The purpose and value of labor support is innumerable. The emotional support that a mother receives while being supported continuously and compassionately makes all the difference in how her body responds to labor. There are measurable outcomes that come with a doula’s presence at a birth. Women who receive continuous support from a doula were more likely to have spontaneous vaginal births. They are less likely to have any pain medication. They are less likely to have negative feelings about childbirth. They are less likely to have instrumental births, such as, births orchestrated with forceps or vacuum extraction; they are less likely to have a cesarean section. They are also more likely to have a shorter birth, by 40 minutes, and their babies are less likely to have low Apgar scores at birth. (1)
Cortisol suppresses oxytocin. Pulsed oxytocin release from the pituitary gland stimulates and organizes uterine activity to help the cervix open and the uterus contract to help make the changes necessary for the infant to be born. When the mother’s oxytocin and other endorphins are suppressed due to stress and fear during labor, labor slows down and sometimes can stall altogether. We have all heard of the failure to progress diagnosis and how that is the number one cause of cesarean section, right? Perhaps this should be called, instead, failure to wait and help the mother be calm and feel like a strong part of her own birth team!
The ability of the mother to feel calm, in control, and respected in labor benefits the laboring family by enabling a more physiological birth. It enables a birth that is empowering and inspiring. Support in birth allows the mother and her family to feel confident in their abilities as parents in the early postpartum period to enable mothers to take more active positions in the care of their infants while recovering from childbirth.
The responsibility of a doula is supporting a birthing mother and her family, The doula advocates for the client’s wishes that are stated in the mother’s birth plan by empowering the birthing family to ask questions of the medical providers. Doulas act as supporters, information givers, mediators and negotiators. The doula provides a continuity of care by being with the mother during the prenatal period, the birth and postpartum period; and by having a qualified doula for backup, or giving the birthing family resources for finding a backup with which they are comfortable.
The role of birth doula is physical and emotional support. It is support that allows the family to become stronger through empowering them to be active participants in the birth of their child. It is to give unbiased and evidence based information to help the parents make their own decisions on how to conduct their birth and parent from a base of understanding, compassion, and evidence. It is the role of the doula to care for the mother and, in caring for the mother’s emotional and physical well-being, to give aid to other members of her non-medical birthing team. A mother can birth more effectively if she knows that her partner and other support people are well fed, rested, and able to be present with her. Reducing distractions that prevent her from being able to ground, focus, and relax during labor is vitally important. The role of the doula is to help the mother to be able to to birth by helping her with breath, vocalizations, listening to her needs and wants, and holding space for her to follow her instincts.
1.) Hodnett, ED; Gates, S; Hofmeyr, GJ; Sakala, C. Continuous support for women during childbirth. Chochrane Database Syst Rev. 2012. 10:CD003766.