Having a separate coach available during childbirth does not have to interfere with what the doctors and nurses are doing. Doulas, who are supposed to help the mother feel comfortable when she is giving birth, can work right alongside the doctors. There has been controversy over whether or not they can work together, as some doulas and doctors have clashed over how the mother should be treated and what care she should undergo. However, if the two agree on what roles they will play in the treatment of the mother before she goes into the delivery room, and if they both respect each other’s opinions, the two can successfully help the mother get through childbirth. Some of the disagreements arise from doulas who prefer as little medical intervention as possible, and from doctors who do not think doulas are necessary, but in most cases, the partnership works well. Having a doula in the delivery room can be helpful to mothers who need extra emotional support that has been consistent to the point where she knows the doula is a team member and not someone sent to randomly tell her to breathe. Doctors and medical associations are generally not opposed to the idea of an extra coach or doula, but some have taken drastic measures against allowing them into the delivery room because of a small group that suddenly tried to push an agenda, particularly an anti-medical agenda, once the mother was giving birth. Careful planning and research ahead of time can head this off. The mother must find a doula who she feels is not going to suddenly interfere with the birth process. It is basically a case of a small group giving the larger group a tough reputation.
One way that hospitals are trying to compromise is by training their own doulas, so that they know the doulas will not try to stop procedures they are opposed to because of an agenda. However, having their own doulas on hand means the mother can have this comforting presence with her in the delivery room. In-house doulas are also available on shorter notice as they know where they have to go, they are not being called to somewhere remote, and they are basically reserved by the hospital — they know where and approximately when the mother will need to go in, or at least they’ll know approximately what weeks they will have to remain on call. They will not have conflicting clients to worry about, and if for some reason the doula becomes unavailable, the hospital will already have other doulas waiting who know how the doctors there work.
The word “doula” is derived from a Greek word for female servants and possibly slaves, but the term nowadays is limited to the English interpretation of someone similar to a birth coach. However, the actual use of doulas is not well documented in research until about the early 1970s. There are organizations nowadays that represent doulas; most of these were started during the 1990s and early 2000s. These organizations mainly handle training and certification, although the training for doulas is not held to any nationwide standard set out by the government. This can create a problem if the training is inadequate, and it is another advantage to having a doula who normally works with the hospital in question. If the hospital has trained the doula, he or she will have a level of knowledge that the hospital has deemed essential to the childbirth process, and the hospital and doctors will not have to worry about whether or not the doula knows what to do.