"Doula" is a word that does not appear in the dictionary of the Royal Academy but that has become popular in recent years. Doulas are women, mostly mothers, who accompany other women during pregnancy, childbirth and the puerperium, offering support, both physical and emotional.
But are these women properly trained for this function? The General Nursing Council has just published the "Doulas Report" to answer no and to denounce the professional intrusion of this figure and the risks involved in some cases.
According to the Council, doulas can put the safety and health of women and their babies at risk, that is the conclusion they reached after an almost three-year investigation carried out by a multidisciplinary group of experts, consisting of nurses (generalists and midwives) and lawyers specializing in Health Law and Criminal Law.
To get started, the figure of the doula does not legally exist in Spain because there is no law or regulation that determines what training or what skills these people should have. Faced with this, the midwives would be the health professionals who, with six years of academic and professional training, are those indicated to care for pregnant women and their babies.
It has been a while since Nursing has spoken of professional intrusion and it has already been stated that the doulas cannot be considered a health profession and today this report has gathered the necessary information to confirm these facts and take them to the State Attorney General's Office.
The courses to become doula have no official recognition and yet they are very expensive and accredit these women to perform a job for which there are other better prepared figures, according to the General Nursing Council. A work that is also expensive, since the doulas charge for a full service of assistance in childbirth and postpartum about 1,200 euros.
And it is not bad if someone wants to spend that money, but the problem comes, I think, at the moment when that doula's work can put the woman or her child at risk.
Content of the "Doulas Report"
The doulas, according to the report, intend to offer women midwifery skills, such as health education (childbirth preparation courses, suggesting favorable exercises and postures during pregnancy, childbirth and postpartum ...) and the assistance itself: diagnose and carry out the control and follow-up of normal pregnancy, assist with counting of contractions and pain management in childbirth, newborn care ...
Today we had access to the Doulas Report website that collects all the information and the Twitter account of the General Nursing Council is fuming, these are some of the phrases they have left on the "Doulas Report":
- Does a doula know how to interpret an analytical or an ultrasound after doing a weekend course? What risk does the mother take?
- In a typically sectarian behavior, the doulas try to separate the father from the gestation and birth process.
- The serious risks to the health of the mother and the child in the hands of a doula in #InformeDoulas.
- A midwife has studied a 4-year degree and two specialization. Doulas are a housewife, dancer, historian ...
- The doulas invite not to cut the umbilical cord and that the child remains tied to a placenta rotting in a village.
Is about pretty sensational headlines and of which even some nursing professionals have been unmarked. Other statements that scare and have moved many of the people who trust the doulas to raise their voice against this document are made in the press report:
Sectarian rites and contrary to public health: They recommend eating the placenta or encapsulating it; Do not cut the placenta until it comes off, forcing the baby to live with it despite its rot or cut the cord with a candle; The pregnant woman does not allow gynecological exams or does not vaccinate the newborn.
His performance endangers the life of the mother and her son: hemorrhages not detected, hypoxia, sepsis, stroke, liver breakage.
It really scares to think how bad the doulas do and I don't think it's something widespread. But I think that from Nursing they are right to claim that the situation of this figure be regularized (if necessary) so that the mother or her baby is not put at risk. And it is that even the Ministry of Health includes the doulas in its "Strategy of normal delivery care in the National Health System".
To prepare the Report they have based on the tracking on different websites and networks that talk about doulas, offer their services, their characteristics are listed ... What I miss are specific data in some sections, what health problems have there been in particular for the bad performance of the doulas? Are there no "official" data on it? Or is there no cases?
Not so good, not so bad ...
And we ask ourselves more questions ... Does all this mean that no midwife or nurse will put the health of pregnant women or their children at risk? Well, unfortunately not, we can all make mistakes and we also have to recycle, renew, always continue to form and meet the scientific evidence and health recommendations of organizations such as WHO.
Nor is it that obstetric violence has been invented by the doulas (as suggested in the report), the "followers" of natural upbringing, childbirth at home or as we want to say, unfortunately it exists and we have to raise our voice against it , but it is not widespread.
I recently learned about the experience of a mother who, with the assistance of a doula, was very afraid of everything that sounded like a doctor and hospital, until she had to go when the birth was complicated and saw that it was not as it had been painted . In his words, they had conditioned him not to go to the health staff.
I do not say that this is common and I am sure that there are numerous aspects in which many doulas could help mothers in a different way than most midwives or nurses do (I refer above all to issues of support, closeness ...); but this does not happen the other way around, simply because the doulas do not have adequate medical training.
So, wouldn't a coexistence be possible, as in other health systems? Couldn't they play complementary roles? The midwife, as a healthcare professional, can attend the delivery. The doula, as a woman trained in motherhood, could physically and emotionally accompany the pregnant woman who wants it. I think so, the problem is when one wants to impose or replace the other.
Definitely, the Doulas Report aims to highlight the lack of regulated training of the doulas and, in quite a few cases, the erroneous actions that they carry out and the competences they assume, which the current regulations attribute to midwives.
Official Site | Doulas Report
In Babies and more | Doula in childbirth, Ten facts about midwives in the world
