doulas, a doula-assisted birth does not have to be medication-free. If a woman opts for medication for pain relief, a doula will support that woman’s decision. A doula will also stay with the laboring mom if she needs a cesarean section.
What are the benefits of having a doula?
As mentioned above, one benefit of having a doula is that more women feel confident and comfortable enough to go through the labor and delivery process without pain medication. Furthermore, the American College of Obstetricians and Gynecologists has found that the presence of a birth doula or other continuous support personnel during labor and delivery increased patient satisfaction and reduced the the rate of cesarean sections.
According to DONA International’s position paper on the role of the birth doula in maternity care, further benefits to laboring moms include a reduction in the use of synthetic oxytocin (used to strengthen contractions, thus speeding childbirth), decreased anxiety, and an increase in moms having a more positive birthing experience.
What types of doulas are there?
There are two types of doulas—the birth doula and the postpartum doula. The birth doula offers support during the labor and delivery process. The postpartum doula offers emotional and physical support in the days following the birth. Postpartum doulas also help with care of the newborn, offer lactation support, and may perform light household chores. Most importantly, the postpartum doula assists with boosting parent confidence and encouraging bonding between the infant and the parent.
In addition, there are different certifications that can be obtained through DONA International:
- CD(DONA): DONA Certified Birth Doula
- AdvCD(DONA): Advanced DONA Certified Birth Doula
- BDT(DONA): DONA Approved Birth Doula Trainer
- PCD(DONA): DONA Certified Postpartum Doula
- AdvPCD(DONA): Advanced DONA Certified Postpartum Doula
- PDT(DONA): DONA Approved Postpartum Doula Trainer
How do I hire a doula?
DONA International has a searchable database of certified doulas. Additionally, they offer a guide for hiring a doula with questions you should ask your potential birthing assistant, such as ‘Where did you receive your training?’ ‘What techniques do you use?’ and ‘Are you certified?’ You will also want to make sure you hammer out the logistics of your relationship by asking when the doula will be available to you, how much does she charge, and does she have a backup doula in case she’s unavailable.
Most important in making your choice is how you feel about your potential doula. Did you and your partner feel comfortable with her and confident in her ability to care for you?
Maternal-Child Health Advocacy
In keeping with its mission “to promote high quality birth and postpartum support by setting the standard for the doula profession through evidence-based training and certification for doulas of diverse backgrounds,” DONA International advocates for maternal-child health via five areas of focus:
- Health disparities and inequities
- Legislative action
- Insurance payment for doulas
- Doula profession promotion and credibility
- Research and data collection.
Furthermore, to expand availability and ensure inclusivity, DONA International has an intercultural coalition which includes an LGBTQIA+ liaison and a military liaison.
Is a doula right for you?
Things to ask yourself when making the decision about whether you would like a doula present at your birth:
- What are my expectations of the birthing experience?
- Will I be in a supportive environment?
- Does my partner feel comfortable in offering me the support I will need?
- Can I afford it?
Only you can know if having the extra support of a birth or postpartum doula is right for you.