If you’re an OB nurse, chances are that you’ve come across a doula.

Doulas are trained professional companions hired by expecting parents who provide support to birthing mothers, their partners, and families before, during, and after birth. Research has shown that having a doula present to offer continuous support during labor significantly improves birth outcomes, lowers the need for interventions, and increases the mother’s satisfaction with her birth experience.

However, with the introduction of doulas into the hospital setting, many nurses have felt imposed or intruded upon in their place of work, especially when doulas question their practices. Doulas have also felt unwelcome by nurses who are territorial about their patients. The result has been “turf wars” between nurses and doulas that have impacted both negatively.

For OB nurses and doulas to work together successfully, it is important to first delineate the role of each. While the goal of nurses is to ensure a safe birth, the doula’s goal is to ensure that the mother feels safe and secure. One tends to the physical, while the other tends to the emotional.

Working in tandem, the nurse and doula can meet the mother’s full spectrum of needs. Understanding this, neither professional need be threatened that their role is being undermined by the other.

Here are some other strategies to successfully integrate doulas into the birthing room:

• Good two-way communication. Especially when the nurse and doula don’t know each other, taking a few minutes to introduce themselves outside the labor room can make all the difference. As it is the nurse’s place of work, it is recommended that the nurse initiate communication and introduce the doula to the nurse taking over his or her shift. By getting to know the staff, the doulas learn how to work well with everyone.
• Integrating Standard Practices. Hospitals and birthing centers should integrate standards of practice when a laboring mother brings a doula to her birth. This will prevent confusion and miscommunication, as well as clearly delineate roles in the birth room.
• Mutual Respect. OB nurses and doulas have a wealth of knowledge to bring to the table and have much to learn from each other. Coming in with an attitude of collaboration instead of an “agenda” will enable both nurses and doulas to enrich their work experience. With a team approach, everyone can fulfill their roles to the best of their ability and work toward the best possible outcome.