The Need to Introduce Doula Occupation in Russia: Investments in Human Capital as a Framework for Demographic Policy

V.G. Valkova.
Thematic vector: Effective Demographic Policy in the Context of Population Ageing
Topic: The Need to Introduce Doula Occupation in Russia: Investments in Human Capital as a Framework for Demographic Policy
“Motherhood is not just giving birth to a child, it is giving birth to a new
force in the world.”
Anna Akhmatova, poet
Relevance
Modern Russia is facing a demographic challenge – population ageing. The decline in the birth rate (1.5 children per woman against the required 2.1) and the increase in the share of the elderly (by 2030, every fourth person over 65 years of age) require effective demographic policy. It threatens economic stability and social sustainability, forcing us to look for unconventional solutions. Introduction of doula occupation (a specialist in accompanying women in pregnancy, labor, and postnatal period) is becoming an opportunity: it is not only a response to demographic decline but also an investment in health and support of families. The topic is relevant because traditional measures (maternity capital) do not solve the psychological barriers for many children, while international experience shows the potential of doulas in this direction.
Demographic Challenge and the Role of the State
Russian population is declining by 200,000-300,000 annually, and by 2045, according to UN projections, may fall to 135 million from 146 million. Doulas supplement material incentives with quality support, reducing fear of childbirth and improving outcomes. Global experience confirms their importance. In the US,
Doulas reduce labor stress by 30-40% and caesarean sections – by 25% (DONA International). In Japan, through the Japan Doula Association, doulas (sanjo) support single mothers, reducing postpartum depression (15% of cases) and encouraging multiple births, which is a valuable example for Russian regions. In Sweden, doulas are integrated into health care, reducing delivery period by 20% and helping migrant women via programs like Doula & Kulturtolk. It opens the possibility of birth support: Doulas could become a support for large families in the Russian countryside and among migrants, and official certification from the state would provide their services with credibility and confidence in the eyes of society. In India (birth companions), they integrate Ayurveda and yoga into urban support, reducing caesarean delivery (40%) and complementing tradition. Mexico reveals creative potential: doulas (acompañantes) integrate herbal recipes, recovery rituals, and rebozo massage into breathing techniques, reducing complications by 20%. In Chiapas, the Partería Intercultural project brings together doulas with indigenous obstetricians, creating a living connection between tradition and modernity. It is not just about support, it is about revitalizing motherhood, where each woman feels stronger after giving birth. These examples show that doulas are adaptable to local conditions, improving health and reducing the healthcare burden, which is the key aspect for Russia with its unequal availability of services.
Investments in Human Capital: Economic and Social Impact
Inclusion of doulas is a strategic investment with a triple effect. First of all, they eliminate fear and depression, increasing the chances of having many children: 30% of women refuse to have children because of negative childbirth experiences (WHO). Second, improvement in maternal and child health reduces the cost of complications by 15-20%, saving billions of rubles annually. Thirdly, it provides workplaces: for example, education of 10 thousand doulas over 5 years could employ women in regions with unemployment of up to 8% (Federal State Statistics Service).
Not only medical professionals but also psychologists or experienced mothers are available for educating doulas through college-based or online courses (3-6 months), including psychology and physiology of childbirth. Their synergy with psychologists in perinatal centers reduces stress by 40-50% and the need for medication, increasing the health of families. It improves willingness for new pregnancies. The benefits for people: stability and confidence for women, stronger relationships for families, and increased fertility for society.
As a lecturer at the Medical Institute of the Almazov National Medical Research Center and a mother, I am ready to take part in the education of doulas, developing programs, and inspiring women to contribute to demographics.
There are many advantages for people in the profession: for women, it brings stability and confidence in motherhood; for families, it reduces stress; and for society, it increases birth rate and reduces burden on medicine.
However, implementation will face challenges: mistrust of health professionals, the need for standardization, and cultural sensitivities. These challenges can be overcome through pilot projects and information campaigns.
In the context of population ageing, doulas are a necessity. They strengthen demographic potential, reducing barriers to fertility and burden on medicine. The experience of the USA, Japan, Sweden, India, and Mexico proves their effectiveness. The introduction of doulas in 2025-2030 could raise birth rate by 0.1-0.2 points by 2035, reduce complication costs by 5-7%, and create 15,000 workplaces. “Motherhood is not just giving birth to a child, it is giving birth to a new force in the world,” Anna Akhmatova wrote. Doulas develop this force, making health and support for families the foundation of Russian sustainable development.