The Many Benefits of Birth Doula Support Part 1 – by Kelly Martin (Family Social Science 2010).

Abstract

This blog post investigates how the presence of a birth doula positively impacts expecting parent’s labor and birth experience, thereby encouraging or discouraging closer bonding and positive long-term familial interrelations between parent and infant.  The consistency of birth support, care given by a doula, as well as one-on-one doula support has been found to consistently result in positive birth outcomes throughout the newly formed familial system.  These positive outcomes encompass the areas of psychosocial, interpersonal, and physiological health.  Parents who do not receive the support of a doula have a higher correlation of medicalized births and use of pharmacological interventions, whose effects can cause a disruption of the long-term positive formation of a healthy parent-infant bond, which in effect interrupts a healthy, interactive familial system.

Key words:  Doula, birth, childbirth, benefits, bonding, support, healthy family, medicalized birth, pharmacological interventions, natural pain relief measures, positive birth, empowered birth.

This blog post will be posted in sections over the next few weeks.  Watch for sections.  Today please enjoy the article introduction.

Introduction

Women maintain vivid memories of the events during their labors and births.  They formulate extremely strong feelings about their overall birth experience (Abramson, 2004: Bennett, 1985;  Hodnett, 2002) that become embossed and embedded into their everyday lives.  The birth of a child is a life-transforming event – a momentous and empowering occasion.  A woman’s birth experience can change and revise their self-image.  A positive birth experience can give rise to lifelong self-confidence, and feeling of empowerment.  It can gift a woman with the idea that she can conquer anything in her life, which enables her to ascend to new heights of accomplishment.  This transformation can enhance her quality of life, echoing into an ability to be a strong parent, solidifying her ability to form strong familial bonds, healthy bonds with her new baby.

There is a great deal of research regarding the impact birth doulas and labor assistants have on perinatal outcomes.  Within the psychosocial and cultural context, more than fourteen randomized trials in several world countries have shown that provision of continuous, social, physical, and emotional support of a birthing mother can encourage long-term positive effects on a woman’s life (Breedlove, 2005; Brill, 2005; DONA, 2005).  Women who are attended by doulas have a documented decrease in the need for pain medication, a reduction in intrapartum interventions used during labor and birth, a reduction in the incidence of cesarean delivery, and a significant increase in overall satisfaction with their birth experience (Hodnett, 1989, 2002, 2002b).  In addition, labor support has been correlated with improved breastfeeding rates, a marked decrease in incidence of postpartum depression through decreasing maternal isolation, and successful initiation of breastfeeding.  Positive results are particularly striking when labor support is given to mothers continuously, throughout active labor and birth, by lay women, versus medical professionals (Hodnett, Lowe, Hannah, Willan et. al, 2002).   These findings suggest that labor support is an invaluable and necessary addition to modern maternity care.

Culturally competent, lay perinatal social support is an imperative component for multicultural populations of childbearing women.  Having a doula from the same culture, who is also herself a mother, who speaks the same language, is tremendously reassuring to a birthing woman.  Birth doula’s improve communication and encourage a positive birth experience for everyone involved (Kennell, Klaus, McGrath, Robertson, Hinkley, 1991; Kennell, Klaus, Klaus, 1993).  Doulas fill in the gap where there is hospital understaffing, or a cultural separation between care provider and birthing parent (Berkowitz, Klaus, 1999; Romano, 2008; Shelp 2004). 

Doulas provide comprehensive models of maternity care that include appropriate and sufficient psychosocial support, especially in those populations of at-risk women who would normally receive sub-standard birth and perinatal support.  A community-based doula model can contribute to increased power among families living in fragmented communities (Atkins, 2009; Baldwin, Jones, 2000; Beck, 2002; Breedlove, 2005).  In these environments, the daily stresses and limited availability of social and cultural support are magnified by poverty and are often associated with negative birth outcomes (Czarnocka, 2000; Fearn, 2004; Hodnett, 1989).  Environmental, social and behavioral patterns within these communities greatly influence the level of stress experienced by mothers.  According to (Romano, 2008) teen population births are again on the rise.    All of these factors work for naught contributing to America’s high incidence of preterm births, and low birth weight infants within at-risk populations (Scott, Berkowitz, Klaus, 1999).   Negative birth outcomes are associated with a lack of education and support, and are magnified by the fractionalized life-circumstances of poverty.  With education and community doula support, these populations can grow and improve.  Positive, supported birth practices have long-lasting implications for families and children.

Pregnant incarcerated women are an at risk population that can greatly benefit from the support of a doula.  These women have birth experiences that fall extremely short of the healthy ideal birth conditions that are described in "Lamaze International’s (2007), Six Care Practices That Support Normal Birth."  These women experience a lack of screening and inappropriate medical treatment which leaves them and their babies at high risk for life-long mental and physical health problems (Baldwin, Jones, 2000; Beck, 2002).  With adequate perinatal support, prenatal care and education, incarcerated expecting mothers can be encouraged to discard negative lifestyle choices that would affect them and their babies (Fearn, Parker, 2004; Fogel, Harris 1986).  The Community Doula Model can provide the psychosocial support these women lack, and empowering them to grow into healthy parents.

Consistency of birth support provided by a doula which includes the giving of care, as well as one-on-one psychosocial and cultural support, has been found to improve overall birth outcomes.  These positive outcomes strengthen familial systems by encouraging new parent and infant bonding within all populations.  These positive outcomes encompass the areas of social, interpersonal, physiological, and psychological health of birthing parents.  With an inexpensive intervention known as "doula support" it is possible to aid in the empowerment and strengthening of women and families in all populations through the childbearing year.

 

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