The reason for doulas – and for authentic midwives in general – can be interpreted from the perspective of physiologists. In the language of these scientists who study the body functions it is easy to explain how certain situations can inhibit the birth process. This is the case when a labouring woman feels observed, a situation which tends to activate the part of her brain (the "neocortex") that should be at rest during labour. In other words, privacy appears as a basic need. This is also the case in any situation associated with a release of hormones of the adrenaline family. This means that feeling secure is another basic need of pregnant women. The physiological perspective helps understanding why all over the world and through the ages women always had a tendency to give birth close to their mother or close to an experienced mother. It helps understanding the role of the doula as a mother figure.
Childbirth is controlled by hormones and any disturbance of this delicate hormonal balance can slow the labour or even stop it completely. Getting the surroundings and atmosphere just right, ensuring that the woman is not being observed and feels safe, and not engaging her in conversation, all allow her to feel uninhibited and her hormonal responses can take control of the labour.
It is also important that anyone present when a woman is giving birth remains outwardly calm and quiet. The labouring woman has heightened sensitivity and awareness and can sense any increase in adrenalin in those around her which can disturb and slow her labour. The Doula acts as a discreet calming presence for the woman and can help by protecting her from any situation that may affect the flow of her hormones. This allows the birth to be as quick and straightforward as possible and reduces the likelihood of interventions.
A doula will remain close to the labouring mother, and while she may appear to be doing little, she will be quietly and unobtrusively listening and watching for the cues telling her what stage of labour the mother has reached, and she will be ever aware of when the time is right to call the midwife, or to go to hospital, whichever is the choice of the parents.