Abstract
Objective: The objective of this article was to gain a deeper understanding and insight into the training and characteristics of childbirth doulas on the maternity care team. The aim was to integrate knowledge obtained from two studies: an integrative review (IR) of doula education programs globally (Study 1) and the qualitative experiences of those training to become a doula (Study 2).
Methods: For the IR (Study 1), the modified Whittemore and Knafl (2005) framework and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used. Five electronic databases were searched (CINAHL, ProQuest Education Databases, ERIC, MEDLINE, and Scopus) using doula and education/training as key terms. Nineteen papers were included in the review. For the qualitative study (Study 2), semi-structured interviews with 10 student doulas were analyzed using inductive thematic analysis.
Results: The results highlighted ambiguity around the education (review) and scope of practice (qualitative) of a childbirth doula. The review showed a variety in duration, content, learning, certificate/accreditation, and educator qualifications in doula training programs, globally. The variety in student doulas’ understanding of their role in the maternity care context emerged from the key themes: (a) what influenced the decision to become a doula, (b) personal attributes perceived as essential to be a doula, and (c) what constitutes the role of a childbirth doula.
Conclusions: This article highlights a variability in doula training legislation and accreditation, as well as program content and length. This variation may be reflected in student doulas’ understanding of their role in the maternity context. A better understanding of doula training and a defined scope of practice can fill the current gap in continuity of care and improve communication within the maternity care health team.