Standard of Care Series Part Five
Continuous Labor Support
Continuous labor support is something that every birthing person has the right to and that research has shown to have numerous benefits for the birthing person and the baby without any risks. “Labor support is defined as the therapeutic presence of another person, and includes physical support, emotional support, information and advocacy” (Dekker, 2019, p 27). Who might provide this kind of care for the laboring person? A partner, friend, or family member may act as continuous labor support. However, if there is limited knowledge about the labor process and various comfort measures, it may be harder to provide physical support, information, and advocacy for the birthing person. Some people go into labor assuming that there will be a nurse with them throughout labor, but this depends on staffing, how many other patients there are at that time, and other duties that the nursing staff may have. Additionally, labor and delivery nurses are not always trained in comfort measures or how to support the birthing family. This is not to say any of the above options are bad choices or are nonessential to the birthing person, but just to highlight that sometimes, additional support is needed. Enter the doula.
A doula is a companion that the birthing family hires to provide continuous, one-on-one support, as well as information, advocacy, physical support and emotional support. Doulas are not medical professionals, and therefore do not provide any kind of medical care. In a 2012 survey that took place in the U.S., 6% of birthing people said they used a doula during childbirth (Declerq et al., 2013). Having a doula is a form of beneficial care that is underused. The benefits of having continuous labor support include a decreased risk of having a Cesarean and using pain medication, labors are shorter and babies are less likely to have complications at birth, and maternal satisfaction with the birth experience is higher. Studies have found that the best results occur if the continuous labor support is provided by a trained doula.
In the American Congress of Obstetricians and Gynecologists (ACOG) Committee Opinion on the Approaches to Limit Interventions During Labor and Birth, it is stated that “Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor” (2017).
A common question or concern with doulas is whether or not they take the place of the birth partner. The short answer is no, they do not! A doula is there to support both the birthing person and their partner. The doula is able to work with the birth partner as they support the birthing person, and studies have found that not only does maternal satisfaction rise, but so does the partner’s satisfaction with the birth experience. Additionally, research has found that adding a doula to the birth partner results in important benefits, including reducing the Cesarean rate from 25% with the supportive partner alone to 13% with a doula added to the supportive partner. The benefits were even more significant with a doula paired with a supportive partner, reducing the risk of Cesarean with induction from 59% with a supportive partner alone to 13% with a supportive partner working with a doula. For more information about why hiring a doula is so impactful, visit the link below.
If I could go back in time, one thing I would do differently for both birth experiences would be to hire a doula. In both cases, I thought that we had enough support with our birth team. For my first birth experience, I had a labor nurse with me the whole time, my husband and best friend (both knowledgeable about the birth process), and a CNM who was with me from the end of transition through the birth of our daughter. For my second birth experience, I birthed at home with a CPM, her assistant, a birth photographer, my husband, and my mom (who was there more for my daughter, but was able to provide some support as well). It was not that I did not have support (*huge* props to my husband who was an awesome companion through both births) or that I had negative experiences (I would say both births were positive experiences overall), but I do think my husband especially could have benefited from having a doula, and I know that I could have. We both agree that if we are to have another baby, we will without a doubt be hiring a doula. As a childbirth educator, it is rare that a class goes by that I do not mention the benefits of having a doula with a strong recommendation to hire one. If you’re local and would like a list of doula recommendations, let me know!
Bonus: Did you know that the last class of the Evidence Based Birth® Childbirth Class is bring your doula to class day? We will do a comfort measures rehearsal where you, your partner, and your doula can practice the various comfort measures we have learned about in class to help prepare for your baby’s birth-day! Register today!
For so much more information on the benefits of doulas, you can visit Evidence Based Birth®’s Signature Article all about the Evidence for Doulas.
Sign up for our EBB Childbirth Class today to gain the knowledge and confidence for an empowered birth! In our last class together, we will do a comfort measures rehearsal that we encourage your doula to attend as well. Don’t miss out!
*Disclaimer: These posts are not intended to be construed as medical advice and are for educational purposes only. Each pregnancy and labor is unique. If you have questions or concerns, please consult your provider.