title: Domains of postpartum doula care and maternal responsiveness and competence.
abstract: OBJECTIVE
  To describe the domains of postpartum doula care and illustrate how doulas facilitate development of maternal responsiveness and competence.
  
  
  METHODS
  Qualitative study using ethnographic method of participant observation.
  
  
  METHODS
  Homes of mothers who received postpartum doula care.
  
  
  METHODS
  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.
authors.affiliation: Wayne State University, College of Nursing, 258 Cohn Building, 5557 CassAvenue, Detroit, MI 48202, USA. jfmccomish@wayne.edu
authors.forename: Judith Fry
authors.initials: JF
authors.lastname: McComish
authors.forename: Joan M
authors.initials: JM
authors.lastname: Visger