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About Mothertree: Doulas, a History

"Creating a Culture of Nurturing — one baby, one family, & one doula at a time."​

Doulas, a History

Birth companionship has dated back to the dawn of humankind.

Global Recognition
Today there are multiple organizations all over the world training birth and postpartum doulas and dozens of books about doula care that has been modernized for contemporary audiences and inclusivity. Doulas are gaining recognition by integrating into the system through Medicaid Provider Reimbursement  , employer based reimbursement and even Military Insurance reimbursement. Currently there is no national certification or designation for doulas. 
 
What does the word "Doula" mean?

From Greek for “A Person of Service”

The term “doula” is a Greek word that refers to “a person of service.” It was coined in the 1970s by the American anthropologist Dana Raphael, who was a strong proponent of postpartum support. Raphael used the term “doula” in her book, The Tender Gift: Breastfeeding, to describe the vital role of non-medical care-givers who offer support to parents during the postpartum. Today a  “doula” refers to a professional trained to provide emotional, physical and informational support to pregnant people and parents  throughout their pregnancy, birth and the early postpartum period. The word has even been popularized to all kinds of “support” through peak life experiences “death” doula, “divorce” doula and so forth. 

Support for Continuous Care

Not long after, Dr. Marshall Klaus and Dr. John Kennell began conducting research on the medical outcomes of childbirth when continuous care is provided throughout labor by a non-medical support person. Klaus and Kennel also adopted the term “doula” to refer to these birth companions and their research revealed significant medical benefits to doula-assisted births. In their studies, Drs. Klaus and Kennell also discovered the benefits of continuous emotional and physical support from another person in labor. The pair conducted the earliest controlled trials examining the effects of continuous support on labor outcomes. The results were impressive. What was this magic that labor support professionals seemed to bring to improve outcomes for people and their babies?
The History Of Doulas
As long as humans have given birth community members, family and midwives  come to support, guide and care for their birthing people. In the modernization of medical care, as birth moved from home to hospital, the role of intimate labor support was excluded as medicalization of childbirth took priority. 
The need for continued support still existed however and in the 1970’s a movement to return to “humanized birth” grew,  considering birthing people’s values, beliefs, and feelings and respecting their dignity and autonomy during the birthing process
Doulas and their grassroots professionalism as initiated from the desire to reducing over-medicalized childbirths, empowering women and the use of evidence-based maternity practice are strategies that promote humanized birth. Doulas have been gaining recognition and integral status as  Traditional Health Workers especially in the 2000’s as solutions the growing maternal and infant mortality and morbidity crisis  has grown around the world.

Penny Simkin, one of the most influential leaders in developing the profession,  self-published the book: The Birth Partner: Everything You Need To Know To Help A Woman Through Childbirth in 1989. This text helped to popularize doulas and their important role in the birth room became a seminal read and  important introduction in updated editions today for both parents and professionals alike.   

  A few years later in 1992, Doulas Of North America (DONA International) was founded and it was the first organization to train and certify birth and postpartum doulas. Then in 1993, Klaus, Klaus, and Kennel published their landmark book: Mothering The Mother: How A Doula Can Help You Have A Shorter, Easier, and Healthier Birth.

MotherTree Mission and Philosophy - inset

Jesse’s early training was side by side with the esteemed Penny Simkin in her home. Penny taught Jesse the power of a question as one of the most significant ways we can change the birthing culture. 

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What is a...

Antepartum Doula

An antepartum (before birth) doula provides physical and emotional support to the parent or birthing person who most commonly are experiencing high risk pregnancies: medical or psychological issues anytime during the pregnancy. This can include pregnancy complications, including multiple babies, and are confined to bed rest up to 20 weeks.

The doula will help with household organization, meal preparation, care of older sibling(s), errands, and general companionship. The doula is educated in normal pregnancy and complications, and is skilled in ways to support the pregnant person physically and mentally, and how to provide care to the entire family. Building a trusted relationship, the doula often lowers levels of stress and anxiety and increases preparedness for the steps to come in birth and postpartum as well as provides advocacy and support around pregnancy and birthing options.

