Thoughts on the Value of Labor Support
Tamara Ashley, CD (DONA), CBE
The birth of a baby is a profound life event, and a rite of passage for the new parents. A woman never forgets the birth of her child; it is an experience that can affect her in many ways for the rest of her life. At its best, childbirth can leave parents with memories of love, safety and support, and can create a stronger bond between them. Mothers can come away with a feeling of strength and empowerment, and new confidence in themselves as mothers. Fathers can come away with a great sense of connection to the mother and baby, and respect for the mother’s strength in bringing forth new life. The baby benefits from being brought gently into the world by a mother who is supported and unafraid, and who has learned to trust in her body, and in her innate ability to care for her child. Historically, the mother’s sense of support and safety usually came from being cared for by female birth companions during labor. This ancient practice of woman-to-woman support has been rediscovered in our modern birth environment. The modern-day version of this birth companion is the labor doula, a woman who is trained and experienced in childbirth.
The word “doula” is Greek for “female servant.” Doulas provide continuous one-on-one support to the laboring mother and her partner. They provide reassurance, encouragement, and emotional support. The mother gains a sense of safety from having a labor professional constantly by her side. While nurses work in shifts, and often have several patients to attend, doulas stay with the mother throughout her labor, no matter how long it may be. When the mother is coping well, the doula may simply be a calm presence in the room. Later in labor, when the mother needs more support, the doula may be face to face with her, guiding her through each contraction. Doulas can help a mother with breath awareness, guided imagery, non-focused awareness, and other pain-coping techniques. They can remind the mother to keep her body relaxed, and to work with the contractions instead of fighting them. Doulas can also help a woman who is shy about vocalizing, teaching her how to make deep, powerful sounds, and even making them along with the mother when that is helpful. Doulas do their best to adapt the birth environment to make the mother feel at ease, dimming lights, adjusting the temperature, and often providing music and aromatherapy.
Doulas offer massage, position suggestions, and often physically support the mother. They usually bring helpful tools for labor, such as birth balls, massage lotions and tools, and hot or cold packs. They encourage the mother to listen to her body and choose positions or activities that feel right to her, such as walking, sitting on the birth ball, slow dancing, bathing, or squatting. They physically support her when she changes positions, help support her when she wants to walk, and periodically help her move from side to side if she has an epidural. They cover her with warm blankets when she is cold, and fan her or wipe her brow with cool washcloths when she is hot. Doulas also remind the mother to drink regularly, and eat small amounts to keep her energy up (if it is permitted by her caregiver.) After the birth, the doula stays with the new family until they are settled, and is available to assist the mother with the initial breastfeeding.
Doulas offer information about childbirth options, including risks, benefits, and alternatives, so that parents can make informed decisions about their birth. Doulas do not make decisions for parents, or discourage parents from making particular choices, but rather support parents in whatever informed choices they make. The doula’s goal is to help the woman have a safe and satisfying childbirth as the woman defines it. This sometimes means supporting choices that the doula herself would not make.
Doulas help the father to help the mother, to whatever extent he is comfortable with—they show him ways to support her, and by taking some of the pressure from him they allow him to experience the birth of his child with less anxiety. The doula does not replace the father, but works with him to support the mother, often giving him confidence in his ability to support her. Her presence allows him to take breaks when he needs to without leaving the laboring mother alone and without support. The doula also encourages the father to eat and rest when it is appropriate, so that he can conserve his energy during what could be a long journey. Most men are not experienced with childbirth, and find it very comforting to have a knowledgeable professional available to answer questions and give them ideas of what to do.
Doulas can help the parents to communicate their needs to the hospital staff. Even if parents have brought a written birth plan, not all hospital staff will have read it, and as shifts change, sometimes new nurses arrive who are unfamiliar with the parents’ wishes. The doula can help to make sure that caregivers understand the parent’s preferences, and at the same time can help explain procedures that are suggested or required by the hospital staff to the parents. Doulas attend to the comfort and emotional needs of the laboring mother, and do not perform any clinical functions. They complement the work of the hospital caregivers, who must focus primarily on the safety of mother and baby. Many doctors, midwives and nurses appreciate the extra attention given to their patients and the greater satisfaction expressed by women who were assisted by a doula.
Parents-to-be can greatly enhance their birth experience by having a trained labor support professional, or doula, attend them during labor and birth. Statistics show that women supported by doulas tend to have fewer cesareans, fewer interventions, fewer requests for pain medication, healthier babies, and improved bonding with their babies after birth. The labor doula is an old idea brought to the modern birth environment, and is an invaluable asset to any birth team.
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