The evidence a birth support partner works

Lay-person support of the labouring woman and her partner has been demonstrated to lead to lower active labour times and decreased intervention rates – including Caesarean sections, use of drugs for speeding up labour and/or for pain relief, forceps and ventouse delivery. The use of a doula can also decrease post-partum depression rates and increase the success of breastfeeding for a prolonged period after birth. There is no research to suggest that the use of a doula is detrimental in any way, yet the presence of a doula is not routinely requested or made available to pregnant women. Many people do not even know what a doula does, although organisations such as Doula UK (www.doula.org.uk), Doulas of North America (www.dona.org) and l'association Doulas de France (www.doulas.info), are working hard to make the doula name commonplace within society.


But why does it work? This is a question that remains unanswered, although many theories have been proposed. Like all mammals, pregnant women labour better in a comfortable environment where they feel safe. The hospital environment is not generally amenable to such a feeling but the presence of a doula can help calm the atmosphere and small changes to the labour room (dimming the lights, moving the bed, minimising the number of people present) can make a huge difference. A doula will help the partner(s) to nurture, love and support the labouring woman and will be a constant presence in an environment where the medical staff may change shifts, take breaks and work in teams. Overall, the presence of a doula can bring calm and security to the newly-emerging family and it allows them to focus when faced with challenges and questions from caregivers.


References:

Nolan, M., Supporting women in labour: the doula's role. Mod Midwife, 1995. 5(3): p. 12-5.

Klaus, M.H. and J.H. Kennell, The doula: an essential ingredient of childbirth rediscovered. Acta Paediatr, 1997. 86(10): p. 1034-6.

Kennell, J., et al., Continuous emotional support during labor in a US hospital. A randomized controlled trial. Jama, 1991. 265(17): p. 2197-201.

Zhang, J., et al., Continuous labor support from labor attendant for primiparous women: a meta-analysis. Obstet Gynecol, 1996. 88(4 Pt 2): p. 739-44.

Scott, K.D., G. Berkowitz, and M. Klaus, A comparison of intermittent and continuous support during labor: a meta-analysis. Am J Obstet Gynecol, 1999. 180(5): p. 1054-9.

Pascali-Bonaro, D. and M. Kroeger, Continuous female companionship during childbirth: a crucial resource in times of stress or calm. J Midwifery Womens Health, 2004. 49(4 Suppl 1): p. 19-27.

Hodnett, E.D., et al., Continuous support for women during childbirth. Cochrane Database Syst Rev, 2007(3): p. CD003766.

Lowe, A. and R. Zimmerman, The Doula Guide to Birth: Secrets Every Pregnant Women Should Know. 2009, New York: Bantam Books. 270.

Stockton, A., Birth Space, Safe Place: Emotional Well-Being through Pregnancy and Birth. 2009, Scotland, UK: Findhorn Press. 102.