Intimate space within institutionalized birth: women's experiences birthing with doulas.

Childbirth in the American context is only peripherally conceptualized in the domain of the family and home, demonstrating the primacy of the biomedical model of childbirth in the institutional setting of the hospital. Medical research has found positive outcomes when women labor with 'doulas', paraprofessionals who are trained and experienced in childbirth. However, medical research has yet to explore the complexity of the labor experience of women with doulas, offering potential insights into how those positive outcomes may come about. Doulas define what they do in birth as 'holding the space'. This research explored what 'holding the space' meant in terms of the experience of childbirth with women who employed doulas. The findings suggest that doulas' conceptualizations of the space of birth were framed in terms of creating/maintaining intimacy and that doulas and women maintained this intimate space even within the institutionalized medical-clinical birth experience. Implications of this research do not point to the generalization of doula attributes for implementation on an institutional level, but rather validate the contributions of external caregivers to producing positive outcomes.