"Cynthya was our doula for the birth of our third child in April 2016. As this was my third birth, and I had been attended to by a doula at the first two, I knew that finding the right doula was crucial to a successful and satisfying birth." - Winter Wheeler-Young
When Childbirth Moved Into Hospitals Labor Support Was Left Behind
The 2013 Cochrane Review concluded that all women should have continuous support during labor, and further state that the services of a person, such as a doula, with some training, who is experienced in providing labor support, is the most beneficial.
Part 4 of 7, written by Christina Thomson, Certified Birth Doula and Lamaze Childbirth Educator
Healthy Birth Practice #3: Bring a loved one, friend, or Doula for continuous support.
As humans, we do better when we’re surrounded by those we love and trust, with people who are positive and encouraging. Historically, women were helping other women as they labored and gave birth. Since most births were happening in the home with a local midwife delivering the baby, the laboring mother took comfort and support from her female relatives or close friends.
As we moved away from home births and into hospitals, this tradition wasn't as common. Your support person became your doctor or nurse. In modern hospitals, however, it is difficult for staff to offer the continuous support that you need during labor and delivery. According to the Journal of Obstetric, Gynecologic, and Neonatal Nursing, women expect their labor nurses to provide information, comfort, and support, but research shows less than 5 percent of a nurse's time is spent doing that.
Credit Lamaze International
What does good labor support look like?
According to The Official Lamaze Guide, it's “making sure you are not disturbed, respecting the time that labor takes, and reminding you that you know how to birth your baby.” Your support person “should spin a cocoon around you while you're in labor – create a space where you feel safe and secure and do the hard work of labor without worry.” Good labor support might include: helping you change positions or move around, offering words of encouragement, reminding you to eat or drink, and offering you cold cloths if you are hot. “Good labor support tries to respond to all your physical and emotional needs throughout labor.”
The 2013 Cochrane Review finds that women who received continuous labor support had the following positive outcomes: more spontaneous vaginal births, fewer cesarean surgeries or instrumental vaginal births, less use of epidurals and other pain medications, slightly shorter labors, and greater satisfaction with their birth experiences. Babies of these mothers were less likely to have low Apgar scores at birth. They conclude that all women should have continuous support during labor, and further state that the services of a person, such as a doula, with some training, who is experienced in providing labor support, is the most beneficial.
“The doula’s presence allows your birth partner to participate in the birth in a way that is meaningful to them.”
In Penny Simkin's book, The Birth Partner, a birth doula “guides and supports women and their partners continuously through labor and birth.” According to Lamaze International, a doula is “trained to provide continuous physical, emotional, and informational support to a mother before, during, and just after she gives birth.” A doula isn't going to replace your birth partner.
In fact, the doula’s presence allows your birth partner to participate in the birth in a way that is meaningful to them. If your partner wants to be more active in supporting you, your doula can gently remind them about techniques they learned in your childbirth class, assist them in physically supporting you, and model ways to provide emotional support. If partners prefer to let the doula be the primary support person, the doula can take the lead and help partners to participate in the birth to their level of comfort, while ensuring that the mother’s needs are met. The doula may even give the partner a break to go to the bathroom or to get something to eat.
The true value of having a doula is that a doula knows birth. She brings a quiet confidence in the process of birth, which allows you and your support team to relax and find strength as you do the hard work of meeting your baby. Research has shown doulas to be so effective that neonatologist and researcher John Kennell says, “If a doula were a drug, it would be unethical not to use it.”
Continuous labor support is an essential component of safe, healthy care during labor and birth. All women should be allowed and encouraged to bring a loved one, friend, or doula to their birth.
In both Atlanta and Tampa, we teach an "intensive" preparation for childbirth - the 3 Hour Labor Lesson. You can schedule a private prenatal lesson here. Registration includes weekly follow-up emails to further learning, and access to our online Learning Center where you may watch videos, review current evidence, and download sample birth plans. This is an excellent opportunity for you and your birth partner to gain knowledge on healthy birth practices to help you have the safest birth for you and your baby.
