I remember being pregnant with my first son and the discussion about doulas came up. This was many years ago and I think Des Moines had two doulas at that time. I wasn’t sure if we needed one in addition to our amazing midwife so we decided not to pursue it. To this day, it’s one of my biggest regrets as a mom. I didn’t realize before I had my first just how intense and long labor could be. After two days of prodromal labor, my husband and me were completely exhausted and overwhelmed. We ended up with many of the interventions that I was so desperately hoping to avoid. I believe my exhaustion and disappointment led me to some pretty serious postpartum mood disorders too.
Now for the good news! For my second son’s birth, we hired a doula. She knew exactly what we needed each step of the way during my labor. We didn’t even have to ask, she just knew. We were able to check in with her in the morning during my early labor contractions. When she joined us in labor, she kept us calm through her reassurance that my labor sounds were normal, strong contractions were good, and by providing amazing neck massages. To this day, when I think about being in labor, it bring me so much joy. I remember sitting on a birth ball, with the windows open in early April, smelling the fresh grass, and waiting for a thunderstorm to roll in. I’m sure she was a big a help at the hospital too, but somehow those memories have escaped me a bit.
Thinking about a doula? Have your partner consider these questions.
- Have you attended a birth before? Think about birth as a marathon. Would you just go out and run a marathon with no prior experience, knowledge, or coaching? Probably not.
- What do you already know about birth? Knowing the stages of birth, phases of labor, and multiple comfort techniques about birth is a must!
- Have you ever supported someone through a birth before? Watching a birth and supporting a birth are very different things.
- Are you comfortable advocating for the mother in the hospital/home birth setting?
- How do you handle stress? If there are “curveballs” in labor, consider that you will be the one to provide support while advocating for the mother/baby too.
- How do you handle lack of sleep? Labors are often overnight and require the support person to stay awake while providing support.
Consider the Stats
One of my favorite statistics shows that having both a supportive partner and doula makes a huge difference in birth outcomes.
“The Cesarean rate for first-time mothers was 25% in the group with a partner only, and 13.4% in the group with a partner and doula.”
(McGrath & Kennell 2008)
In addition to having great partner support, continuous labor support from a doula also can make a huge difference. In 2017, Bohren et al. published an updated Cochrane review on the use of continuous support for women during childbirth using 26 trials that included more than 15,000 people.
- The women in these studies were randomized to either receive continuous, one-on-one support during labor or “usual care.”
- Overall, people who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and Cesareans.
- In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth. There is a smaller amount of evidence that doula support in labor can lower postpartum depression in mothers.
- 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
- 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
- 10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
- Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
- 38% decrease in the baby’s risk of a low five-minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
- 31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff
More statistics can be found at Evidence Based Birth: Evidence for Doulas
Births with Doula and Partner Support
Our doulas at The Iowa Baby Ladies love working as a birth team with partners. (You would have one doula on your birth team.) It really takes two or more people to provide comprehensive, compassionate support to a laboring mother! We will never replace the support partner or take over their role. We want them to be as involved as they want to be!
If you are considering adding a doula to your birth team, please let us know by sending an email to katie@theiowababylady.com. Be sure to ask the doulas during interviews how the include the support partner in the birth process! I know you’ll love their answers.
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