Can the Postpartum Doula Care Model Improve a Mother’s Psychosocial Wellbeing, and Responsiveness in Low and Middle Income Countries (LMICs)?

Sustainable feminist futures begin with a healthy birth, an empowered woman and an informed society.

Source: Can the Postpartum Doula Care Model Improve a Mother’s Psychosocial Wellbeing, and Responsiveness in Low and Middle Income Countries (LMICs)?

Can the Postpartum Doula Care Model Improve a Mother’s Psychosocial Wellbeing, and Responsiveness in Low and Middle Income Countries (LMICs)?

Sustainable feminist futures begin with a healthy birth, an empowered woman and an informed society.  Birth is a feminist issue and a Doula’s core practice is enshrined in the feminist framework that ensures women have the right and control over where, when, and how to give birth. We can’t begin to speak of, or envision a just future of equality, rights and justice for women and families without confronting and dismantling economic and political structures that nurture disparities and inequalities in maternal and child health outcomes in communities of color around the world, especially in Africa and Diaspora communities-Deborah Dauda.

The post below also appears on WorldPulse.Com

Childbirth is a bittersweet experience for many mothers. It can bring joy, happiness, and satisfaction to the home. It can also be challenging, overwhelming and stressful, especially in the context of poor social and physical support networks.  The sound of a baby crying can cause significant stress for a mother ill-equipped to soothe her child. By extension, the type of response the crying child receives from the mother (i.e. holding to feed vs. letting baby “cry it out”) can influence a child’s sense of trust or mistrust. Maternal sensitivity (also known as maternal responsiveness[1]) is the ability of a mother to respond in a timely and appropriate manner to the cue of her child. It is a critical component of the maternal caregiving system[2] and has also been positively associated with mother-infant interaction, attachment and children’s cognitive development[3]’[4].

Historically, through different cultural practices and rituals, pregnant women received free physical and social support during and after childbirth from a community of women, and their families through a process called social birth7. Research by Stern & Kruckman (1983), suggests that postpartum rituals and psychosocial support available to women in non-western settings, for example, among the Ibibio (Nigeria), Punjabi (India), and Mayan (Yucatan) women, contributes to the lower incidence of postpartum mood disorders[5].

Today, in the U.S., the Doula embodies this role as someone who is experienced and professionally trained to provide non-clinical support to the birthing mother, and family, according to their respective needs and wishes[6]. Doulas who help during childbirth are called birth doulas and those who facilitate the transition into parenthood are called postpartum doulas.  Investigations by Eschel et al., (2006), Zeanah, Stafford, & Zeanah, (2005), and Cooper et al., (2002) show that professionals and trained lay-person (s) can facilitate maternal responsiveness. These studies and others have yet to explore the postpartum Doula care model as an integrated framework that could work in tandem with a mother’s clinical team to mitigate psychosocial stressors associated with the postpartum period. Preliminary studies have shown promising outcomes on maternal-child relationship in western societies utilizing a doula care model in childbirth but not in their non-western counterpart, perhaps due to the lack of empirical data, or poor institutional support for this type of practice. For example, review of twelve randomized clinical trials by Scott K., Klaus P., & Klaus M., (1999) substantiates evidence that the benefits of a Doula supported childbirth extends into the postpartum period, through increased rates and duration of breastfeeding, improved self-esteem, decreased symptoms of depression[7], and increased maternal sensitivity.  In addition, an observational study conducted by McComish & Visger’s (2009) reflects the benefits of the postpartum care model in facilitating maternal capacity and responsiveness in the areas of feeding, attachment and integrating the child into the family.

Since studies amongst impoverished communities in industrialized countries already demonstrate that Doulas help improve birth and psychosocial outcomes[8], contextualizing, and operationalizing this model to fit into an ecological framework for Low and Middle-Income Countries (LMICs), especially in Africa can prove useful in achieving dignity in maternity and motherhood, while increasing the possibilities of achieving promises of the post-2015 development agenda.


[1] McComish J., & Visger J., (2009). Domains of Postpartum Doula Care and Maternal Responsiveness and Competence. JOGNN 38(2).

[2] Pechtel, P., et al., (2013). Reactivity Regulation, and Reward Responses to Infant Cues Among Mothers With or Without Psychopathology: An fMRI Review. Translational Developmental Psychiatry (1).

[3] Eshel N., et al., (2006). Responsive Parenting: Intervention and Outcomes. World Health Organization.

[4] Farsi M., & McCarroll E., (2010). Crying Babies: Answering the Call of Infant Cries.

[5] Stern G., & Kruckman L., (1983). Multidisciplinary Perspectives on Postpartum Depression: An Anthropological Critique. Social Science and Medicine 17(15).

[6] Placksin S. (2000). Mothering The New Mother: Women’s Feeling and Needs After Childbirth. Newmarket Press.

[7] Scott K., Klaus P., & Klaus M., (1999). The Obstetrical and Postpartum Benefits of Continuous Support During Childbirth. Journal of Women’s Health & Gender-Based Medicine 8(10).

[8] Gruber K., Cupito S., & Dobson C., (2013). Impact of Doulas on Healthy Birth Outcomes. Journal of Perinatal Education 22(1).


