Unlike a midwife, doulas are not classified as medical professionals and therefore cannot administer medication. Doulas are typically certified with some courses taking over a year to complete. Practical training is involved to become certified.

Continuous support during birth from a person outside the mother's family or social circle, such as a Doula, is associated with reduced mortality rates, improved overall health of the mother and the baby, shorter labor time, reduced risk of a C-Section, and a lower need for medical intervention or pain relief. 

The overall goal of a doula is for the mother to feel safe, be informed and feel comfortable, enhancing the role of doctors and nurses which is to ensure a safe delivery for mother and child. Doulas have no clinical role, duties or decision-making.

A doula provides support, assistance and comfort during childbirth (massages, positions), emotional support (providing company, encouragement or simply talking in a soothing tone of voice), and acting as an advocate for the woman undergoing childbirth (suggesting options or supporting the woman's decisions to a medical team). Doulas may also be involved during pregnancy and after birth (postnatal care).

Most doula-client relationships begin a few months before the baby is due. Before the labor, the doula and the family can develop a relationship where the mother and her partner feel free to ask questions and express fears and concerns, and where the mother can take an active role in creating a birth plan. Continuity of support by the same person is thought to be an important aspect of the relationship between doula and mother. 

Postpartum doulas provide educational support and practical support in the home in the first weeks and months after childbirth or after adding an infant to the family. The same doula often provides both birth and postpartum services. They provide emotional support and companionship by encouraging a mother when she might be feeling overwhelmed.

The overall goal of a doula is for the mother to feel safe, be informed and feel comfortable, enhancing the role of doctors and nurses which is to ensure a safe delivery for mother and child. Doulas have no clinical role, duties or decision-making.

Benefits:
· Easier childbirth
· 50% reduction in caesarean section rate
· 25% reduction in working hours
· 60% decrease in the use of an epidural
· 40% decrease in the use of oxytocics and the use of
   forceps is decreased by 30%
 
(Source: Marshall H. Klaus, John H. Kennell, Phyllis H. Klaus, The Doula Book: How Can We Help You Have a Shorter, Easier, and Healthier Birth Perseus Press, 2002)

'' A doula or companion, offers non-medical support to parents during pregnancy, childbirth and postpartum. She gives the necessary information so that parents make their own choices. As early as 1970, Klaus and Kennel's first research showed that the continuous support of a woman in labor by another woman (physical, practical and emotional support) increases the chances of giving birth physiologically. When a mother contacts another woman to benefit from her support, she is looking for a companion who can offer her warmth and empathy, or the mere presence of another woman - a happy companion to hold her hand with integrity and not necessarily someone capable of offering specialized services beyond the work of a doula. ''

(Sosa, R, Kennel, JH., Klaus, MH. et al. « The effect of a supportive companion on perinatal  problems, length of labor and mother infant interaction» New England Journal of médecine 1980)

For the postpartum period, the doula is also very important as a stable marker for the mother. She will offer support for breastfeeding and also in the daily life that must be reinvented. The number of postnatal lows has been increasing for 20 years as women are very lonely after birth. There are not enough support networks to encourage, inform, guide and help new moms. Observations suggest that mother-to-child attachment is improved and the risk of post-natal pathology is lower in doula-assisted mothers.

(Golbort, J «postpartum dépression :bridging the gap between medicalized birth and socila support» international of childbirth éducation , decembre 2002.)