How Doulas Make a Difference in Childbirth

Updated research demonstrates clinically meaningful benefits of bringing a doula, loved-one or friend for continuous support during childbirth.Many women may be surprised to learn that there is a simple strategy they can use during childbirth to increase their chances of spontaneous vaginal birth, as well as satisfaction with their childbirth experience, without any adverse effects. The trick? Bring a professional labor assistant, or doula, for continuous support during labor and childbirth.A newly updated research review featured in the Cochrane Library a publication of the Cochrane Collaboration, an international organization that evaluates medical research examined the effects of continuous, one-to-one support. The review examined births where support was provided either by hospital staff (such as nurses or midwives), by someone from the woman's social network (such as her husband, partner, mother or friend) and by trained supporters who were not hospital employees and had no personal relationship to the laboring woman (such as doulas). The review found that women with continuous support during labor and childbirth were more likely to have a spontaneous vaginal birth (give birth without a vacuum, forceps or cesarean surgery), have a slightly shorter labor and be happier with their childbirth experience. The review also found that these women's babies were less likely to have low five-minute Apgar Scores, a health assessment of newborns performed at one and five minutes after birth.These findings confirm what Lamaze educators have been teaching for more than 50 years continuous support from a loved-one, friend or doula can help a woman feel more comfortable and help the labor progress, said Marilyn Curl, CNM, MSN, LCCE, FACCE and president of Lamaze International. Additionally, the review explored whether the mother's relationship to the person providing the support made a difference. Researchers found that the continuous support was most effective when it was provided by a doula a labor support professional who was not a hospital employee and had no personal relationship to the laboring woman. Doulas are trained in how to offer physical comfort and emotional support to laboring women, said Ann Grauer, a Lamaze certified childbirth educator and doula from Milwaukee, Wis. and past president of Doulas of North America (DONA). I've heard time and time again from couples that having someone at the mother's side throughout labor who is completely focused on her needs is incredibly helpful. Giving women continuous support during labor is part of Lamaze International's Six Healthy Birth Practices. Based on recommendations by the World Health Organization and backed by extensive research that supports a woman's natural ability to give birth, these practices are:

• Let labor begin on its own
• Walk, move around and change positions throughout labor
• Bring a loved one, friend or doula for continuous support
• Avoid interventions that are not medically necessary
• Avoid giving birth on your back and follow your body's urges to push
• Keep mother and baby together; it's best for mother, baby and breastfeeding

To learn more about the Lamaze Six Healthy Birth Practices, please enroll in a Lamaze childbirth education class and visit www.lamaze.org/healthybirthpractices.

Published: April 26, 2011

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