Public Release:  Community doulas can be a big help for mother-baby relationships

University of Chicago

Young mothers are more likely to breastfeed and have positive relationships with their babies when they have another woman "mothering" them in the delivery room, according to new research at the University of Chicago on the value of doulas--women who help with deliveries and early care for mothers and babies.

The assistance from doulas is particularly valuable to young mothers from disadvantaged backgrounds. Those mothers sometimes receive help from women known as community doulas, who are from similar backgrounds as the young women and who visit them weekly for several months before and after delivery.

"Follow-up interviews and observations of disadvantaged young women who received help from a community doula demonstrated that mothers showed more positive emotions and were more encouraging of their four-month-old infants' learning than were similar women who did not receive the help," said Sydney Hans, the Samuel Deutsch Professor at the University of Chicago School of Social Service Administration.

"In addition, infants whose mothers had been assigned to the doula intervention were less likely than were infants in the comparison group to have long periods of distress," added Hans, who is lead author of two recently published scientific studies that are the first to look at the value of the work of community doulas.

For this research, the team enrolled 248 mostly low-income African American women. Half received normal prenatal care, and the other half received weekly visits from doulas from before birth to three months after birth. During their visits, the doulas, who received 10 weeks of training, discussed pregnancy, health, childbirth preparation and bonding. They were present at the child's birth and discussed child development during postpartum visits.

In examining breastfeeding, Hans' article, published in the journal Pediatrics, showed that 64 percent of mothers who were assisted by a doula breastfed, compared with 50 percent of the mothers in the control group. The mothers with doulas were also nearly twice as likely to continue breastfeeding longer than six weeks, Hans found in the November 2013 study. Breastfeeding has been shown to reduce infections and childhood obesity.

"The doulas were present in the first moments after the birth to encourage mothers to put the infant to breast and to help the infants latch," Hans wrote in the Pediatrics article, "Breastfeeding and Complementary Food: Randomized Trial of Community Doula Home Visiting." That study also showed that the women were less likely to introduce solid food earlier than recommended for their babies.

Hans and her team also wrote about the value of community doulas and the possible reasons for their success in creating positive mother-baby relationships in "Promoting Positive Mother-Infant Relationships: A Randomized Trial of Community Doula Support for Young Mothers," published in August 2013 in the Infant Mental Health Journal.

"Throughout their time together, doulas focus on helping the mother understand the meaning of her baby's behavior and see things from her baby's perspective. The doulas always model gentle handling of the baby, and provide guidance to the mothers on responding effectively to the baby's cues," Hans wrote.

Although the benefits faded after a year, Hans suggested that a sustained period of home visiting could effectively build on the work of community doulas. She is working to evaluate this approach, which is used by The Ounce of Prevention Fund in Chicago. This organization has found that repeated, sustained home visits can reinforce the work of community doulas.

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Co-authors for the Pediatrics paper were Renee Edwards and Linda Henson, researchers at SSA; Matthew Thullen, assistant professor at the School of Health Professions, University of Missouri, Columbia; Jon Korfmacher, associate professor at the Erikson Institute, Chicago; and Dr. John Lantos of Children's Mercy Hospital in Kansas City.

Joining Hans in preparing the Infant Mental Health Paper were Edwards, Henson and Thullen; Victor Bernstein, a research associate at SSA; and Helen Lee, a former postdoctoral scholar at the University of Michigan.

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