NEWS FROM AMERICA

How birth doulas have a beneficial effect on new mothers for months afterwards

Doulas, as you know, are far more common in America than in this country but even over the water they are still very much at the fringes of the healthcare professions. However, recent reports show that local government and hospital management are beginning to see in doulas a possible answer to financial and social problems surrounding hospital births.

A new American study has reported that the benefits of a doula attending a birth extend beyond the birthing room. Women in the study who had doulas during labour were assessed as more sensitive, loving and responsive to their infants two months later. Since doulas were assigned to the women at random, the study eliminated the possibility that women who chose doulas were innately more nurturing than the others in the study group, said Dr. Susan H. Landry, a psychologist at the University of Texas at Houston Medical Center who conducted the study. The University of Texas study included 104 pregnant women who were delivering their first babies at Ben Taub Hospital, a county hospital in Houston.

''I was surprised and really thrilled by the long-term findings,'' Dr. Landry said. ''It's very exciting that such a brief intervention could have such striking effects.''

In America, doula training consists of a three-day course that covers the anatomy and process of labour, as well as techniques for providing emotional and physical comfort to women in labour, according to Kathie Lindstron, president-elect of Doulas of North America, an international organisation that trains and certifies doulas. In addition, a doula must also attend at least three deliveries to be certified.

Doulas attend just 1 percent of all births in the US, but they are gaining wider acceptance by doctors, hospitals and insurance companies, according to Debra Pascali-Bonaro, a doula in River Vale, New Jersey, and spokeswoman for Doulas of North America. In the New York region, for example, the University Hospital and Medical Center at Stony Brook on Long Island is planning to have doulas on call 24 hours a day for women who give birth there.

''Doulas complement the work that midwives do,'' says Jane Arnold, director of midwifery services at University Hospital and Medical Center in Stony Brook. ''We usually can't be with a woman throughout her labour because we have more than one woman in labour at once. But a doula can be there all the time.''

Ms. Pascali-Bonaro says that doulas can be helpful even when a midwife or doctor is present. ''At moments when a woman in labour needs medical care, a doctor or midwife is busy providing medical support but a doula can offer emotional support,'' she said.

Doula services are covered by several insurance companies in New Jersey, including Provident Life, Ms. Pascali-Bonaro said. And Kaiser Permanente in Westchester is planning to provide doulas for at least some pregnant women in the next four months.

''We are trying to find innovative ways of lowering the Caesarean section rate,'' said Dr. David M. Ross, chief of obstetrics and gynaecology for Kaiser in White Plains. Kaiser feels the use of doulas ''will be well received by patients and will probably be cost-effective,'' he says.

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