Birth Doula: A Vital Role in Modern Maternity Care pt1

The challenges and triumphs experienced by a family during pregnancy, labor and childbirth have lasting effects on the bonds between partners and their children. The way a person is made to feel while pregnant or in labor can greatly influence their confidence in the ability to birth and care for a new baby. A person’s birth experience has been correlated with their mental health and wellbeing in early parenthood. Applied on a larger scale, the birth culture of a society can impact whole generations.

While childbirth is, in its essence, an automatic body process, the emotional, mental and physical state of the person giving birth greatly influence how smoothly the process takes place. This is why, for all of human history, there have been experienced companions to support birthers during labor, birth, and immediately postpartum. We see evidence of people (usually women) fulfilling this role in ancient works of art, historical and religious texts, and folklore in nearly every culture as far back as researchers have looked.

Well into the modern era, births were attended by experienced family and community members, often women who had seen and experienced many births in their lifetime, yet didn’t receive formal training. This ensured that all the birther’s needs were met during labor and birth, as well as during an extended postpartum period. This tradition began to change in the early 20th century. The industrial era was fully in effect, and modern medicine was exploding with remarkable new discoveries. In industrialized, western societies, people began to look to modern medicine to improve outcomes for mothers and babies during the historically dangerous process of birth. This led to the migration of birth from home to hospital, and with that, individualized, continuous labor support became the exception rather than the norm.

Maternal and infant mortality was greatly improved with the advent of antibiotics, and other life saving medicines and techniques, however, the childbirth experience became somewhat dehumanized. During the “natural childbirth movement” of the 1960s, families started looking for a more holistic and supportive approach that went beyond the basic expectation of “healthy mother, healthy baby” . In the early 1990’s the first organizations of childbirth support professionals were formed, and the term “doula” was coined.

Doulas are now defined as a professional support person, trained to provide individualized support to families during pregnancy, labor, birth and the postpartum period. They provide evidence based information, physical and emotional support, and act as an ambassador for their clients as they navigate the new role of parent. Doulas receive a combination of in person training, hands on childbirth experience during certifying births, and self led education through additional reading, and complimentary workshops.

Modern doulas bridge the gap between birth professionals, and personal companions for birthing people and their partners. They are available to their clients throughout the pregnancy to provide support, evidence based information, coaching on informed consent, and often have a soothing and normalizing effect on anxious parents. During labor and birth, a doula is there for their clients alone. While nurses, doctors, and midwives often have numerous patients to care for, a doula provides continuous care for one family and can anticipate and meet many of the needs that come up. A doula ensures that the birthing person and their partner remain well nourished, hydrated and as comfortable as possible, even in a sterile, clinical environment, such as a hospital. Doulas are trained to recognize common patterns and signs during labor and know which positions, and techniques can assist in coping with discomfort, and can often make suggestions to help encourage labor to progress without unnecessary medical interventions.

To be continued...

References:

https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth

https://evidencebasedbirth.com/the-evidence-for-doulas/

https://www.nationalpartnership.org/our-work/health/maternity/listening-to-mothers.html

https://hekint.org/2017/01/27/changes-in-childbirth-in-the-united-states-1750-1950/

https://www.dona.org/wp-content/uploads/2017/08/COESOP-2017-FINAL-Birth.pdf