Yesterday, both the Chicago Tribune and the New York Times ramped it up with pieces on issues greatly affecting the health of mothers and babies.

The Trib ran a great piece on the whole issue of VBAC and how it’s actually not as risky as it’s often presented to be and how it should be readily available  option for women.

Health Experts: Most Repeat C-Sections Unnecessary

Then the NYT ran a great article about a Brooklyn Lactation Consultant who provides women with wonderful breastfeeding support and advice.

The Breast Whisperer

Noruishing a Baby

I love her ground rules:                1. Enjoy the baby.   2. Feed the baby.

Sometimes the first few weeks of an infant’s life can be so stressful (ours was with our first) for new parents that rule number 1 can be forgotten.   I love that she sees her job not simply as getting breastmilk into babies, but fostering the relationship between mothers and their babies.

Underlying both of these articles, which appear to be about two very different things, is the issue of adequate support for women and families during the childbearing year.  Giving women the options, the benefits and risks of these options and then letting them decide which they are most comfortable with and then SUPPORTING them through the outcomes gives families a much better start.

Many times the disappointment I hear in women’s voices when they tell their story about breastfeeding or birthing comes not because of a bad outcome, but it comes at the point in the story when they felt most alone and least supported.  Had these same women been truly supported in a decision that they were allowed to make in those moments, instead of a decision they were coerced into, I believe that in the same situations with the same outcomes, these women would be telling their stories in a very different way.

Adequately supporting mothers and families during the birth year is definitely one major reason that drew me to teaching childbirth classes, serving as a doula, and referring women to La Leche League and lactation consultants when needed.  I support whatever decisions families make for themselves – if a woman herself chooses a repeat cesarean or to formula feed knowing all the benefits and risks on both sides, that is her choice.  What kills me is when women are backed into corners and finding themselves headed toward a repeat cesarean or formula feeding mainly becasue they didn’t have good support for the choices.

This past October I was interviewed by the Chicago area  TribLocal newspaper about being a doula and what role we play in the birth process.  I love how she talks about the role of doulas supporting dads and partners as well.

I really enjoyed the interview because it made me realize how much I really love what I get to do as a doula and childbirth educator.

Check out the article here.

It’s beautiful.

Before we get to the statistics, having a doula at a birth simply makes sense in today’s environment.

Women who are given continuous emotional and physical support during their births tend to be more calm and relaxed and less fearful during the birth process.  Having someone experienced and trained in what is normal, to help women into positions that aid in the baby’s descent and maternal comfort all the while telling the mom that what she is doing is safe and normal helps tremendously.  Adrenaline produced by tension, fear, and anxiety in the mother are all shown to slow down and even halt the birthing process.

As labor and delivery floors are staffed with fewer nurses and more technology, women are increasingly not provided with continuous support in the standard hospital environment. Many labor and delivery nurses are too burdened with the duties of monitoring the mother and baby’s physical well-being along with the hospital paperwork and protocol to be able to provide the kind of intense non-medical emotional and physical support a woman needs in labor. Having a doula present ensures that a woman is supported by a trained professional whose sole focus is to take care of the non-clinical needs of the mother.  A labor and delivery nurse is constantly juggling her responsibilities to care for laboring women, follow hospital protocol and the orders given by the woman’s care provider – a doula’s primary responsibility is to her clients.

So, back to the stats:

DONA International, the organization through which I am certified as a birth doula, has published a position paper.  It is well worth the read.  In this paper they highlight some studies that attempt to document the value of doula support.  Some of the highlights of what they found were:

• Women who have doulas are safer:

26% less likely to have a cesarean section(major abdominal surgery), 41% less likely to have a birth assisted by vacuum extraction or forceps, and doula care even reduces the likelihood that the child would score less than a 7 at a five minute APGAR

• Women who have doulas have shorter births:

the average length of the labor is decreased by by 25%

• Women who have doulas have less painful births:

Doula support has also shown to facilitate less painful labors with women using analgesics and anesthetics 28% less than women without doula support

There are some things in life that just make good perfect sense and having a doula  or someone trained and equipped to provide continuous emotional and physical support for women at a birth is crucial.

I have another doula friend who likes to joke that her clients don’t get epidurals for pain in labor – they get epi-doulas.

And please don’t think that I am naive to think or suggest that women with doulas will have pain or discomfort free labors.  I have had three babies  – all of them were un-medicated births.  I understand the intensity of the  pain a laboring woman can have – and I know that many of the suggestions doulas have can make that pain manageable.

We were overseas for their births and we made the best choices we could in our given circumstances (no doulas).  Looking back I think we did a great job considering, but there were definitely moments when it would have been very helpful to have had an advocate translating (literally and figuratively!) the system to us.

For example, with our second, we went in for an un-scheduled induction.  Looking back, I was in early labor and didn’t know it and the doc was just trying to hurry things along. At the time, I thought that if we didn’t induce, then something seriously awful could happen to me or the baby.  Later during the induction, We couldn’t tell if I had simply a regular IV or one with Pitocin.  We had a lot of questions during that birth that a doula would have been able to help with and ease my/our anxiety through the whole process.

I truly love being a doula.  Supporting women and families through the amazing transition that is labor and birth is a honor that I am thrilled to have – every time.

Klaus, Marshall H, John H Kennell, and Phylis H Klaus.  The Doula Book: How a trained Labor Companion Can Help You Have A Shorter, Easier and healthier Birth (Da Kapo Press, 2002)

“DONA International Position Paper: The Birth Doula”, p. 3: Hodnett E, Gates S, Hofmeyr G, Sakala C.  “Continuous support for women during childbirth.”  The Cochrane Database of Systematic reviews 2003. Issue 3, Art No. CD03766. DOI: 10.1002/14651858.CD003766.

“Caregiver Support for Women During Childbirth: Does the Presence of a Labor-Support Person Affect Maternal-Child Outcomes?”, American Family Physician, October 1, 2002.   http://www.aafp.org/afp/20021001/cochrane.html

Bradley, Robert.  Husband Coached Childbirth (Fifth Edition): The Bradley Method of Natural Childbirth. (Bantam Books, 2008).

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