Midwives' and doulas' perspectives of the role of the doula in Australia: A qualitative study

Objective: to explore midwives' and doulas' perspectives of the role of the doula in Australia. Background: doulas are relatively new in Australia; nevertheless, demand for them is increasing. Research has not previously explored the role of a doula in Australia. This research aimed to answer the question: What are midwives' and doulas' perspectives of the role of a doula in Australia? Design: qualitative study using focus groups that were digitally recorded, transcribed and the data analysed using thematic analysis. Setting: New South Wales, Australia. Participants: 11 midwives and six doulas. Findings: the key theme that emerged was that 'the broken maternity system' is failing women and midwives. The system is preventing midwives from providing woman- centred care. As a result, doulas are 'filling the gap' and midwives feel that doulas are 'taking our role'. Doulas fill the gap by providing continuity of care, advocating for women, protecting normal birth and by providing breast-feeding advice and emotional support in the community. Midwives are concerned that doulas are taking the caring part of their role from them and want the 'broken' maternity system fixed. Midwives described that doulas take their role from them by changing the relationship between themselves and labouring women, by reducing their role to obstetric nurses, by overstepping the doula role boundaries, and by holding the power at births. Implications for practice: despite the conflict reported between midwives and doulas, both groups identified that they see the potential for future collaboration. Taking into account the continued employment of doulas, it is important to improve collaboration between midwives and doulas for the sake of childbearing women. (C) 2010 Elsevier Ltd. All rights reserved.