About doula presence

In the past, it was natural for women to be supported during labor by older, more experienced, familiar women from their family and neighborhood. Only a few decades ago, every milestone of life — arrival and departure alike — was a community event. As large families and supportive communities fragmented, as family and neighbor ties weakened, and as birth moved into hospitals, the chain of transmission broke: the ancient, natural community knowledge and experience that generations passed on to one another, sustaining continuity and social support. In modern, highly mechanized hospitals it is increasingly difficult to create a personal atmosphere, even though the need for it keeps growing. Personal connection and dedicated attention are especially important for mothers — this is what a doula's presence can offer during pregnancy, birth, and the postpartum period, and often beyond.

• Complementing the healthcare system, she can provide physical, emotional, and informational support to the birthing woman and her family.
• She recognizes birth as a key life event.
• She understands the physiology of pregnancy, labor, and birth.
• During labor support, she attunes to mother and baby, accepts and supports what is happening.
• She stays with the laboring woman throughout, without shift changes.
• She offers continuous presence, care, and a personal relationship.
• She helps support the comfort and wellbeing of the mother (and father/partner).
• She helps decision-making with objective information, without pushing preferences onto the mother (or couple).
• She supports communication between the laboring person, their partner, and healthcare staff.
• She complements the care provided by the partner and hospital staff.

A doula's supportive presence, based on experience, can significantly reduce the frequency of medical interventions, as she can often help the mother through the more difficult emotional moments of birth. In addition to supporting the mother, she can also support the partner emotionally — her calm can strengthen and encourage an anxious father/partner.

Dr. Marshall Klaus, a pediatrician and neonatology professor, introduced doula services in the USA in the 1990s. He conducted more than 2,000 observations with two groups. Both groups received standard obstetric care after uncomplicated pregnancies, but in one group a doula was also present at birth. The results: labor duration was shortened by 25%; cesarean births decreased by 50%; oxytocin was used 40% less often; forceps and pain medication were used 30% less often; epidurals 60% less often; and episiotomies were performed less often. Fathers/partners were also much more actively involved when doulas were present.

In the first hours after birth, these mothers were gentler with their newborns; later they had fewer breastfeeding difficulties and were less anxious. (Marshall H. Klaus, MD.: Mothering the Mother, Addison-Wesley Publishing Company, 1993)

All of this suggests that the more attention and care a woman receives during labor and birth, the more naturally and smoothly bonding and a positive relationship with the baby can develop — and the more competent she can feel.

The American College of Obstetricians and Gynecologists (ACOG) describes doulas in its 2026 committee statement as trained support people who complement healthcare by providing emotional, physical, and informational support. They help with communication and self-advocacy, and support mothers in understanding information and forming questions. ACOG also emphasizes collaboration between doulas and healthcare professionals.

Research on doula support has observed lower rates of some interventions. This does not mean a doula's goal is to avoid cesarean birth, epidural anesthesia, oxytocin, or any other medical intervention.

A doula is beside the mother, not against interventions.

If an intervention becomes necessary, the doula continues to support the mother: helping her understand what is happening, formulate questions, and feel emotionally held, safe, and informed.

When several options are available, the doula does not decide for the mother. She helps the mother understand the information, ask questions, and make decisions based on her own values and preferences.

A doula's role complements healthcare; it does not replace it.

The goal is an informed, supported, and respectful birth experience, however the birth unfolds.