The aim of this descriptive, qualitative study is to describe the content and process of postpartum doula care from the perspective of women receiving care and the doulas providing care. Historically, in nearly every culture, women have been supported by a """"""""doula,"""""""" an experienced laywoman who provides continuous support during labor, delivery and the postpartum period. In the last 20 years, several studies and two Meta analyses of randomized trials have examined continuous support during labor by midwives, nurses, or trained lay-persons (doulas). No known studies have examined either the content or outcomes of doula support during the postpartum period. While the intrapartum studies have consistently found positive effects on decreasing medical interventions and increasing satisfaction, few have examined psychosocial effects or effects on the infant. In a few studies, mothers were found to be more likely to breastfeed, have higher self-esteem, more positive mother-infant interaction, and less depression and lower anxiety in the postpartum period. Based on inferences drawn from this limited evidence about the potential benefits of doula care in the postpartum period, postpartum doula care is being provided by doulas throughout the United States and Canada. Some insurance companies cover postpartum doulas, but not birth doulas. Before this care becomes institutionalized in practice, studies are needed that examine outcomes of postpartum doula care. However, it is necessary to document the content, process and meaning of postpartum doula care before outcomes can be studied systematically. In this study, the content, process and meaning of postpartum doula care will be documented using ethnographic methods. Data will be obtained through observation of doulas as they administer care during postpartum home visits and through in-depth interviews with mothers and doulas. Maternal and doula narratives, and responses to questions exploring maternal sensitivity and sense of self as parent will be coded for themes and patterns reflecting the meaning and importance of doula care. Perceptions about the content and process of providing supportive care will be triangulated with field observations to ensure a holistic description of postpartum doula care. Findings from this study will provide the foundation for continued theoretical examination of this type of care and will provide the basis for future outcome studies of postpartum doula care for women and their infants. ? ?
| Campbell-Voytal, Kimberly; Fry McComish, Judith; Visger, Joan M et al. (2011) Postpartum doulas: motivations and perceptions of practice. Midwifery 27:e214-21 |
| McComish, Judith Fry; Visger, Joan M (2009) Domains of postpartum doula care and maternal responsiveness and competence. J Obstet Gynecol Neonatal Nurs 38:148-56 |
