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Domains of postpartum doula care and maternal responsiveness and competence.

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.