Let’s End the Hesitation Around Menstruation

Women's iLab

AsheyAunnaBehringer_Allison - #menstruationmatters

Deepali LacyScharfstein_Rebecca - #menstruationmatters

The Pasand Team participated in #menstruationmatters, a global campaign to raise awareness about menstrual health and hygiene.

To this day, I blush when I say “menstruation.” I can’t count the number of times I’ve heard teenage girls refer to their periods as their “friend,” too embarrassed to utter the word “period.” Although menstruation is our “friend,” it doesn’t always feel that way. Societies around the world have deemed menstruation a “taboo topic,” limiting access to knowledge about menstrual hygiene management, and restricting women from participating in a variety of activities during their period.

Motivated to start a healthy and open conversation on menstruation, WASH United spearheaded an effort last year to bring together individuals, organizations, and the media for the first annual Menstrual Hygiene Day, a movement designed to break silence around menstrual hygiene management. Today, we celebrate the 2nd annual Menstrual Hygiene day, appropriately held on May…

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Why, in Kenya, menstruation doesn’t have to mean an end to education for young girls

Let’s Stop The Hesitation Surrounding Menstruation

Break the Silence on Menstruation Keep the girls in school

For girls and women in Ireland, it is impossible to imagine attending school as an adolescent without the basic necessities of underwear and sanitary towels, but this is the reality for many girls in Kajiado County, in Kenya, home to the Maasai people, a semi-nomadic pastoralist community.

Menstruation without these items means many girls have no choice but to stay at home from school for 4-5 days per month. The impact of such frequent absenteeism results in lower educational achievements and often leads to girls dropping out of school before completing the KCPE – the Kenyan Primary Certificate.

Aidlink and the Girl Child Network have worked in partnership on this issue for 10 years, creating girl-friendly learning environments for some of the most isolated and disadvantaged school children in Kenya. Together they developed the School Sanitation Improvement Project, which is now operational in almost 100 primary schools throughout Kajiado.


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How do sanitary kits boost up the quality of girls education in Somalia?

Sahra Ahmed Koshin - Exploring, Researching and Documenting Gender Issues in Somalia.

How do sanitary kits boost up the quality of girls education in Somalia?

Sanitation is dignity. We come from a culture where we have never had sanitary kit packages. Menstruation was a personal and private matter and you were to seek your own solutions. Now we have factories developing kits for us. Now we have a choice. Having a choice is empowerment.

By Sahro Ahmed Koshin, Gender Technical Adviser at MoE Puntland and PhD Candidate ‘Gender in Education in Somalia’.

Contributing to efforts geared towards bridging the gender gap in the education sector in Puntland through lobby-oriented activism and professional writing.

Introduction and background

The CARE-led EU-funded Waxbarashada Waa Iftiin (WWI) Education project works closely with the Gender Unit of the Ministry of Education in Puntland. The WWI project strives, among others, to contribute to the overall achievement of one of the goals of education in the world; gender equity…

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Let’s Talk about Power, Violence and Men in Crisis


By Sam Rosmarin*

This week, hundreds of Kenyans marched in downtown Nairobi chanting “My Dress, My Choice” in response to recent violent public attacks on women. On the surface, these attacks focused on the indecent attire of the victims, while the march focused on the freedom of women to dress how they please. While I laud the marchers for putting this issue into the public space, I can’t help but think their slogans are misguided. By centering their slogans on dress, the activists allowed Kenya to slip into the wrong conversation: a debate on morality and appropriate attire.

These conversations aren’t inherently bad, but I believe they are wasted opportunities to confront the real issues of power and violence.

When a mob of men strips a woman naked for being “indecent” in public, this is an act of power not morality. Let’s be honest: if it were truly…

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In Search Of The Menstruating Goddess

Mythri Speaks

When it comes to conversations around Menstrual Taboos, usually there are two strong view-points: One which says that it is all rubbish and we need to set women who follow these taboos “free”. Another, equally strong but externally silent viewpoint says that we should never stop following what women in our families have done for generations. The two view-points do not meet and usually have no tolerance for the other.

In our stubbornness to prove what we wish to be true, we rarely look at the rituals for what they are. Rituals and taboos are only external forms of some belief. They are either good or bad depending on the belief that gave birth to the ritual. Sadly, the most commonly heard beliefs around the menstrual rituals are negative, hinting at menstruation as being impure. And therefore, the rituals that arise from this negativity cause more harm than good.


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By Nakyazze Julian*

This year, World Population Day is celebrated on the 11th July with the theme invest in young people to ensure a bright future. According to the statistics there are 1.8 billion people aged 10-24 in the world, making one quarter of the world’s population.

Every day the world seems to keep getting worse with many shocking stories of violence and war. Often it is the young people who are mostly blamed for these challenges. We blame terrorism on the unemployed young men who become radicalized extremists. We blame poverty on the illiterate young women who become pregnant and give birth to babies they can’t afford. We blame young girls for engaging in early sex and end up acquiring STIs.

If you believe the stories, and follow the blame game, the world’s biggest problem is young people because currently over 1.8 billion young people with 88 percent…

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