Bring a Loved One, Friend, or Doula for Continuous Support

When discussion of doula care surfaces on the Internet, it is always surprising how many commenters dismiss continuous labor support by a trained professional as unscientific fluff. Couples who hire a doula are sometimes labeled as selfish, out for “the experience” and elitist.

When a person believes that a pregnant woman (who is not planning a cesarean) checks into a hospital in labor to have a medical procedure performed on her, the idea of labor support seems superfluous. You wouldn’t bring a doula to heart surgery, the naysayers grumble. However, hospital birth should be an opportunity to allow a physiological process to take place in a location in which skilled professionals are readily available to intervene immediately if necessary. A primary goal of maternity care should be determining exactly what is optimal in supporting this physiological process, then ensuring that women in institutional settings have access to whatever best supports the normal process of birth.

Until the 1970’s, most American women labored alone, separated from her loved ones. Advocates, vocal consumers, obstetricians like Robert Bradley and childbirth educators fought hard for the right to labor with a partner. In Birth as an American Rite of Passage, Robbie Davis-Floyd wrote, “Hospitals tolerance of fathers’ presence increased as it was discovered that when fathers are educated and prepared for birth, the support they provide the laboring woman enables her to cope with her labor in more socially acceptable ways (breathing instead of screaming, for example), thus helping her and making it easier for hospital personnel to cope with her.”

While the normalization of epidural anesthesia has filled the role of allowing hospital staff to cope with laboring women, often multiple laboring women at one time, many women would still prefer to optimize support of the physiological process of birth and are not given the chance to do so in hospitals or are discouraged from hiring a doula by those who claim that birth is best left to science.

Fortunately, everyone wins with continuous labor support, the efficacy of which is supported by scientific evidence. According to Childbirth Connection, women who received continuous support were less likely than women who did not to:

• have regional analgesia
• have any analgesia/anesthesia
• give birth with vacuum extraction or forceps
• give birth by cesarean
• report dissatisfaction or a negative rating of their experience.

Here are just a handful of links that detail the evidence supporting continuous support of laboring women. And, really, is support of laboring women something that needs scientific evidence to justify its normalization?

Cochrane Review on Effects of Continuous Labor Support (Childbirth Connection)

Best Evidence: Labor Support (Childbirth Connection)

Healthy Birth Practice #3: Bring a Loved One, Friend, or Doula for Continuous Support (Lamaze)

A Doula at Your Birth (VBAC.com)

CAPPA Position Paper: Evidence-based Labor Doula Care (pdf)

OBs denying doula access: Where’s the SCIENCE!!!1!? (Hoyden About Town)