According to Doulas of North America (DONA), International, which is the oldest and largest doula association in the United States, the word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to “a trained and experienced (and usually certified) professional, who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.” 

DONA, International defines the following functions for a birth doula:

• Recognizes birth as a key experience the mother will remember all her life
• Understands the physiology of birth and the emotional needs of a woman in labor
• Assists the woman in preparing for and carrying out her plans for birth
• Stays with the woman throughout the labor
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
• Facilitates communication between the laboring woman, her partner and her clinical care providers
• Perceives her role as nurturing and protecting the woman's memory of the birth experience
• Allows the woman's partner to participate at his/her comfort level

We support this beneficial support for the patient and recognize that the presence of a certified doula is associated with decreased use of analgesia, decreased incidence of operative birth, increased incidence of spontaneous delivery and increased maternal satisfaction in 15 trials involving 12,791 women. ^(1).

To facilitate involvement of patient-chosen support personnel, the Hospital’s Obstetric Nursing Policy, “Labor Coach/Doula” is attached for your review. We strongly recommend that all clinicians review the attached policy, distribute it to and speak to their patients about these issues before labor begins. Uppermost in our minds is the safety and quality of patient care. Doulas and other support people have a role to play at BWH, and the attached nursing policy clearly outlines the support roles that the doula may participate in and specifically states that “at no time may the labor coach/doula assume the responsibility for or engage in activities of the professional medical or nursing staff. An example of this is any uterine massage or vaginal perineal stretching and certainly not to act in any manner that excludes the nursing or medical staff. 

1. Berghella, V, Baxter JK, Chauhan SP. Evidence –based labor and delivery management. Am J Obstet Gynecol 2008: 112: 445-454 (page 450 specifically)