Why a doula is your BFF (BreastFeeding Friend)


“If a doula were a drug, it would be unethical not to use it.”  – John H. Kennell, MD

Doulas (trained support people for childbirth and postpartum) are associated with some great things:  shorter labors, less interventions, fewer c-sections, and a more positive birth experience overall.

But did you know that having a doula can help you meet your breastfeeding goals, too?  I’m happy to share just some of the evidence on how doulas can help you beat the Booby Traps.™

Can’t afford a doula?  Read on for some suggestions on finding a low cost or volunteer doula, and also for some evidence that having a trained close family member or friend can make a difference in your breastfeeding success.

Studies showing that doulas are your BFF:

A 2009 randomized controlled trial in a California hospital assigned mothers either standard care during labor or the addition of support from a doula.  Mothers with doula care also got two home visits from a doula.  Here’s what they found:

  • Mothers who had doulas were less likely to experience a delay in their milk coming in.
  • 68% of women receiving doula care and 54% of women receiving standard care were breastfeeding at 6 weeks.
  • For women with a “prenatal stressor” (history of substance abuse, tobacco use during pregnancy, depression or anxiety disorder, chronic health condition, pregnancy-induced, hypertension, gestational diabetes, or other serious pregnancy complications) mothers who had doulas were more than twice as likely to be breastfeeding at 6 weeks.

A 2009 study on the effect of doulas (called “Birth Sisters” in this hospital) on exclusive breastfeeding at a Massachusetts Baby Friendly Hospital found that mothers who had a Birth Sister had higher rates of exclusive breastfeeding, delayed their first formula feedings, and fed less formula overall.

What if a close friend of family member is trained as your doula?  A 2007 randomized controlled-trial found that when a mom’s close female friend or relative was “minimally trained” as a doula and supported her, she was more likely to initiate breastfeeding.

What special magic do doulas have that results in better breastfeeding outcomes?

This is an interesting question.  Is it that doulas actually support mothers in breastfeeding (by providing encouragement and practical help), or is it that they help mothers have births that are more supportive of breastfeeding?

The authors of the California study I mentioned above looked at this question and point out that in one randomized controlled trial, “the doulas did not provide any direct assistance with breastfeeding, yet by 6 weeks postpartum the intervention group was signi¢cantly more likely to be exclusively breastfeeding: 51.4% versus 29.3%.”

Can’t afford to hire a doula?

I asked Ananda Lowe, co-author of The Doula Guide to Birth: Secrets Every Pregnant Woman Should Know, to offer some suggestions for moms who can’t afford to hire a doula.  She writes:

Most doulas-in-training offer a reduced fee until they are certified.  A trainee has enough education in birth to be a valuable presence at a woman’s labor.  Contact the national doula organizations to find a trainee or an experienced doula, at www.cappa.net, www.dona.org, www.ictcmidwives.org, and www.tolabor.com.

Otherwise, ask a friend who had a positive birth experience or a natural childbirth to be at your birth.  Our culture thinks of birth as a private event between a woman and her mate, but hospitals are full of staff who are strangers.  In past eras, it was a woman’s experienced female friends who guided her through birth.  I strongly encourage women to bring a friend or two to their labor.  Birth is such an intense experience, and hospital procedures can seem so overwhelming, that it is probably asking too much of a pregnant woman and her mate to get through labor alone.

Did you have a doula for your birth?  Would you recommend it?







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5 Comments | Last revised on 06/30/2011

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