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Domains of Postpartum Doula Care and Maternal Responsiveness and Competence


Judith Fry McComish, PhD, RN, Wayne State University, College of Nursing, 258 Cohn Building, 5557 Cass Avenue, Detroit, MI 48202


Objective: To describe the domains of postpartum doula care and illustrate how doulas facilitate development of maternal responsiveness and competence.

Design: Qualitative study using ethnographic method of participant observation.

Setting: Homes of mothers who received postpartum doula care.

Participants: Thirteen women and their infants; 4 postpartum doulas.

Results: Eleven domains emerged: emotional support, physical comfort, self-care, infant care, information, advocacy, referral, partner/father support, support mother/father with infant, support mother/father with sibling care, and household organization. Emotional support was used consistently and in combination with the other domains. Activities in all of the domains were used to facilitate the development of maternal responsiveness and maternal competence with 3 issues: resolution of infant feeding, integrating the infant into the family, and supporting developmental care and attachment.

Conclusions: Data suggest that by using 11 domains of care, postpartum doulas facilitate maternal responsiveness and competence. Development of a long-term relationship, mother-centered care, and education and support related to infant feeding, integrating the infant into family, and developmental care and attachment may contribute to these outcomes.