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Encounter with a doula: is the system failing new mothers?

BMJ 2009; 339 doi: (Published 02 December 2009) Cite this as: BMJ 2009;339:b5112
  1. Abhijoy Chakladar, anaesthetic trainee, department of anaesthesia, Worthing Hospital, West Sussex
  1. abhijoy.chakladar{at}

    “Anyone know what a doula is?” I asked in the coffee room. I was met with a roomful of blank faces. Earlier, during the morning obstetric meeting, a midwife told me that her patient had a doula. “A what?” I asked. “You know,” she said, “a birthing partner.” I didn’t know; anyway, isn’t that the job of the partner or the baby’s grandmother?

    The word doula derives from the ancient Greek for “woman of service.” Recently it has been used to describe experienced women who help mothers care for newborn infants; the role now extends to attending prenatal classes and the birth itself.

    On this occasion an epidural had been inserted as per the birth plan, and I was called to assess the patient’s analgesia, as she complained of discomfort. I found a missed segment and planned an epidural bolus with repositioning. The doula had been present since admission, as had the husband. Both the mother and father were confident and articulate, so I couldn’t help but wonder why they needed to pay for support.

    In my practice the mother is the principal focus, but I address the couple together, recognising their joint experience of bringing a new life into the world. I found myself disconcerted by the doula’s presence, as I was unfamiliar with …

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