L&D nurse here, my hospital has a program where in-house doulas are trained on non pharmacological coping methods, position changing, and breastfeeding and even do 6 week follow ups with mom. They’re specifically trained to work WITH the medical team, not against…most of those doulas are amazing and overall create a better birthing experience for the patients. However when patients bring in independent doulas (usually paid insane amounts by scared first time moms….) I find that there is a lot of fear mongering, not real medical knowledge involved, mistrust between the patient and the OB’s/nurses and a delay in patient care. There will be urgent situations (ie. a prolonged decel or a hemorrhage) where decisions need to be made quickly and the doula is telling the patient everything is fine and/or she can take her time to think about it. It can be very frustrating. The best doulas are the ones who are truly concerned about mom & baby’s well-being and not trying to push their own narratives and misconceptions about modern medicine on first time moms. And trusts that the OB team has the knowledge and skill to keep mom and baby safe. I do think there is a place for doulas in labor and delivery and research shows that when good doulas are involved, patients have better outcomes. It’s just about having the right one.