More American Women are Hiring Doulas To Provide Continuous Care During Labor According to Birth Ambassadors, a New Book Published by Praeclarus Press

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In Birth Ambassadors: Doulas and the Re-Emergence of Woman-Supported Birth in America, a new book published by Praeclarus Press, Christine Morton and Elayne Clift describe why women are seeking continuous care during labor and how this lowers their risk of medical interventions. Many women are hiring doulas to help them avoid highly interventionist births common in today’s hospital setting.

Doulas provide continuous support to women in labor. Photo credit: Kyndal May

Doulas are the Birth Ambassadors for the midwifery model of care in the U.S.

According to Birth Ambassadors, a new book from Praeclarus Press, an increasing number of American women are hiring doulas to attend to them during labor and provide continuous labor support. Doulas are part of the framework that comprises the midwifery model of care, which views birth as a normal, not pathological event, and where the rates of interventions, such as epidurals and cesarean sections, tend to be lower. Midwifery care is not available to the majority of American women, but hiring a doula can provide many of the same advantages, especially at a time when the rates of cesarean sections are at an all-time high. Almost half of American women described their recent childbirth experiences as “traumatic,” with 9% meeting full criteria for post traumatic stress disorder.

Doulas are women who accompany women throughout their labor, and provide individual attention, information, and support to their clients. But this role does not come without dilemmas, as Christine Morton and Elayne Clift describe. One dilemma doulas face is how to advocate for the woman in hospitals, where they may not be welcome. Doulas often enter the profession because they want to support women in childbirth. But to continue, they need to find ways to navigate the challenges inherent in their role, and find ways to deliver their services in the highly medicalized settings in U.S. hospitals.

Another dilemma is what doulas should do when hospital policies or clinical practices violate their core beliefs that women have the right to plan for their birth, to be active participants in their care, and to be treated with dignity and respect. This core belief can be at odds with the structural care models currently in place at most U.S. hospitals. Thus, doulas sometimes find themselves in awkward and emotionally charged interactions with health care providers.

One common situation is when a woman’s desire for an unmedicated birth is not respected, or when interventions are proposed without allowing for a full discussion of risks and benefits. Women may feel coerced into intervention because clinicians implicitly--or explicitly--convey the idea that if a woman does not comply, she will harm her baby. Knowing how to handle situations like these is often difficult for women working in hospitals as doulas. Birth Ambassadors summarizes results of the first scholarly study of the role of doulas and the dilemmas they face. It is a fascinating and readable volume destined to become a classic in women's health.

Christine H. Morton, PhD is a research sociologist whose research has focused on women’s reproductive experiences and maternity care roles. Since 2008, she has been at Stanford University’s California Maternal Quality Care Collaborative, where she conducts research on maternal mortality and morbidity.

Elayne G. Clift, MA is a writer, journalist, and Humanities adjunct professor. She has worked internationally as a health communications and gender specialist, and is an educator/advocate on maternal and child health issues. A volunteer doula and Vermont Humanities Council Scholar, she has edited anthologies and published fiction and poetry collections, a novel, and a memoir.

Praeclarus Press is a small press founded by Dr. Kathleen Kendall-Tackett and specializing in women’s health. It features books, webinars, and products that support women's health throughout the lifespan. Praeclarus Press is based in Amarillo, Texas, USA.

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Kathleen Kendall-Tackett
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