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J Obstet Gynaecol Can. 2010 Jul;32(7):642-9.

The life of a Canadian doula: successes, confusion, and conflict.

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Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON.



Despite evidence that doulas improve maternal and newborn outcomes, some maternity care professionals have had difficulty both in understanding the role of doulas and in accepting doulas as collaborators. We sought to examine the backgrounds, practices, and professional motivations of doulas and to understand their role and interactions with other maternity care providers.


We conducted a postal survey of 212 Canadian doulas whose contact information was provided by DONA International. The main outcome measures of the survey were demographics, practices, motivations, perception of working environment, interactions with and acceptance by other maternity care providers, and overall work satisfaction.


The most common reasons for becoming a doula were the desire to support women in childbirth, personal interest, and a wish to share their own positive birth experience with others. Only 21.7% described the doula role as a means of achieving personal financial support. Most respondents intended to continue doula work in the next five years. Doulas felt more accepted by midwives than other care providers. Most doulas reported no conflict with other maternity care providers, but on rare occasions, doulas had been excluded from attending birth by maternity care providers, hospital and/or administrative regulations, and rarely by a client. Almost all doulas (98.5%) rated their overall professional experience as good or excellent.


Better recognition and respect from other providers significantly influenced doulas' satisfaction. This study helps clarify areas of possible conflict and obstacles that doulas may face in their work environment and in their interactions with other maternity care providers.

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