Specialty Care in the Maternity Journey: Doulas Drive Better Outcomes with Education and Compassion

Specialty care providers play a pivotal role in the maternity journey, rounding out the “maternity village” with targeted forms of care for specific needs. These specialty providers, including doulas, are growing increasingly popular in the maternity journey, especially from a benefits perspective. Walmart, among others, are including doula support in their maternity benefits offerings because they can drive better maternity outcomes, especially for vulnerable populations. Organizations of any size looking to improve outcomes for parents in their workplace should consider adding doulas, among other specialty providers, into their benefits ecosystem.

An abridged history of the doula

Although the role of a doula is speculated to be an ancient tradition, today they are trained and licensed professionals. And despite their reputation in pop culture as being exclusively used in lieu of trained healthcare providers for “natural births,” they often provide support as a part of a broader, community-oriented care team, through things like breathing exercises, pain management techniques, peer-reviewed and clinically supported research, and more. 

According to anthropological research, it has long been a tradition for a family member or close friend to accompany a woman during childbirth. The term doula, roughly translating to “servant” or “slave,” is derived from ancient Greek, according to the research of anthropologist Dana Raphael. And although the maternity journey has changed dramatically since the days of yore, the idea of bringing along a trusted non-clinician to aid in the birthing process has withstood the test of time.

Doulas, in an official sense, came into vogue in the late 1960s during the so-called “natural childbirth” movement, and were employed in a much different capacity than as a servant. In the 1980s, the organization that later became known as DONA became the first foundation to train and certify doulas, and is one of the leading organizations in the practice of being a doula to this day. As of 2012, 6% of birthing people in the U.S. used a doula.‍

According to CE Durfee,  MSN, CNM, ARNP, CLC, CD(DONA), “doulas used to be called ‘labor coaches’ and I think there is still some truth to that. However, the partner of a family I worked with once described the doula's role as similar to a "birthy tour guide." A doula can tell growing families about the birth process, policies and procedural norms at their planned birthing location, and offer insight in addition to their birth support-specific expertise.” 

What role do doulas play in the maternity journey?

Doulas help improve outcomes for both parent and child by easing stress, encouraging healthy behaviors, and providing continuous assistance throughout the pregnancy journey. Lauren Ryan, a Certified Supported Doula and founder of Supported Birth Care, describes the benefits as such: “using a doula lets a birthing parent and their support person more fully enjoy the time leading up to birth and the actual birth because neither have to worry about what to remember.” 

Teaching parents how to advocate for themselves

Empowering new parents to advocate for themselves in clinical settings is crucial to positive health outcomes. Doulas can act as trusted advisors and advocates to encourage expecting parents to seek help when necessary, and to speak up about their experiences. “So many moms do not know that it’s okay to have a discussion with their healthcare providers to learn more about benefits, risks and alternatives and that they can say no. Doulas can empower moms to make decisions they didn't even know they had a choice in.” says Ryan.

Advocacy is especially important for people of color and LGBTQIA+ families who may have a different experience navigating the healthcare system, and likewise parenthood. Doulas are an additional voice in the room who can act as a sounding board for families if they don’t feel comfortable asking questions, or don’t feel heard or respected by their providers. 

As Durfee describes it, “doulas can help to preserve a safe space, remind the rest of the support team of the family's roles/names/pronouns, and keep staff accountable for the care they provide.” 

Providing better healthcare outcomes

Through their emotional support and advocacy, doulas can help drive better outcomes for birthing parents in almost any clinical setting. According to a 2019 CHIPS Policy Brief by UW, "Doula-supported individuals are less likely to: have a cesarean birth, have a low birth weight infant, and give birth to a newborn with a low APGAR score (a metric used to determine if the newborn requires immediate medical attention after birth)." 

A 2013 study of the YWCA Greenboro Doula Program found that, resoundingly, mothers with doula-provided assistance had better experiences and clinical outcomes in controlled settings — however the researchers recognized that, while the support had statistically significant impacts, it wasn’t given in a vacuum. That is, doulas working in tandem with a coordinated care team that provides continuous, holistic care throughout the journey to parenthood contributes to better outcomes. In other words, they can play a vital role for healthier parents and babies. 

As a part of the care team, “doulas help to keep the birthing person as calm and comfortable as possible as they journey through their birth. Doulas are there for the parents so a majority of their interactions will be with the parents themselves, though they do have conversations with the other providers with the shared goal of a healthy birth.” says Durfee.

Coordinated care helps in postpartum too

Doulas can help new parents acclimate to parenthood in the postpartum phase as well. The so-called fourth trimester is where parents lay the foundations for their future, and success in the first few weeks is critical to the health and wellbeing of the family, as well as the likelihood a birthing parent returns to work. Doulas can support new families, both the birthing parents and their partners, with things like sleep, feeding, and even changing a diaper. They can share information, help parents understand what they’re feeling and experiencing, and make recommendations when they should seek clinical care. 

The benefits of virtual doulas

There are a variety of well-documented reasons to implement doulas in your maternity benefits, especially among vulnerable populations, and in particular Black women, who can benefit from additional support and advocacy. However, doulas can be expensive, ranging from $300 to $3500 for their services. Virtual doulas, available through telehealth platforms like Maven, can cut out-of-pocket expenses for individuals while improving access. 

Modernizing maternity care

Doulas, as a part of the larger maternity care village, contribute to the modern maternal care journey. In tandem with other specialty providers like infant sleep coaches, lactation consultants, midwives, and more, their inclusion in the care plans for expecting parents can drive better outcomes for all, and ensure families can start on firm foundations for the future. 

Maven offers families 24/7 access to a robust network of doulas and other specialty providers through an easy-to-use telehealth platform that covers everything from prenatal care and fertility to maternity and postpartum care. To find out how Maven can help families in your organization, contact us today.