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A Case for Doula Support

What if I told you how to have a better labor?

 

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by Chloe Quinn MSN, RN, WHNP-BC in New Mom, Pregnancy

Recently, the American College for Obstetricians and Gynecologists came out with a Committee Opinion¹ that less is more in terms of healthy term, vertex babies. They essentially narrowed down the basic ideas that midwives and doulas held for decades in a more official paper kind-of-way. Let’s discuss why this is important.

For centuries women have been having home births, unmedicated births and uninterrupted births without much intervention. In times of non-sterility and less medical knowledge, women and babies did lose their lives, yes, but the experience of childbirth was untampered with and it was raw.

Welcome the 21st century, where medicine is in full swing and obstetricians (doctors and many more males) are performing more deliveries than ever. The medical model of care intends to “fix” the problem with deliveries. The safety problem, the length of time problem, and the pain problem. While, the intention was good; safer, more effective labors and less painful births was achieved, more women started to lose the control over their deliveries. And in turn, greater fear of labor pain developed. In fact, sometime around the 1950s, women were KNOCKED OUT (with medication) at the time of their deliveries. They were made completely unaware of what was happening to them and left with no memory of their deliveries either!

There are mixed vibes and mixed opinions from women and providers on what is best for a women during her labor experience. Some women would prefer not to feel anything, there are some women who want to experience everything; all aspects of labor and birth to it’s fullest extent. The commonality amongst most women is this: they want a safe and satisfactory experience which leaves them happy and content with a healthy baby and a healthy mind/body for themselves.

The Committee Opinion¹ paper is important because it fully identifies the return of a more natural birth process and allows medical providers to slow down and let Mother Nature take her course (within necessary parameters).

Key take-aways of the article include: less interventions altogether, allowing a women to “labor down” if she doesn’t have the urge to push, intermittant auscultation of fetal heart tones, intermittent IV fluid, frequent position changes, pushing as compelled, and continuous labor support¹.

A Cochran evidence review² found continuous labor support to benefit mom by:

  • reducing her need for analgesia  (less pain, more control & better coping)
  • shorter length of labor
  • less cesarean sections
  • higher satisfaction with labor and delivery
  • higher APGAR scores for baby

So who can provide continuous labor support? Doulas, mothers, sisters, friends, aunts, husbands, wives and even brothers and fathers etc. Any other person who is non-medical and is present with mom throughout her labor!

Doulas are honestly awesome. As a former labor and delivery nurse, if I knew a doula was present, I knew my role as counselor, back-rubber, breathing partner and emotional support person would be somewhat relieved. I could focus on the medical health and well-being of mom and baby without being distracted by her pain (every 3 minutes). Not that labor and delivery nurses mind at all, it’s just sometimes husbands don’t quite know how to support a mama in the throws of tremendous pain and the expectation is that the nurse does and can provide the necessary support while juggling 1-2 other patients. Also, sometimes laboring women don’t want their mothers or other family members in the room filling the role of support people. Cue the doula. A doula is a great person for support, comfort and just simple knowing. A doula is trained to “get you” where you are at and what you’re going through during this tender and vulnerable state. They should have prior experience in doing this and will know how to encourage you. Additionally, it seems to take a lot of stress off your partner while they’re trying to keep it together too.

So what about your midwife? Midwives are also awesome, but like doctors and nurses, they are also in the role of medical caretaker for the two of you. Midwives do tend to be more involved with a women’s labor process but they should have their finger on the pulse of you and baby’s well-being in case emergent management is needed. I don’t see why midwives, doulas, RNs, MDs, partners and the like could not function well together when they all have one common goal: a healthy baby and a healthy mom.

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¹Approaches to limit intervention during labor and birth. Committee Opinion No. 687. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;129:e20–8.

²Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5.

Photo: From Labor to Love, Joann Marrero


All opinions are my own. The contents of this website are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, dietary supplement, exercise, or other health program. We may receive compensation through the issuer’s affiliate programs when you click on links to products. 

	
		
	
	
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GET MY FREE MYTH-BUSTING FACTSHEET

THE 10 MOST COMMON MYTHS ABOUT DELIVERING A BABY and why you shouldn't believe them.

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