20 February 2018
We are concerned that the term “doula” is being misused by certain quarters, and the Malaysian public being made to misunderstand the true function of a birth doula. Doula means a woman servant. It is a modern take of the support a birthing woman would normally receive in a village setting in the olden days – where typically her aunt, sister or neighbor would accompany her while she birthed. Today a doula is a professional birth companion who provides physical, emotional and informational continuous support before, during and shortly after childbirth.
Having the presence of a doula during birth has been shown to reduce the incidence of medical intervention such as pitocin and epidural anaelgesia; mothers have shorter labours, fewer cesarean sections and a more satisfying birth experience; and babies tend to have higher Apgar scores (Hodnett et al). In a joint statement on reducing primary cesarean delivery, the American College of Obstetricians & Gynecologists (ACOG) and the Society for Maternal Fetal Medicine declared in 2014, “[O]ne of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.” The latest WHO recommendations on Intrapartum Care for a Positive Childbirth Experience (2018) recommends that all women be accompanied by a companion of choice such as a doula throughout labour and childbirth.
A doula does not perform any medical or clinical duties and cannot give medical advice. A doula is not able to make decisions for the birthing mother, but instead provides mothers with information to help her make informed decisions. Therefore doulas do not take the place of a trained medical professional.
In Malaysia, there have been certain individuals who attend unassisted births who claim to be doulas. (An unassisted birth or free birth happens when the birthing person chooses not to be assisted by a medical professional such as a qualified midwife or doctor during birth.) This gives a false sense of security to the birthing family, as the doula is unable to recognize and take appropriate action in the case a medical emergency arises. These individuals do not necessarily represent the doula profession.
Doulas work hard to maintain a good working relationship with obstetricians and maternity ward staff, as we are cognizant that we are all part of the birthing woman’s birth team, and the smooth working of the team is paramount to a good outcome. A doula does not override the authority of the medical staff, but rather ensures that the birthing woman’s birth preferences are supported within the maternity healthcare system. Hospitals such as Pantai Bangsar Kuala Lumpur, Pantai Cheras, Gleneagles KL have all been welcoming and working well with doulas for the past nine years. We look forward to a continued good working relationship with the maternity healthcare system, and hope that the public can come to understand the benefits of having a doula during birth.
The Gentle Birthing Group Doulas