Labor Support

Part 3: Who Provides Support During Labor And Birth?

Doctor/Midwife:
Physicians are typically only in attendance at the delivery itself, and for about one hour after the baby is born. Prior to that, they are available for phone consultation. They may come in briefly a few times during labor to check on you, answer questions, or provide recommendations about your care.

In one study, 70% of moms reported their baby was delivered by the same caregiver who had provided most of their prenatal care. However, 10% said it was someone she had only met briefly prior to the delivery, and 19% said they had not met their primary birth attendant before the delivery. Midwives may remain with you through a much larger portion of your labor, and are more likely to offer the kinds of supportive care described in this article.

Nurses:
Hospital staff can meet your concrete needs and attend to the safety and well-being of your baby. Many nurses are excellent at providing hands-on labor support and offering emotional support and encouragement. However, they have other duties and responsibilities, which may prevent them from attending you continuously through labor. Also, usually your nurse is a stranger to you, and you may have multiple nurses attending you, depending on the length of your labor.

Husband / