Postpartum doulas: Motivations and perceptions of practice

Objective: to describe the perceptions of a US cohort of experienced birth doulas who were among the first in the country to be trained to provide postpartum support. Design: a qualitative, longitudinal study using ethnographic methods; participant observation and semi-structured interviews. Setting: midwestern, urban, US; postpartum home care over three months. Participants: four postpartum doulas; 13 families. Measurements: participant observation during six postpartum home visits per family; 13 semi-structured interviews with doulas at the completion of each family's care; four summative interviews with doulas at the end of the study. Findings: when describing their postpartum practice, four themes emerged: supporting women, taking the mother's perspective, empowering women and empowering families. When speaking of the motivations, three themes emerged: being 'called' to practice, interest in preventing negative experiences, and career development. Key conclusions and implications for practice: in the US, new mothers see midwives and doctors sporadically after discharge from the hospital. Postpartum doulas fill this gap in continuity of care by providing support for families as they transition to life with their new infant. Understanding the beliefs, values and practices of these important paraprofessionals will help midwives effectively integrate postpartum doula care into the care of women and infants. (c) 2010 Elsevier Ltd. All rights reserved.