A coroner has issued a warning over doulas impeding the work of midwives after a baby girl died just two weeks after birth.
The coroner for Hampshire, Portsmouth and Southampton, Henry Charles, gave the warning after an inquest last month into the death of Matilda Pomfret-Thomas.
The baby’s parents had hired a doula as part of a plan to give birth at home after they had previously experienced a traumatic hospital birth.
A doula is an unregulated, non-medical professional whom some parents employ to provide emotional support during pregnancy and birth.
The use of doulas has proved controversial, with some arguing they play a key role in supporting women, while others, including some doctors, say they put women and babies at risk.
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In the latest case, baby Matilda died aged 15 days on November 13, 2023, from brain damage caused by a lack of oxygen to the brain.
Coroner Charles said Matilda developed the condition over a period of hours while her mother was in labour at home.
He also said the doula ‘negatively impacted’ the midwives’ ability to provide advice to the mother and usual care.
He said meconium had been observed, which is the baby’s first stool and is sometimes a sign of a baby in distress.
Decelerations – which are decreases in foetal heart rate – were also noted by midwives at the home.
Despite these complications, Matilda’s mum wasn’t taken to Queen Alexandra Hospital until a few hours later.
‘Matilda’s parents had seen a home birth as the best way forward,’ the coroner found.
‘Labour started in the early hours of October 29, 2023, and there was prompt midwife attendance.’
The midwives’ suggestion to transfer Matilda to the hospital two times was apparently ignored.
‘A difficult atmosphere had developed; the midwives felt access was being restricted by the doula. I found that she did not actively discourage midwife access but that she was seen as, in effect, a buffer by members of the midwifery team,’ the coroner added.
‘The doula was following the birth plan. The doula was supporting the parents per the birth plan, and this appears to have been perceived as grounds for hope that a home birth was still possible.’
Though Doula UK has membership requirements and training, the role of a doula is still questioned.
He concluded: ‘The issues of doula registration, regulation and training are therefore points of concern I would commend for review.’
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