Many expectant mothers have tapped into the trend of hiring a doula - so named from the ancient Greek for woman´s caregiver – to guide them through pregnancy and to accompany them at the birth itself.
But Spain´s leading nursing and midwifery organisations are warning that the doula “profession” is completely unregulated and that hiring one could pose significant risks to the newborn baby and mother.
"These birth attendants have no formal qualifications, they put mother and baby at risk and should be investigated," Maximo Gonzales Durado, the president of the General Nursing Council said in a statement last Monday, as reported by La Vanguardia.
He warned that some doulas even carry out practices akin to a “cannibalistic cult” in reference to those who recommend that new mothers eat the placenta because of its nutritional benefits.
Nursing organizations complain that doula qualifications are completely unregulated and that anyone can claim to be a doula after attending a workshop.
By contrast midwives have six years of academic and vocational training and are required to pass exams and take out professional liability insurance.
He also slammed the fact that doulas can charge around 1200 euros for the complete care package offering assistance from early pregnancy through to the birth and the first weeks of new motherhood.
The General Nursing Council presented a report this week calling for Spain´s Attorney General to investigate malpractice concerning doulas and urged the Health Ministry to regulate the profession.
Poor training or issuing the wrong advice to a pregnant woman "can endanger the life of both mother and child," added Gloria Boal, spokesman for the National Midwives Commission, according to a report in El Mundo.
She listed serious conditions that could be exacerbated if an expectant mother was in the care of a doula rather than a widwife, such as preeclampsia, postpartum infections, or conditions that if not treated could lead to premature birth.
Doulas have rejected the claims that are endangering mother and child and insist that they provide "support and guidance" and do not provide medical care.
"The report is absolutely incorrect," Beatriz Fernandez, president of the Spanish Doulas Association (AED), which represents 200 doulas in Spain told El Mundo. "In fact, we are the ones who have called for our profession to be properly regulated."
"We don´t pretend to be medically trained. We offer helpful advice and spiritual support," one experienced doula working in Madrid, who asked not to be named, told The Local. "We are there to help the mother achieve a positive and happy birthing experience alongside the advice of medical professionals."
She added that she had never encouraged the eating of the placenta. "Although I know that some do."