providing support and education for the childbearing year.

The Purpose and Value of Labor Support

- Robyn W Haas

       A Birth Doula is a professional trained in childbirth that provides a laboring woman or couple with continuous support throughout the entire labor.  A Doula is unique in being the only professional whose sole focus is the mother and personally walking with her through the birth journey.  The purpose of labor support is multi-faceted; the value of a Doula's services are far-reaching. 

       The purpose of labor support is primarily to serve the mother and guide her in her birthing decisions, ultimately affirming and backing her choices.  In doing so, a Doula nurtures a woman with personal and individualized care.  Ideally, labor support begins prenatally, when a Doula can assist the mother in creating a birth plan, help her get answers to her questions and address any concerns.  A goal should be to bring the mother to her baby's birth with increased confidence.  That support continues into the earliest postpartum hours and the first weeks, including breastfeeding support if desired, offering requested information and feedback, and helping to process the birth experience.  The Doula's aims are to give informational, emotional and physical support to the mother/couple, and to advocate for the birthing mother, with the mission of helping to ensure that she has a satisfying birth experience, regardless of the situation.

       Within the scope of a Doula's caregiving, (s)he may perform any or all of the following tasks, complex or simple: serving as the woman's lone companion or simply being an additional caring presence for the couple; offering natural comfort measures such as the use of heat, cold, hydrotherapy, massage; suggesting position changes and assisting in the use of a birth ball; advocating for the mother's wishes and facilitating communication with her caregivers; helping create and maintain a safe and tranquil birthing atmosphere; serving as a liaison between the mother and awaiting family members; retrieving water, ice chips or washcloths; acting as photographer/videographer.  A Doula does not, however, make decisions for the mother or couple, speak to the medical caregivers for them, or perform any medical procedures.

       The support provided by a Doula is valuable in several aspects.  The most obvious is the value to the mother.  Through conveyance of confidence to and education of the mother, fears and anxieties regarding the upcoming birth are allayed.  Keeping the mother as calm and relaxed as possible, combined with offering physical comfort measures, is vital to curtailing the fear-tension-pain cycle and making the birth as comfortable as possible.  Also significant is the psychosocial impact of a positive birth experience upon the new mother.  When a woman's abilities are affirmed, when she is made to feel strong and safe, and when she comes through her birth experience empowered, she starts off motherhood on the right foot. A positive birth experience contributes to healthy parent-newborn bonding, making for a secure infant, a confident mother, and a connected family.  The experience of giving birth has the potential to be life-changing when a woman has felt like an active participant in the process rather than a bystander, and professional labor support helps ensure that a mother is engaged in the experience as much as possible.  The affirmation of womanhood that is a byproduct of a positive birth experience makes labor support invaluable.

       Labor support has true value to a laboring woman in its cost effectiveness.  With labor assistance, there is the potential for decreased use of costly pharmaceutical augmentations, epidurals, and cesarean sections.  Additionally, there is a benefit to the mother in the potential to reduce overall length of the labor.  These findings are documented in the widely recognized studies of John Kennell and Marshall Klaus.  

       Labor support is also of great value to the woman's partner.  Many labor partners can feel overwhelmed by the potential amount of responsibility they may take on during labor: verbal encouragement; physical support; advocating for the mother's wishes; reading her emotional signposts; getting her ice chips; reminding her to empty her bladder frequently; knowing what to suggest to help labor progress.  Labor can be a great emotional effort for the partner, who feels concern for the baby's well being and helplessness over the mother's discomfort, as well as the pressure to remain calm when unforeseen circumstances arise.  This is a huge undertaking for somebody so emotionally close to the laboring woman.  A Doula can help support the partner emotionally or physically during difficult situations, make suggestions for how the partner can comfort the mother, and also manage all of the other extraneous matters.  This allows the couple to more effectively labor together and the partner to simply focus on loving the mother and baby.  With a Doula present, the partner can participate as much or as little as matches their comfort level. 

       The medical staff also greatly benefits from labor support.  Having another skilled and educated person present throughout labor, focusing completely on the mother and her well being, frees up the nursing staff.  They, in turn, can devote more time to a patient who may not have any additional support.  It also affords a logistical advantage and helps keep situations more controlled should complications arise and the medical staff then need to focus on the baby.  Many doctors, nurses and midwives are pleased to have the patient receiving care from somebody whose sole purpose is catering to the mother and ensuring she has the most satisfying experience possible. 

       Finally, labor support can ultimately be of value to society.  As noted before, when a Doula helps to ensure a positive birth experience, the family starts off bonded and empowered.  On a grander scale this contributes to a healthier, kinder and safer society, one family at a time.  Tragically enough childbirth is not very widely regarded in this society as the miraculous, honorable, sacred, empowering, rewarding, beautiful, and even fun experience that it can be.  The average American woman learns to dread and even fear labor and birth.  The very fact that childbirth, a rite of passage in a woman's life and the first milestone in every human's life, is frequently viewed more like a problem in need of a solution than a normal, natural process, is very troubling on some anthropological level.  If each and every Doula can serve and advocate for at least one mother in a way that helps her have the best birth experience possible, maybe this trend can be reversed.  It can only be a healthy thing for our society.  If education and caring support can reconstruct thoughts and views of childbirth, if society can be re-educated, then perhaps that is the greatest value of labor support.


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