birth,  doula

The Power of the Continuous Presence

The loss of continuous presence

It goes without saying a huge part of the role of a doula is her ability to patiently abide in the presence of a laboring mom. The doula’s sympathetic presence alone unlocks a treasure chest of comfort and strength for a mother experiencing childbirth. But why is this so? What is the psychology behind the phenomenon of a continuous presence?

Let’s look at history. From the beginning of time we see from art depictions and historical texts women attended by other women during birth – often a midwife along with female attendants –  most likely the birthing woman’s friends. When birth moved into the hospitals at the turn of the century, the idea of having close friends nearby during labor and birth seemed unnecessary and not needed.

Continuous presence: the doula

roman birth
A Roman midwife from the port of Ostia is depicted at her work on a terracotta plaque from her tomb.

As the years passed, it became apparent a key piece of the puzzle was missing for the laboring mothers.  It was the support for their emotional and physical well.  During the 1970’s a pediatrician by the name of Dr. Kennell did research in a Guatemalan hospital. His research centered on women giving birth in the hospital.  The women who were attended by a sympathetic and encouraging woman during their labors and births. They delivered their babies faster and had fewer complications.

This laid the foundation for the continuous presence known as the doula.  Today, we know that having a doula present can provide the following benefits:

  • 50% reduction in cesarean rate
  • 25% shorter labor
  • 60% reduction in epidural requests
  • 30% reduction in pain medication use
  • 40% reduction in forceps delivery
  • 40% reduction in oxytocin (pitocin) use

Not only are  physical benefits associated with the presence of a doula, women who have a doula are more emotionally satisfied with their births than women who were not supported.

The continuous presence of a doula during labor is an asset to birth, benefiting the laboring mother’s emotional and physical well being before, during and, after birth.

It is only fitting that this post finishes with the wise words of Dr. Kennell:

If a doula were a drug, it would be unethical not to use it.
~ John H. Kennell, MD



Marcie Hadley, CD(DONA), PCD(DONA), CLC, and LCCE(LAMAZE), has been serving families since 2010. She especially enjoys getting to know her families, meeting their unique needs, and sharing evidence-based care information. Marcie has worked with unmedicated, medicated, C-section, family friendly C-Section, and VBAC labors, Her postpartum experience includes working with families of first children to families of 10. She has worked with mothers who have experienced postpartum depression and illness following birth. Her goal is to empower mothers in their own mothering wisdom.

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