The Purpose and Value of Labor Support
Having support during and after delivery is vital to the mothers emotional and mental health as well as the relationship to the mother and her newborn baby.
Labor and birth can have a negative or positive impact on the mother emotionally and mentally. Having support during and after delivery is vital to the mothers emotional and mental health as well as the relationship to the mother and her newborn baby. Any woman in general, but especially a laboring woman, needs to have support, comfort, feel respected, and be encouraged. Feeling safe and secure is key to having a calm and gentle birth. A birth doula can help a laboring mother feel safe, secure and confident while she is in labor and delivering her baby. According to DONA International, Standards of Practice, it states, “The doula accompanies the woman in labor, provides emotional and physical support, suggests comfort measures, and provides support and suggestions for the partner.” The birth doula’s role is to help the laboring mother have the labor and delivery she hopes for. In contrast, a birth doula does not give any sort of medical advice, perform any clinical tasks, diagnose any medical conditions or make the decision for his/her client.
Birth doulas, regardless of baring a child of her own, are well trained in childbirth. As a birth doula, he/she will have prenatal meeting(s) and show the mother and her partner comfort measures that can be used during labor and delivery. For example, he/she can show and teach their clients how to relax, what positions to labor in, breathing techniques, etc. The doula will also have evidence-based information gathered to be able to inform their clients on any questions they may have such as; “What is a vitamin K shot”? If it is a medical question, then the doula will refer his/her client to their care provider. The birth doula will then support both the parents during labor and delivery whenever he/she is called upon and stay until after the mother has breastfed the baby. It is important to note that the birth doula is also very supportive for the partner as well. He/she can help the partner feel relaxed and show the partner how to support the laboring mother.
Doulas also help to enhance the communication between the care team and his/her clients. The doula’s motive is to try and create the best possible atmosphere for every party involved. The doula will respect the clients wishes on any matter and never interfere with any type of medical advice from the Care Provider or nurses. The doula has developed well training skills in his/her schooling and knows when and where to involve him/herself.
A doula’s sole purpose is to form a relationship with their client and partner in order to better support them throughout pregnancy, labor and delivery, and early postpartum period. Nurses and doctors provide wonderful medical care; however, they have multiple patients and cannot be by every single woman’s side 24/7. A doula will be there the moment her client and partner need him/her, whether that is in their home or hospital, and through the duration of her labor. To have a doula at their side is immeasurable for the mother and partner. It is common that the partner may not know how to support his/her spouse or is exhausted and needs a few moments to sit and re-cooperate. A doula can show the partner how to support his/her spouse by showing comfort measures such as; massages, maneuvers with the rebozo, etc. The doula can also encourage the partner to be supportive to his/her spouse through words of affirmation. Lastly, the doula can give the partner a break to rest or to eat something, especially when it is a long delivery. The partner can be comforted knowing that he/she can get away for a few minutes with the knowledge that their partner is being supported by someone who is knowledgeable and experienced. A doula is invaluable to both the mother and the partner.
One of the studies that I found most interesting from the DONA Birth Position Paper was a study done by Drs. John Kennell and Marshal Klaus. It states, “In the late 1970’s, Drs. John Kennell and Marshal Klaus investigated ways to enhance maternal-infant bonding they found, almost accidentally, that introducing a doula into the labor room not only improved the bond between mother and infant, but also seemed to decrease the incidence of complications. Since their original studies, published in 1980 and 1986, numerous scientific trials have been conducted in many countries comparing usual care with usual care continuous labor support.
In fact, the largest systematic review of continuous labor support, published in 2011, reported the combined finding from 21 randomized controlled trials, including over 15,000 women. The trials compared “usual care” in the hospital with various types of providers of continuous labor support: a member of the hospital staff (i.e., a nurse); a family member or friend; and a doula (not a hospital employee, family member or friend) whose sole responsibility was to provide one-to-one supportive care. According to a summary of the findings of this review, the doula-supported women were:
28% less likely to have a cesarean section
31% less likely to use synthetic oxytocin to speed up labor
9% less likely to use any pain medication
34% less likely to rate their childbirth experience negatively
Obstetric outcomes were most improved and intervention rates most dramatically lowered by doulas in settings where:
the women were not allowed to have loved ones present
epidural analgesia was not routine (when compared to setting where epidurals are routine)
intermittent auscultation (listening to fetal heart rate) or intermittent (versus continuous) electronic fetal monitoring was allowed”
This study supports the value of having a birth doula present during labor and delivery and the positive effect they have on the parents mental and emotional state.
In summary, a birth doula can assist in ways not attended to by the actual Care Giver. Addressing the clients mental and emotional wishes results in a safer and more harmonious delivery. This improves the overall well-being of the client and establishes a stronger birth-bond between the mother and the newborn. With a doula present at a birth, the client can be more satisfied, more at peace, and more content with their birth experience. From my own personal experience, I have seen the positive influence that doula support has!! It is 100% worth the investment.