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Nurses Plus Doulas Equals Magic

www.taprootdoula.com – Guest Blog

Ever since I first became an L&D Nurse, I’ve been searching for the missing piece.

How can I provide laboring mothers with the best possible care while still fulfilling my duties as nurse?

How can we work collectively to improve birth outcomes by reducing the C-Section rate?

How can I not only keep women and babies safe and healthy during their birth process, but help them achieve a satisfying experience?

How can I, as a nurse, honor the birth experience as the momentous, joyful and life-changing event in a family’s life?

The true answer: I can’t do it alone.

This upcoming April marks the first anniversary of the Labor Support for Nurses Project, a collaboration between Melissa Espey-Mueller, experienced doula and owner of the North Dallas Doula Associates, and I. Together we have developed an innovative approach to care for the Laboring Woman. An integral aspect is continuous labor support ~ collaboration between L&D nurses and BIRTH DOULAS.

6% is not enough.

L&D Nurses have an important role as well as a unique responsibility. 99% of births in the U.S. are attended by L&D nurses. However, only 6% of a L&D nurse’s care activities typically include labor support. Birth doulas are an emerging, essential contribution to the maternal health care team. Research has shown that continuous labor support by independent birth doulas reduces the rate of birth interventions including vacuum or forceps delivery or C-Sections, need for pain medication and anesthesia, and enhances a woman’s satisfaction with her birth experience. Despite all the known benefits, only 6% of women utilize doulas for continuous labor support.


Through our project, we offer continuing education for labor nurses about the evidence and benefit for continuous labor support by doulas. We emphasize the importance of the CIRCLE OF CARE – the birth team.

Melissa and I teach workshops and clinics to L&D nurses about positioning for labor, how to honor a woman’s privacy and enhance bonding between her and her partner, and the importance of birth as a transformative event in a woman’s life. We emphasize that it truly takes a TEAM to create a DREAM birth … we must all work together, build on each other’s strengths and appreciate our differences to help a mother create an ideal birth experience.

A year later, nurse attitudes and practices at our hospital are already shifting. Our leadership has supplied every labor room with a birth ball and peanut ball to assist with labor progress. Our nursing staff regularly utilizes a new toolkit of labor positions, including Walcher’s, to prevent arrest of descent and correct fetal malpositions. We are offering a new, 6-hour continuing education workshop in May for L&D Nurses across North Texas. We plan to offer clinics and workshops to more hospitals in our area.

More and more, we are learning and teaching that BIRTH IS AN EXPERIENCE THAT CHANGES A WOMAN’S LIFE FOREVER, and that we need to work together to make that experience as satisfying and empowering as possible. We are excited to share this project with more nurses to improve birth for even more women. Please spread the word about our work, give us feedback about ways you believe we can #makebirthbetter. If there’s anything I would like my fellow nurses to learn, it’s that we can’t do it alone.


 Kate Novotny
Registered Nurse, BSN, RNC-OB

Before finding my home in Dallas, Texas, I served birthing women as a nurse in Los Angeles, San Diego, California’s Central Valley and the Navajo Indian Reservation. Each setting taught me new lessons. Each woman I meet in labor, I feel invited to serve with passion and love. I consider myself a “with-woman”, a guide and protector of birthing women and their babies. I consider this work my deepest calling (my ministry, mitzvah, or dharma.)