Download Volunteer Doula Project Executive Summary

The case for a Volunteer Doula Programme in Leith
Executive Summary
Overview
Doula care is emerging as an effective way to provide consistent emotional and
physical non-clinical support from the last trimester of pregnancy through to the first
six weeks post-partum. An examination of the evidence shows that doula care
significantly reduces medical interventions in labour, shortens active labour, improves
maternal self-efficacy and increases breastfeeding rates.
Doula care is historically a private service which must be purchased. As this has
proved to be a barrier for some women, there has been a move towards innovative
programmes that train women as doulas who then volunteer their services.
This report explores the evidence-base of doula care, the implementation of a
volunteer doula programme in Hull and how this model could be applied to address
the needs of vulnerable pregnant women in Leith.
Doula Care defined
A doula is a trained and experienced partner who accompanies a woman through
pregnancy, childbirth and the first three weeks of family life. It is important to stress
that a doula does not take the place of medical care. A doula’s speciality is to provide
emotional and physical support throughout pregnancy and birth.
Doulas work with a woman and her partner to:
 Establish a birth plan and discuss expectations surrounding labour and birth
in the last trimester
 Provide constant emotional and physical support during labour and the first
hours after birth
 Provide support and advice during the first six weeks after birth
 Refer the family to any services that are indicated
Doula care and tackling health inequalities
The Greater Glasgow and Clyde Inequalities Sensitive Practice Initiative (2009)
recently released a qualitative study examining the experiences of vulnerable
childbearing women. These women reported feeling like an “outsider” and had
difficulty communicating their wishes to care providers. They expressed a need to
become involved in their care and become part of the decision making process as
opposed to being recipients of care.
In order to respond to the needs of vulnerable women this report advocated services
that would respond to their specific and complex needs. It emphasised quality
interpersonal communication and relationship building as the way to achieve this.
In Hull, Green (2008) conducted a qualitative study involving 39 women who had
participated in the Goodwin Volunteer Doula project either as expectant mothers or
volunteer doulas. The expectant mothers highly valued “having someone there” who
was on their “side”. They often reported developing a supportive relationship with
their doula and feelings of personal empowerment. The report concluded that the
160-162 Great Junction Street
Leith, Scotland
EH6 5LJ
Charity Number: SCO 36721
Company Number: 278505
programme was a beneficial service to both childbearing women and volunteers
doulas and suggests that this program has the potential to complement current
maternity services.
Doula Care: the evidence base
This report discusses 3 systematic reviews and several individual studies examining
the effectiveness of constant support during labour and Doula care.
All research has shown a marked decrease in obstetric interventions such as
caesarean sections, forceps and vacuum delivery, oxytocin induction and use of
epidural anaesthesia when consistent care was a part of the labour process.
Example of Excellence: The Goodwin Volunteer Doula Project, Hull.
The first UK volunteer doula programme has been implemented in Hull, through Sure
Start funding and specifically supports women who suffer health inequalities. To date,
50% of the women supported by volunteer doulas are from the immigrant community
with the other 50% generally presenting with complex needs surrounding drug
misuse, teenage pregnancy, and sex work.
Since 2005, the project has supported 190 women and currently holds a
breastfeeding initiation rate of 73% with 52% of supported mothers continuing to
breastfeed at 6 weeks.
National support for this project has culminated in a financial contribution from the
DOH of £270,000 over three years to roll-out this programme in 8 locations
throughout England.
Moving Forward
The success of a volunteer doula project will largely depend on the strength of the
support of its partners and a strong belief in its ethos. Therefore, it is important that
buy-in is achieved in both the public and voluntary sectors. Following this study, it is
recommended that a working group is formed comprising of voluntary agency
representation, NHS staff (midwives, general practitioners, health visitors) and
relevant council and government representatives.
Conclusion
This report provides robust evidence that supports the implementation of a voluntary
doula project in Scotland. The outcomes of a volunteer doula project would greatly
benefit vulnerable women who are pregnant by providing the ability to fully participate
in their care, the advocacy to inform and support their decisions resulting in holistic
care that reflects their individual needs.
The ethos surrounding doula care and its firm evidence base provides an easy fit into
many current government targets and policies, for example, HEAT breastfeeding
targets, the Equally Well strategy, Better Health, Better Care and current NHS
maternity targets.
160-162 Great Junction Street
Leith, Scotland
EH6 5LJ
Charity Number: SCO 36721
Company Number: 278505
Any questions, queries or requests for the full report may be directed to:
Sam Anderson, Co-ordinator
The Junction: Young People, Health and Well Being
160-162 Great Junction Street
Leith, Scotland
EH6 5LJ
0131 553 0570
[email protected]
Or
Shauna Powers
Health Promotion Specialist
NHS Lothian Health Promotion Services
[email protected]
0131 536 3500
References
Greater Glasgow and Clyde. 2009. Inequalities Sensitive Practice Initiative: Analysis of the
Maternity Services User Engagement Survey, Final Report. Dalian House: Glasgow
Green, J. 2008. Volunteer Doulas for women in a Sure Start area: What does the service
mean to them?. University of Hull: Hull.
Goodwin Volunteer Doula Project: http://www.goodwindoulas.org/
160-162 Great Junction Street
Leith, Scotland
EH6 5LJ
Charity Number: SCO 36721
Company Number: 278505