Continuous Female Companionship During Childbirth: A Crucial Resource in Times of Stress or Calm


  • Debra Pascali-Bonaro BEd, LCCE, CD(DONA), CPPD(DONA),

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    • 1Debra Pascali-Bonaro, BEd, LCCE, CD(DONA), CPPD(DONA), is the president of MotherLove, Inc., a DONA-approved labor support and postpartum doula training and consulting agency in River Vale, New Jersey. She is a member of the Leadership Council Coalition for Improving Maternity Services and of the Adjunct Faculty for Continuing Education, School of Nursing, State University of New York at Stony Brook, Stony Brook, New York.

  • Mary Kroeger CNM, MPH

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    • 2Mary Kroeger, CNM, MPH, is an independent international health consultant. The author of The Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum (Jones & Bartlett, 2004), she has worked with the United Nations Children's Fund, the World Health Organization, the American College of Nurse-Midwives, and other non-governmental organizations and national ministries of health.

Debra Pascali-Bonaro, BEd, LCCE, CD(DONA), CPPD(DONA), 584 Echo Glen Ave., River Vale, NJ 07675. E-mail:


Continuous support by a lay woman during labor and delivery facilitates birth, enhances the mother's memory of the experience, strengthens mother-infant bonding, increases breastfeeding success, and significantly reduces many forms of medical intervention, including cesarean delivery and the use of analgesia, anesthesia, vacuum extraction, and forceps. The contribution of doula care has become increasingly available in industrial countries and is beginning to be adopted in hospitals in underdeveloped countries. Research continues to demonstrate the far-reaching value of supportive companionship as a corollary to professional health care during birth. Mothers who are at risk because of medical or social factors and those delivering in situations of stress, including disasters, can benefit greatly from labor support.