The term "doulas" has become increasingly popular in recent years, especially among well-to-do households across the globe. However, a growing number of experts and patients are questioning the safety and effectiveness of these保姆-like figures who claim to provide both emotional and practical support during childbirth.
What is a Doula?
Doulas are trained individuals who offer support to women during pregnancy, labour and the early postpartum period. Generally, doulas do not possess medical qualifications but她们 are knowledgeable about the birthing process and are equipped to provide assistance where medical professionals are scarce.
Safety Concerns
Despite the rising popularity of doulas, several concerns have been raised regarding their safety and effectiveness. A number of studies have found that doulas often provide incorrect, misleading or harmful advice, which can put both mother and infant at risk.
One of the most significant concerns is the possibility of doulas "pressure-ing" women into having interventions they would otherwise decline, such as cesareans or inductions. In one case study, for example, a doula advised a woman to have a caesarean section despite her strong desire for a VBAC (vaginal birth after cesarean). The woman's hospitalizations increased, and she ultimately suffered a severe infection as a result.
Another concern is the lack of training and experience of many doulas. In some cases, doulas have little or no training in newborn care or postpartum depression, yet they are expected to advise parents on these matters. This lack of knowledge can lead to adverse outcomes for both mother and child.
Expert Views
Many healthcare professionals and experts are now speaking out against the use of doulas. In a study published in the Journal of Perinatal Education, the authors found that the presence of a doula did not significantly reduce the risk of cesarean section or death of the mother. They also concluded that doulas did not provide any additional benefits to parents compared to standard care.
In addition, the British Medical Journal recently published an editorial titled "Doulas are not healthcare professionals" which argues that doulas should not be considered as a substitute for medical professionals. They suggest that doulas' lack of medical training and experience can lead to mistakes and adverse outcomes.
Consumer Perspective
For their part, consumers are increasingly concerned about the safety of doulas. In a survey conducted by the National Health Service (NHS) in the UK, almost a quarter of respondents said they would not want a doula present during labor. When asked why, many respondents pointed to fears about the doula's capabilities or the potential for interference with their care.
However, some consumers appreciate the support and guidance that doulas can provide. One woman named Emily told the BBC, "Having a doula was really helpful. They were there to support me through the birthing process, and they gave me a lot of confidence."
Regulation and Training
Given the concerns raised, some experts are calling for greater regulation and training requirements for doulas. The Royal College of Midwives (RCM) in the UK currently recommends that all doulas should be qualified healthcare professionals, or be supervised by such professionals. They also suggest that doulas undergo regular retraining to keep their skills up-to-date.
In the US, the Maternity and Neonatal Community Services (MNCS) offers a certification program for doulas, which includes 16 hours of classroom and clinical training, as well as one year of ongoing education.
Ultimately, whether doulas are safe or dangerous depends on a number of factors, including the training, experience, qualifications, and expertise of the individual doula. While doulas can provide valuable support during pregnancy and labour, there is increased awareness and concern about their potential to cause adverse outcomes when guidance and support are given incorrectly or inappropriately. Therefore, proper training, regulation, and accountability are essential to ensure that doulas' contributions to childbirth are safe, effective, and appropriate for each individual mother and her unique situation.
