NY Times looks at doulas

• And the doula makes four

The New York Times takes a look at doulas... and it remains skeptical. The recent piece adopts an overall hostile attitude toward doulas and doesn't really try to be comprehensive. They never even nail down the purpose of the doula.

In short, a doula is a non-medical professional who aids during the labor process. There are also some postpartum doulas out there as well. A doula serves as a patient advocate, labor coach, and general helper. They have knowledge and training on birthing, but aren't medical professionals.

With our two kids, we didn't use a doula, but have known others who have. Indeed, sometimes during labor an extra pair of hands and ears can be helpful. Since it is unlikely that the nursing staff at a hospital have spent more than a few minutes discussing the birth plan with the patient, it may not be a bad idea in some cases to have someone experienced and independent advocating on their behalf. The doctor-knows-best mentality here is a relic from the '70s I suspect.

If there is a pattern of a problem of doulas overstepping boundaries by making medical determinations and giving medical advise for which they are untrained and unlicensed, that would probably require some action. (e.g. enforcement of current laws, adoption of new laws clarifying medical practice, or regulation of doulas.) The New York Times isn't successfully persuasive that there is any pattern of abuse. Yes, a doula walking out on a patient after she chose an intervention the doula didn't like is incredibly unprofessional and unethical. But even collecting a handful of these troubling anecdotes, it doesn't seem to follow in any case that doulas are generally harmful.

The article implies that since they have stories of some patients and hospital staff who were unhappy with the performance of some doulas, that they shouldn't be permitted. I'm sure we can find plenty of patients with negative experiences with a doctor or a nurse, but no one would reasonably suggest we need to remove doctors or nurses from hospitals.

On the other side, you can see the point of view of doulas at DONA International. They cite research that shows how the use of a doula leads to births with fewer complications and medical interventions. If a patient can choose to bring in family members in the room, I don't see why they shouldn't be able to choose to bring a doula.