History of Birth Doulas

Birth Doula

A Birth Doula,  is a trained professional birth companion who provides personal, nonmedical support to birthing people and families throughout a birthing person’s pregnancy, childbirth, and postpartum experience with an emphasis on the birth event itself.

The doula will help with household organization, meal preparation, care of older sibling(s), errands, and general companionship. The doula is educated in normal pregnancy and complications, and is skilled in ways to support the pregnant person physically and mentally, and how to provide care to the entire family. Building a trusted relationship, the doula often lowers levels of stress and anxiety and increases preparedness for the steps to come in birth and postpartum as well as provides advocacy and support around pregnancy and birthing options.

 

Birth doulas are being recognized around the world and nationally in the US as integration of their care into the health system as traditional healthcare workers, medicaid providers, insurance coverage and employer reimbursement.

Like travel guides in a foreign country, birth and postpartum doulas help support new families through the life changing experience of having a baby!

Birth doulas  offer physical comfort measures, informational support, advocacy and emotional relaxation support. They often include prenatal visits that emphasize preparation and education for birth. Their continuous support throughout labor will include a toolset of labor positions, comfort massage, hydrotherapy, emotional support, reassurance, visualization and evidence based information. Postpartum home visits often include  nurturing, education and referrals for mental health and physical recovery needs (see below).

Postpartum Doula

A postpartum doula is professionally trained in the needs of the family in the 4th trimester after birth. In  the days, weeks, and months after birth a postpartum doula offers non-judgmental support and guidance during the tender postpartum period  as the family adjusts to the stressors of caring for a newborn, feeding, sleepless nights, recovery from labor and delivery, baby blues or postpartum mood and anxiety disorders. 

Offering Nurturing, Education, Assessment and Referral, a postpartum doula’s role may include emotional support, newborn care during the day or night, evidence based information on the range of normal, feeding support, babywearing support, and physical support including meal preparation, laundry, light housekeeping, running errands, and child care for older children. Many families utilize this care when other caregivers are not available, when recovering from a difficult birth or with twins and multiples.

Sometimes the same doula  provides birth and postpartum support and can provide the continuity of care that comes with knowing a families entire journey through the childbearing year.

Sibling Doula

A sibling doula provides on-call child care for the siblings  of the expecting infant, and much like birth doulas they go on call to be available day or night to support the family as they transition into the laboring time. 

A sibling doula visits during pregnancy to spend time with the children, learn about their schedules and activities, and get a tour of your home. They have the skills of a doula while bringing a special reassurance that allows the parents to focus on the birth without worrying about other siblings –especially if they cannot secure family or friends or other caregivers or don’t wish to disrupt the children’s routines when labor happens in the middle of the night.

Full-spectrum Doula

A full spectrum doula provides nonjudgemental client-centered support services for a variety of reproductive circumstances including fertility, antepartum, birth, postpartum, miscarriage, abortion, stillbirth, surrogacy, and adoption.

Some doulas also branch into Fertility or Sex Doula work which is helping families with emotional comfort measures, information and physical suggestions to support fertility or sexual intimacy anytime in the childbearing year.

Bereavement Doula

A bereavement doula provides support to families who have experienced loss on any level that impacts their pregnancy, birth or postpartum journey. 

For some this can be  an anticipated loss of their baby in cases of miscarriage, stillbirth, or a diagnosis in which the baby is not likely to live long after birth. For others it can be the loss of a spouse or significant other in their lives that impacts their well-being.

In the case of infant loss, Bereavement doulas can provide information on what to expect, gently encourage parents to bond with their baby and create meaningful memories, and offer resources for families experiencing loss. A bereavement doula walks with families on their journey through loss offering lots of emotional support and  a safe space to grieve and talk through the choices available to them.

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JOIN THE CONVERSATION

Private Facebook Group: Doula Talk

This is a forum for connection, support and sustainability of the doula profession and welcomes all people of any color, gender and birth philosophy. Founder and Administrator Jesse Remer is a mother, international doula trainer, leader and innovator of birth justice who through her organization Mother Tree International has supported thousands of birthing families.