Traditionally, women helping women during labor has been part of the birthing process. Today, that tradition is continued by a group of trained caregivers called doulas who provide physical, emotional and educational support to mothers during pregnancy, labor and the early postpartum period.

The number of women using doula support is growing as they discover the benefits of working with a doula. Using a doula decreases first-time labor by an average of two hours, according to the Johnson & Johnson Pediatric Institute, which has launched an initiative called Mothering the Mother to encourage the use of doulas. Other benefits include decreased need for pain medication or medication to induce labor, a lower risk of postpartum depression, increased success in breastfeeding and reduced hospitalization time for infants. This evidence comes from data compiled from 14 randomized clinical trials involving more than 5,000 women. The data also highlights another important trend: studies show that the help of a doula can reduce the chance of a Cesarean section by as much as 50 percent.

Having a doula is appropriate for every type of birth situation, suggests Debra Pascali-Bonaro, a certified doula and president of MotherLove Inc. "Birth, no matter how it unfolds, is emotional, physical and spiritual," she says.

Pascali-Bonaro is the mother of five children and a founding member of Doulas of North America, which started with 30 members in 1992 and now has more than 5,000 members. Eighty hospitals across the nation have doula programs and many are grant funded or volunteer based. Pascali-Bonaro also sees an increase in the use of doulas internationally, including in the European Union and Brazil. Doulas are increasingly becoming an accepted and requested part of the birth team.

"Birth has always been more of a social event than a medical event," says Pascali-Bonaro. "We now have the advantage of integrating the social and the medical."

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