Monday, April 13, 2009

The Purpose and Value of Labor Support

A doula a woman experienced in childbirth who provides continuous physical, emotional, and informational support to the mother before, during and just after childbirth. She understands the physiology of birth and the needs of a laboring woman.

The role of the birth doula greatly depends on the woman and family for whom she is providing care. The doula’s main purpose is to be a friend, a mentor, and a helper to the mother, as well as a support to her partner and/or family. If the mother chooses a doula in the early stages of pregnancy, the doula can help to provide information and education for several months leading up to the birth. This can also help the mother and family build an established, comfortable, and trusting relationship with the doula. The doula will usually have one to three prenatal consultations with the mother and family prior to the birth. These sessions may include meeting with other caregivers, answering questions for the parents-to-be, providing referrals when necessary, and massage and other pregnancy comfort measures. Throughout the pregnancy, the doula assists by listening to the mother’s desires, helping her have a comfortable, nourishing pregnancy, helping her to create the plan for the birth she desires, providing factual and unbiased information to enable her to make choices she can feel good about, keeping her comfortable during the birth while doing all she can to ensure the birth outcome the mother wants, advocating on her behalf, encouraging her in her birth decisions, and even providing lactation consulting after birth to help create a breastfeeding relationship. She has no agenda and has nothing to gain by convincing the mother to make certain choices.

As labor and birth are imminent, the doula is experienced in providing comfort measures and relaxations tools. This may include visualization and meditation techniques, preparing cool clothes, utilizing the birth ball, positions to enhance labor, counter pressure massage, aromatherapy, encouraging the mother stay hydrated and energized, and, providing relaxing music. Some doulas may also be skilled in other modalities such as massage therapy, acupuncture, Reiki, and reflexology to help facilitate labor in a positive manner. These techniques can be used in such a way to allow the woman to have a natural, unmedicated birth. And, in some cases, these techniques have been known to help labor and birth progress more timely and efficiently. Or, if the mother chooses or needs to labor with the help of medications, these methods can also help facilitate the labor and birth. These techniques may help reduce the need for prolonged analgesic drugs or augmentation medications. The doula is one of the only birth attendants that does not leave the side of the mother as she labors. This may be several of hours, but she stays near and helps the mother feel empowered during the birth. The doula ensures that the mother’s needs are being met and that her birth plan is carried out in the best possible way without intervening or interfering with the process. She provides guidance and reassurance to the mother and reminds her of her progress and power when labor becomes more difficult.

Statistics show that women who utilize a trained doula are 50% less likely to have a cesarean. They typically have a 25% shorter labor. Additional figures suggest there is a 60% decrease in the number of women who request an epidural, a 40% decrease in her chances of receiving Pitocin, and a 30% reduction in the use of analgesic drugs. Furthermore, the risk of having a forceps or a vacuum delivery is lessened by 40%. Doulas can make a woman feel more empowered and prepared to make good choices during their delivery, and they even can provide encouragement for the expectant fathers and help them to have a more active, supportive role in the birth.

Following the birth, the doula can provide initial breastfeeding support as well as newborn care. A doula will usually follow up the birth with one to two postpartum visits with the mother and family to ensure baby and mother and family are getting appropriately acclimated to their new roles at home. In-home postpartum visits may also include light cooking and housekeeping as the family adjusts into parenthood. In addition, new parents may benefit from education on bonding, attachment, and coping skills

Whether she is a new mother or has had many experiences in childbirth, a mother can always benefit from the care, love, support, and encouragement that comes from the loving heart of a birth doula.

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