The Purpose and Value of Labor Support

In even the most remote period, however crude or primitive the people, aid was given the childbearing woman.  The delivery of children and the healing of wounds are two arts that can be traced to earliest records and of necessity received attention from the most primitive people. Women who had themselves borne children and were thus taught by experience assisted their neighbors, just as warriors or hunters, exposed to injury, rendered aid to their injured fellow men.1

 Beginning with the "take over" of predominately women assisted childbirth in the 1600's by male medical professionals a woman has been forced to take a passive role in the birth of her child.  Doctors striving to learn more about the mechanics of the physical body disregarded the holistic experience of childbirth.  Through centuries of fear of and disappointment with medicalized childbirth women have taken steps to regain control over their own bodies and the births of their children.  Many have suffered ridicule and been accused of endangering themselves and their babies by demanding any changes in the doctors protocol. 

Fortunately today women have more freedom in the choices they make for prenatal care and the births of their babies.  Unfortunately many women do not realize that they should utilize this freedom by thoroughly educating themselves to participate in possibly the most impacting life experience until they have suffered a "birth loss."  This loss does not necessarily indicate a bad outcome according to the definition of live mother and baby.  It does however affect the mother emotionally and possibly physically if not resolved.  This loss is in the mother's confidence and self worth given that some inadequacy caused the need for medical interventions to insure the safety of her baby. An unprepared mother may find herself helpless in a moment that should make her strong and powerful.  Ultimately the mother may find herself in much the same position as her own mother or grandmother before any change in care was initiated.

            Most women who have experienced a loss in their childbirth experience will then seek out an alternative approach to care with subsequent pregnancies.  They have a better idea of what they want in their birth experience.  Therefore usually the typical childbirth class offered by the hospital educating parents on their options in pain medication becomes inadequate.  Classes offering techniques in pain coping without medication are sought out.  With a little deeper digging into birth literature a mother may learn of midwifery and birth assistants called doulas. The value of labor support by midwives and doulas to the mother and her family is proving itself again and again in research regarding the family's satisfaction in their birth outcomes.  It may be that the birth does not follow the mother's ideal for labor and delivery of her baby.   However, having an experienced, knowledgeable labor support person or doula to care for her emotionally, physically and bridge the gap to the medical model of childbirth or the technicalities of birth by helping her reach an understanding of the deviations to her plan may provide a way for her to embrace the experience rather than work against it. 

Along with nurturance and support, modern doulas offer another important service.  When procedures or drugs are being considered, the doula helps parents become an active part of the decision-making process by teaching them to ask the "right" questions.  Without adding her own agenda, the skilled doula assists parents in making informed decisions.2

     The greatest value of labor support to mother and family then becomes the protection of their right of choice in normal labor and birth.  An experienced doula can provide this protection through informational support along with mediation subtle enough to often go unnoticed by the medical professional. 

The value of labor support to mother increases with physical support.  Providing pain coping practices that empower the mother and offering comfort measures through massage and constant intimate attention to her pain gives her an edge to reduce the often overwhelming reality of it.  Providing physical support to mother's partner allows less tension to fill the birthing space.  A simple shoulder rub or pat on the back, perhaps a run for coffee when the couple needs a moment alone shows support of the birthing family as a whole.  Protecting the sanctity of the couple acknowledges to all that birthing is a shared experience.

The value of support to mother and family emotionally can have the greatest lasting effect.  Simply being present and understanding through experience the feelings of birthing in situations that are not entirely desirable as well as situations that provide the best outcomes in satisfaction can offer the mother and family an anchor of stability.  Extending the support postpartum to listening to mother and family relive their experience with acceptance and understanding allows them to validate their feelings.  This support will forever remain part of the memory of the birth experience. 

The purpose behind providing labor support is to accomplish satisfying outcomes for babies, mothers and entire families.  By encouraging mother and assuring her she is strong and capable of birthing normally and supporting her with knowledge when interventions are needed to bring birth back to the normal path can avoid the panic and disappointment of deviations from the birth plan.  Physical support improves outcomes by reducing the length of labor and lowering the use of analgesia and anesthesia thus reducing the need for surgical interventions.3  Emotional support improves outcomes by helping the family embrace the experience they will remember for the rest of their lives.

Labor and birth unfold within a

complex, and infinite web,

Spun by the mother,

And by everyone who has ever taught her

about mothering, birth, sexuality, pain,

control and surrender.

All the people at her birth

helped spin the web with threads from

their histories, beliefs, experiences, fears…

and recent birth experiences that they have witnessed,

which empowered

or terrified them.4           

             The purpose for providing labor support is to protect the birthing experience for families whatever the experience may prove to be.  It is important for the labor support person/doula to value the miracle of birth and communicate the experience as naturally miraculous to help families to appreciate the moments of life, living and death in all outcomes. The purpose for providing labor support to women and their families is to aid in the acceptance of their birth experiences and support them in their journey informationally, physically, and emotionally.  The purpose extends to help families enjoy their birth experiences as unique and valuable life experiences by reducing physical risks caused by fear and loneliness and lack of education about birth.  Helping the family to embrace medical intervention when it is necessary instead of opposing it as something undesirable will improve the family's satisfaction with the birth experience.  Viewing a necessary intervention as a lifeline for mother to use to bring baby safely into her arms allows her to take possession of her birth even though she may be forced to a passive role. 

The doula's responsibilities are of the highest importance.  Conducting oneself with the awareness of the intense effect of ones actions on the life experience of another person should be continually observed.  The doula has the responsibility to provide the best support possible for every client and to put the interests of the client above all others.  No compromise of confidentiality should be made. In upholding a professional service what is shared between the doula and client is strictly private.  The doula should maintain responsibility to clients even in the event that service is unable to be provided by referring them to capable alternative support.  Being reliable and honest, working with the highest ethic and ability will serve the purpose and value of labor support to families in the best possible professional way.  Being continually aware that ones actions reflect upon the profession of labor support and the care given to birthing families must be ever present in the intentions of the doula. 

Birth can be a positive and life-changing experience for a woman.  It can be a time of great introspection for the mother-to-be as she feels her body working to bring forth new life.5      

 The doula is a valuable asset to the maternity care profession.  The role carries the privilege of impacting life experiences and improving birth outcomes.  By responsibly executing the role with professional dignity doulas will continue to promote the recognition of the value and purpose for labor support.  

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