This post is part 4 of a 7 part series written by our team of Lamaze Childbirth Educators. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.
Read part 2, Hormones and the Waiting Game
Read part 3, Make Labor Productive
Read part 4, When Childbirth Moved Into Hospitals
Read part 5, Avoid Routine Medical Interventions
Read part 6, Benefits of Upright and Spontaneous Pushing
Read part 7, Keep Parent and Baby Together
Related posts:
How Taking a Childbirth Class May Prevent Birth Trauma
5 Reasons to Hire a Birth Doula
6 Points For Birth Partners to Consider When Hiring a Labor Doula
5 Reasons Your Labor Nurse Cannot Be Your Doula
How To Avoid a C-section Without Changing Hospitals For Less Than The Cost of a Latte A Day
Get dependable support for less than $5 per day of your pregnancy. Think about that. Then think about the cost of a c-section and an extended hospital stay. Hiring an experienced doula who works well with your care providers WILL SAVE YOU MONEY.
Do you know how to avoid the primary c-section? Hire a doula.
The American College of Obstetricians and Gynecologists (ACOG) backs this claim. An excerpt from their website:
"Today, approximately 60% of all cesarean births are primary cesareans. Although cesarean birth can be life-saving for the baby and/or the mother, the rapid increase in cesarean birth rates raises significant concern that cesarean delivery is overused without clear evidence of improved maternal or newborn outcomes."
Read ACOG's full article published March 2014: Safe Prevention of the Primary Cesarean Delivery, which discusses ways to decrease cesarean deliveries, including:
Allowing prolonged latent (early) phase labor.
Considering cervical dilation of 6 cm (instead of 4 cm) as the start of active phase labor.
Allowing more time for labor to progress in the active phase.
Allowing women to push for at least two hours if they have delivered before, three hours if it’s their first delivery, and even longer in some situations, for example, with an epidural.
Using techniques to assist with vaginal delivery, which is the preferred method when possible. This may include the use of forceps, for example.
Encouraging patients to avoid excessive weight gain during pregnancy.
One of the main points is to use continuous labor and delivery support:
"Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery (111). Given that there are no associated measurable harms, this resource is probably underutilized."
“Approximately 60% of all cesarean births are primary cesareans.”
At the hospital, laboring families aren't truly supported during childbirth unless they have a doula present. Care providers are quite busy and frequently enter and exit the room leaving you unattended while they are busy with other patients. Our birth doulas stay by your side and provide support when you need it most!
Still wonder if doula support is necessary? Research your hospital's c-section rate - many metro hospitals are WELL ABOVE the national average of 32.2%. Afterwards, watch The Business of Being Born, a documentary "eye-opener" about birth in America.
Simply put, our team helps you obtain your true childbirth options so you can have a great labor and birth experience.
For less money than you'd spend on a latte a day, you can hire an experienced labor doula.
Get dependable support for less than $5 per day of your pregnancy. Think about that. Then think about the cost of a c-section and an extended hospital stay. Hiring an experienced doula who works well with your care providers WILL SAVE YOU MONEY.
Many of our clients use their HSA/FSA debit cards to pay for childbirth services such as classes and doula support. Our agency includes our NPI number and taxonomy code on our order confirmations so you may attempt reimbursement from your insurance company or HSA/FSA accounts.
You should also note that we offer eGiftCards. If you receive a gift card after to you after you've paid, you'll be refunded the amount to the credit card used to reserve services through our website.
“For less money than you’d spend on a latte a day, you can hire help from an experienced labor doula.”
You'll remember your birthing experience forever. I wish you and your family a healthy and happy birthday.
Be well,
Cynthya
Click to visit http://www.lamaze.org/p/cm/ld/fid=160
Reference: Safe Prevention of the Primary Cesarean Delivery http://www.acog.org/Resources-And-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery
