Views of Doulas, Childbirth Educators and Labor and Delivery Nurses on Each Other, Emotional Burnout and Quality Improvement: Results from the Maternity Support Survey
Megan M. Henley and Christine H. Morton
This presentation provides an overview of results from the Maternity Support Survey, the first cross-national survey of doulas, childbirth educators, and labor and delivery nurses across the United States and Canada. Despite research on the benefits of supportive care during pregnancy, childbirth and postpartum, most researchers have explored how mothers and families view this care, with less attention to the views and experiences of individuals who provide such care (Liva et al. 2012; Morton & Clift, 2014). Similarly, research on maternity care providers has largely focused on midwives and obstetricians, neglecting the important roles of labor and delivery nurses, childbirth educators, and doulas (Monari et al. 2008; Morton & Clift, 2014; Reime et al. 2004; Smith et al. 2009). As a result, previous studies have not systematically studied or compared the practices and perceptions of workers who provide informational, emotional and physical support and advocacy to pregnant women. To address this gap in the literature, the Maternity Support Survey asked maternity support workers (doulas, childbirth educators, labor and delivery nurses) for their views on typical childbirth practices, their sense of efficacy in their maternity support roles, their orientation toward maternity support as a job or career, and their experiences with the American or Canadian health care system. This presentation is designed to inform learners of key findings from the Maternity Support Survey. These findings can increase participants’ knowledge of notable differences between these roles in terms of attitudes toward childbirth practices and toward other maternity support roles.
How birth doulas help clients adapt to changes in circumstances, clinical care, and client preferences during labor.
Amram NL, Klein MC, Mok H, Simkin P, Lindstrom K, Grant J.
J Perinat Educ. 2014;23(2):96-103.
This study examined how doulas adapt to challenges in client’s labors. There were 104 Canadian and 92 American doulas who responded to a survey distributed at a doula conference. We report results from open-ended questions in which doulas describe how they manage changes deviating from the mother’s birth plan and how they navigate differences of opinion between themselves and providers. Four themes emerged: giving nonjudgmental support, assisting informed decision making, acting as a facilitator, and issues with advocacy. Although 30% of doulas said that advocacy and information giving could result in conflict with providers, doulas reported working within their scope of practice and striving to be part of the team. Issues in doula responsibility and patient advocacy remain, and ongoing role clarification is needed.
This recent article in the Journal of Perinatal Education focuses on how doulas help women adapt to unexpected changes in their birth plan during labor. The authors surveyed doulas attending a DONA International conference in Vancouver, Canada in 2008. In terms of interactions with care providers, the authors found that doulas acted according to the DONA International standard of practice.
According to the doulas surveyed, “support” does not mean supporting women through one set birth path, but supporting them through any turn labor may take and respecting the decisions of all others involved in the process. The Maternity Support Survey found that doulas were more likely than other support workers to have strong opinions about common labor practices such as epidurals, induction, and the use of Pitocin. Yet, the authors of this article found that doulas surveyed were able to put aside their personal opinions and focus on the desires of the women they serve.