Saturday, June 5, 2010

the value and purpose of labor support

Labor support can be priceless to a mother. As doulas, we often times do put a price tag on our services and time, but the benefits received outweigh the cost. Studies have shown that by hiring a doula a mother can reduce her need for pain medication, increase overall satisfaction with the birth experience, drastically reduce the risk of a cesarean and reduce the risk of assisted delivery by forceps or vacuum extraction. The studies have  also shown a reduction in postpartum depression for mothers who had a doula or continual labor support by a person trained in birth. Much of this is the result of an increase in confidence levels by both the mother and the father. Second time mothers often say that their birth with a doula was so much better than their first birth without one because they knew they had someone there whose sole purpose was to tend to her physical and emotional needs.

Part of labor support is empowering a mother to have confidence in her ability to birth. Having someone available for the entire length of labor provides security and confidence for the mother as practitioners are typically caring for multiple patients at a time or have other responsibilities, such as the clinical needs of the mother and the baby. Paperwork also must be completed and shift changes occur, bringing in new people to the birth environment. Having a constant throughout the entire labor process provides a sense of familiarity and safety for a laboring mother. Doulas also help the mother and father both communicate with the hospital staff or birth attendants, which is necessary in a time such as labor when the parents are usually distracted with the labor itself. While it is not the role of a doula to speak for the parents to the practitioner, she should advocate in order to help the mother or partner speak for themselves. Helping the mother and partner ask the questions appropriate to their situation and navigating the terminology used is also often helpful.

Supporting a mother emotionally during labor and birth helps the mother to believe that she can do it. Sometimes being told that she can do it is all that a mother needs to hear to keep going strong during a long labor. Understanding that laboring women are vulnerable and that the birth space should be protected is very important. Laboring women should have peace and quiet and no unnecessary interruption--and holding that space for a mother is a priority. When a doula and a partner help create a peaceful and safe environment for a laboring mother, practitioners will often follow suite and respect that space, allowing a sense of calm for the mother that helps her to maintain stamina through labor. Emotional support does not end at the birth, however. Helping a mother to process her birth experience is equally important. In unforeseen complications or unexpected situations or traumas, a mother needs the continued emotional support to facilitate healing. Being especially sensitive to these needs helps to reduce postpartum depression and negative feelings towards her birth.

Labor support also includes physical support for the laboring mother. Every woman has a different need in labor, whether it is continual touch, massage or counter pressure, while other women want very little physical touch. Women will often not know what their need will be until labor has progressed and it is important to be able to understand what the mothers needs are and at what time her needs are the greatest. Incorporating the partner into the physical aspect of labor support is often very affective as they usually already have a certain intimacy between them as a couple.

The needs of a laboring and birthing woman are very complex. Mothers deserve the continual support of a doula, someone trained in labor support. If all women had a doula present for their labor and delivery, most of them would be able to birth without medication and with little medical intervention. The cost of maternity care would decrease as a result, and there would be higher success rates in breastfeeding. Postpartum depression rates would also lower. Every woman deserves a memorable and meaningful birth experience. Every woman deserves a doula.

Artwork: Birthing in Pink by Aiyaart

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