The Benefits and Value of Birth Doula Support
While modern medicine has made great gains in improving obstetrical outcomes for mothers and babies, improvements in psychosocial outcomes have been shown to have a lasting affect on families and are gaining greater attention in research. According to DONA International’s The Birth Doula’s Contribution to Modern Maternity Care, “The quality of emotional care received by the mother during labor, birth and immediately afterwards is one vital fact that can strengthen or weaken the emotional ties between mother and child.” Penny Simkin, in her essay the “Benefits of Continuous Support” also notes important psychological outcomes. She reports that women who had doula support had more positive outcomes 4 to 8 weeks later than those who did not have a doula. Positive outcomes included ‘enhanced breastfeeding; better maternal-infant interaction; less postpartum depression, anxiety, and low self esteem; greater maternal assessments of their baby when compared to the ‘standard baby’, and greater satisfaction with the birth experience.’
Numerous studies have also shown that obstetrical outcomes may improve when women receive continuous emotional and physical support during labor. According to Hodnett et al. in “Continuous support for women during childbirth” a meta-analysis of 15 trials from North America, Europe, and Africa:
‘Women cared for during labor by a birth doula, compared to those receiving usual care were:
• 26% less likely to give birth by cesarean section
• 41% less likely to give birth with a vacuum extractor or forceps
• 28% less likely to use any analgesia or anesthesia
• 33% less likely to be dissatisfied or negatively rate their birth experience’
While doctors and midwives provide essential medical care for the needs of their patients during pregnancy, birth and postpartum; a birth doula’s role is to provide important non-medical physical, emotional and informational support to her clients and their partners during childbirth. Most importantly, a doula’s continuous presence during labor and birth often fills in a gap left open by medical practitioners who are, for the most part, unable to provide the kind of uninterrupted and continuous support provided by birth doulas. In fact, continuous support appeared to have the greatest impact when the labor companion was neither on the hospital staff nor selected from the woman’s social network.
According to DONA International “The most crucial role for the doula is providing continuous emotional reassurance and comfort … [and] a doula’s goal is to help the woman have a safe and satisfying childbirth as the woman defines it.” Doulas help women and their partners understand the risks and benefits of childbirth options and interventions. Doulas also work as advocates for their client’s birth wishes, as expressed in her birth plan. The advocacy role is best described as support, information, and mediation or negotiation. Additionally, doulas work with partners and other support people to help the laboring woman, role modeling comfort measures, offering encouragements and information, and assisting in practical ways when needed.
Scientific evidence has proven the benefits of doula support for women and shown how a trained labor companion can help women experience better birth outcomes. According to Klaus, Kennell and Klaus in The Doula Book, “Doula support enhances the well-being of mothers and babies, leads to fewer medical interventions in the process of labor and delivery, and saves money. The findings provide a strong argument for expansion of doula services.”
