Last week, we dove in deep to learn the hard facts about current birth outcomes in America. I hope that this information has been helpful for you in understanding what the possibilities are. For some of you, this information and my own philosophy about birth might be a stretch. It might be hard at first to hear what I’m saying. And honestly, sometimes I get nervous sharing it. I care for each and every one you, and I want nothing more than for you to have a positive birth experience, one that’s empowering and fulfilling. What we know is that birth is important. It’s a rite of passage. And regardless of how you thought about birth before you got pregnant, this birth will affect you for the rest of your life. I want you to have your best birth possible, for your baby, and for your family. If you’re not on board yet, that’s ok. Pregnancy gives you lots of time to think, make choices, and prepare for your transformation into Motherhood. In the end, it’s all about choices. It’s my job to inform you about your choices, to remind you that you have them, and the rest is up to you.
How to have a better birth?
1) Chose the right care provider
2) Chose the right birthplace
3) Hire a doula
This week, I'm focusing on hiring a doula. In the coming weeks, I will touch on choosing the right care provider and birthplace.
What exactly is a doula?
The word doula comes from the ancient Greek word meaning, “woman who serves.” Today it is an internationally recognized term for a non-medical birth assistant who provides continuous support to the mother throughout labor. Different from a labor and delivery nurse, a doula never leaves the mother to attend to other women or to chart paperwork.
What do they do?
A doula offers third party, objective information on choices that are involved in the pregnancy, labor, and birth process. She supports the mother and birth partner emotionally, addressing fears and concerns, to help calm, soothe, and normalize the pregnancy and labor experience. A doula also prepares the mother and birth partner for labor by providing comfort measures, positions, and relaxation techniques. A doula does not take the place of a birth partner, as there is no replacement for the support that only a loved one can offer. Rather, a doula integrates the birth partner into the labor process, working together as a team to support the mother the best way possible. Similarly, partners cannot take the place of a doula, as doula’s provide expertise and experience that partners do not have.
How doulas improve birth outcomes
The largest systematic review of continuous labor support is available here. It summarizes the experiences of more than 15,000 women who participated in 22 randomized controlled trials.
The authors conclude:
Continuous support during labor has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labor and birth. Hodnett, E.D., Gates, S., Hofmeyr, G.J., Sakala, C., & Weston, J. (2013).
Compared with women who had usual care (no labor support), women who labored with continuous support had shorter labors and were more likely to have a "spontaneous" birth (with neither cesarean section nor vacuum extraction, nor forceps). Women with continuous labor support were also less likely to:
- Have an epidural or other "regional" analgesia to manage pain.
- Use any type of pain medication (including narcotics).
- Give birth by C-section.
- Give birth with vacuum extraction or forceps.
- Give birth to a baby with a low Apgar score (a rating of the baby’s wellbeing five minutes after birth).
- Be dissatisfied with or negatively rate their childbirth experience.
So, there’s the facts about doulas. I hope this sheds light on a very important choice for you and your birth. If you have any questions, please reach out to me. I’m here for you!