Doulas & Partners

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The Purpose and Value of Labor Support

 I once heard, that it is not how we how we give birth, but how we remember it. While the birth process is extremely important for the long term health of the mother and the baby, a women's experience of childbirth impacts her emotionally and psychologically for the rest of her life. It is for this very reason, that the presence of a doula is so important. A doula recognizes birth as a powerful experience and aims to help her client have a "safe and satisfying childbirth as the woman defines it". (DONA). 

Throughout history, women have supported other women in labor. Today we call such a woman a "doula". A doula is defined by DONA as “a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth". This continuous emotional reassurance and support allows women to bring their babies into the world with less pain and greater satisfaction.  When a woman is supported and cared for during childbirth she is more likely to be satisfied with her overall birth experience.  As a result, she is less likely to experience post partum depression. Furthermore, women who have been continuously supported throughout labor tend to bond with their babies more quickly and breastfeed more easily. Those babies tend to have shorter hospital stays, and receive more affection from their mothers. Not only do studies show that "obstetric outcomes were most improved and intervention rates most dramatically lowered by doulas in settings were women were not allowed to have loved ones present", but also that (DONA) doulas are an invaluable resource even when a woman's partner is present.  While some partners are incredibly intuitive and supportive towards their birthing partners, others struggle to find their place. Having a doula there helps the birth partner focus on the mother and keep her calm.   Furthermore, she can demonstrate or perform massage techniques that either she or her partner can utilize.  When a woman enters the maternity ward she is often cared for by strangers. This is especially the case when a doctor is her caregiver. A doula, however, is a friendly, familiar face who is familiar with the woman's preferences and concerns and who has established both rapport and connection with her. These things can be invaluable in a situation where the laboring mother is anxious or experiences conflicts with the medical team. According to DONA international, the presence of a doula not only results in shorter labors with fewer complications, but also reduces the requests for pain medication by 9% and the use of synthetic oxytocin by 31%. The continuous support of a doula has shown to dramatically reduce the incidence of cesarean sections by 28%, as well as the use of forceps and vacuum extraction. Studies also show that the presence of a doula reduces the incidence of negative feelings about one’s childbirth experience by 34%. These are powerful statistics!

While the medical staff are preoccupied with the health and welfare of laboring woman and her unborn child; keeping track of fetal tones, blood pressure and other vitals, the doula is primarily concerned with helping the mother cope emotionally and physically with the rigors of childbirth. Often this means providing  comfort measures such as massage, counter pressure, movement, encouragement,  positioning, breathing, relaxation as well as providing her partner with tips on how they can provide support. In doing so, the doula is able to give the continuous support that the hospital staff is unable to provide due to time constraints and charting responsibilities.  When the doula focuses on meeting the non-medical needs of the mother while facilitating communication between the couple and the medical team, she becomes a perfect complement to the hospital's existing medical staff. A doula plays a significant role in that she is able to pace her client and is not emotionally caught up in the experience. She is calm and reassuring. While a doula is a valuable resource during labor, she is also tremendously helpful in emotionally and mentally preparing the pregnant woman and her partner for labor. She is an incredible resource and "informed about various options available to the pregnant women, “including the risks, benefits and accompanying precautions or interventions for safety" (DONA). She does not require an appointment and is available for questions or conversation at any time. Furthermore, she can help the couple create a birth plan after discussing all their options with them.  The doula then pays attention to the birth plan and uses it to guide her actions and suggestions.  She makes sure that the staff is aware of the mother's birth plan, especially with regard to her preferences for pain medication and other interventions. Because a doula understands the physiology of birth and the emotional needs of a woman in labor, she can reassure both the laboringwoman as well as her partner, as birth transpires. She can explain procedures, as well as help the couple ask the appropriate questions when faced with a decision. During labor she helps the laboring woman find a ritual that helps her cope with contractions. After the delivery, the doula remains with the mother, her partner and child to help with breastfeeding. In the days following, the doula gives the mom and her partner the chance to reflect on their experience and talk about their feelings about labor and delivery.  In doing so she acknowledges the sacred power of childbirth and its impact on families as a whole.

 It is unfortunate that in modern society, childbirth has become an impersonal, conveyor belt of sorts, divorced from the sacred deeply spiritual experience that it is. I believe that doulas have and will continue to play a significant role in not only improving women's maternal outcomes but also slowly shifting attitudes and perspectives towards birth as a whole.