When Childbirth Moved Into Hospitals Labor Support Was Left Behind

Part 4 of 7, written by Christina Thomson, Certified Birth Doula and Lamaze Childbirth Educator

Stay tuned for future posts in this series, How To Alleviate Fears and Manage Labor Pain by our team of Lamaze Childbirth Educators. Part 1 can be read here. Scroll down for more links.

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Healthy Birth Practice #3: Bring a loved one, friend, or Doula for continuous support.

As humans, we do better when we are 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

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 with our "ONE DAY" group class. You can reserve 2 seats here. If you cannot attend an in-person birthing class with us, we suggest you schedule a private prenatal lesson. Registration for either the Intensive class or a private, in-home lesson includes access to our online Learning Center where you may watch videos, read further research and download sample birth plans. Both these class options are an excellent opportunity for you and your birth partner to gain current evidence based birth practices that can 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. Part 3 can be read here. Stay tuned for upcoming posts in our series, How To Alleviate Fears and Manage Labor Pain.

Part 1 can be read here.
Read part 2, Hormones and the Waiting Game.


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