Doulas are to be distinguished from labor nurses in that they perform no clinical tasks nor do they assist with traditional nursing functions. Doulas are also to be distinguished from midwives or obstetricians, as they perform no medical tasks nor do they assist in the actual physical act of the birth. The role of the doula is to provide emotional support, companionship, physical comfort measures and encouragement during labor and delivery. In fact, one recent randomized trial of hospital-based doulas found that over half the women rated the doula as more useful than their husband during labor. 1 Doulas are readily available and becoming more popular.
Some hospitals provide access to doula care, although most are arranged by private contract.
Frequently, the interaction will be minimal or nonexistent, as many doulas are strongly committed to nonpharmacologic methods of pain control, and many patients who seek doula support are equally committed to attempting a medication-free labor. While some doulas will limit their client base to those women who only desire to labor without medications, it is not the role of the doula to make this decision for the woman. It is not the role of the doula to discourage the mother from her choices. The comfort and reassurance offered by the doula are beneficial regardless of the use of pain medication. Some obstetric anesthesiologists are of the belief that doulas will exert undue pressure on women to avoid epidural analgesia.