You may have heard of doulas but aren’t sure what they do or what the benefits of having a doula at your birth might be.
Doulas are trained to provide informational, emotional and physical support to women and families during pregnancy, birth and the early postnatal period.
Doulas can support women birthing in hospitals, birth centres or at home. They’re not medical professionals and don’t work for a hospital or a health professional. A doula is hired by you, for you and is focused on supporting you.
Be sure to read our blog post What Is A Doula? Benefits Of Birth And Postnatal Doulas for more information about what doulas do.
In recent years, there’s been a huge uptick in the number of women hiring doulas as birth support. This is thought to be a response to women wanting more personalised care than is achievable in the current medicalised birth system.
As such, there’s been a number of studies into doula support and whether it actually does offer better outcomes for mothers and babies.
A review of 22 trials looking at continuous support for women in childbirth involving over 15,000 is found in the Cochrane Library. The review was updated in 2012 and looked at the effects of continuous support during labour, as well whether the type of support made any difference.
Let’s take a dive into this evidence and see what the benefits of having a doula at your birth really are.
#1: Less induction
The Cochrane review found one of the benefits of having a doula is 31% of women with continuous support were less likely to be induced with artificial oxytocin (Syntocinon).
Labor induction is the stimulation of uterine contractions before labour begins on its own. This can be done a number of ways but the most common is to use medications such as Syntocinon.
Induction labours are generally more painful, as the uterine contractions are stronger and more intense much more quickly compared to natural labour. Constant monitoring of the baby for fetal distress means women aren’t able to move around as easily, restricting movement and increasing pain.
In 2018, it was reported 41.6% of first time Australian mothers were induced, an increase from 30.6% in 2010. Induction of labour should only be recommended for medically necessary but recent research shows many inductions are recommended with no medical reason.
Continuous support during pregnancy and labour allows women to be more informed about their options should an induction be offered. One of the benefits of having a doula is having a sounding board who listens and responds without judgement. She can discuss why your doctor is recommending induction, help you find more information about the risks and benefits, and support you in making an informed decision.
Should an induction of labour be the best and safest choice for you, a doula can support you to have a positive experience with the least amount of intervention. We invite you to read Labour Induction- What Are My Options for more information.
#2: Fewer c-section births
The review found a nearly 30% reduced risk of c-section as one of the benefits of having a doula.
C-section is major abdominal surgery that has a host of risks for mothers and babies. We take a look into this more in What Are The Risks And Benefits Of C-Section Birth?.
The World Health Organisation says c-section rates should be around 10-15% but unfortunately in Australia they’re double that.
While c-sections are undoubtedly life saving when necessary, the fact they’re increasing worries many health experts and indicates the surgery may be overused. If you’re hoping to avoid having a c-section, then doing everything you can might include having continuous support from a doula.
During pregnancy and labour, a doula will help to keep you calm, encouraged, reassured and motivated to achieve your birth preferences. They will create the space you need to feel comfortable and supported, perfect ingredients for a normal birth.
If a c-section becomes the best option for you and your baby, whether it’s elective or unplanned, your doula can help you have an empowered birth experience.
#3: More normal birth
Another of the benefits of having a doula is more women have a spontaneous vaginal birth than those who don’t have continuous support.
When a woman goes into labour without any induction methods used, and births her baby without needing any assistance such as forceps, vacuum or c-section, this is known as a normal spontaneous vaginal birth.
Nature has designed the labour and birth process to be beneficial to both mothers and babies. During labour, a woman’s oxytocin levels build, peaking at the moment of birth. This hormone stimulates the powerful contractions that thin and dilate the cervix, push the baby down and out, push out the placenta and limit bleeding from the uterus.
As contractions open the cervix, they also help the baby to move into the optimal position for birth, and shift fluid out of the lungs in readiness for breathing.
Both mother and baby meet each other without any barriers or separation. Their immediate bonding begins, as both their brains are primed to attach to each other.
#4: Fewer requests for pain medication
During a normal labour and birth, the pressure of your baby against the cervix and the vagina send signals to your brain to increase both oxytocin and endorphins. Endorphins are our body’s natural pain killers, helping you to cope with contraction pain.
More oxytocin means more endorphins, and so the process of labour goes. Less oxytocin, less endorphins and contractions can become unbearable, labour can stutter and stall. This leads to health professionals responding with interventions and increased requests for pain relief.
Oxytocin is promoted when a birthing woman feels safe, isn’t stressed or anxious, isn’t being observed or under bright lights. During your pregnancy, your doula will discuss any triggers or concerns you have so she can ensure your birthing space is protected.
One of the benefits of having a doula is how encouraged and reassured you feel. Your brain will release oxytocin and endorphins to keep labour progressing, your stress levels are low and you work with your body, not against it. Your doula can support you physically and emotionally, helping you during labour to find positions and ways to work with contractions, reducing pain.
#5: Babies do better
One of the benefits of having a doula and continuous support during pregnancy and birth is it leads to fewer newborns being admitted to special care nurseries.
This is likely due to a combination of factors, mostly relating to their mothers being supported to have normal spontaneous births and having immediate skin-to-skin afterwards.
Inductions increase the risk of babies being born early, leading to respiratory issues as their lungs haven’t finished developing properly. C-sections can also lead to respiratory distress, usually because fluid hasn’t been moved out the lungs by contractions during labour. This causes fast shallow breathing and can mean oxygen and possibly IV fluids if they can’t feed properly.
When babies are born, they’re assessed at 1 and 5 minutes and given a score on the APGAR test which provides information about how well a newborn is coping after birth. Low scores on the AGPAR test are often due to fetal distress, maternal anaesthetic, or lack of stimulation which normally happens when born vaginally. C-section births tend see babies score lower on the APGAR test than those born vaginally.
Babies who are given the time and opportunity will crawl to their mother’s breast after birth and begin breastfeeding. This closeness enhances both mother and baby’s production of oxytocin and prolactin, which is essential for bonding, early attachment and breastfeeding.
Attachment is crucial for newborn survival and separation at this point can create devastating stress levels for both mother and child.
#6: More birth satisfaction
Overall, mothers who have continuous support from a doula are more satisfied with their birth experience. While this might not seem like an important benefit, the rising rates of women experience birth related stress trauma speaks to the lack of positive birth experiences.
How satisfied a woman is with her birth experience influences early bonding and attachment with her baby. It affects her self confidence and self esteem and will impact on future birth expectations. Women who feel in control of the choices they’ve made for such a life changing event will often be more confident as they navigate the transition to motherhood and feel more empowered to make strong choices in the future.
Doulas often use the term empowerment to describe the nature of their role. Empowerment means to offer support that gives women the freedom or confidence to have power and control over their bodies and choices. This may look different for different women, but ultimately, the goal is to encourage self-confidence.
To enjoy all the benefits of a having a doula, contact Nurtured Birth to discuss how a birth doula can best support you.
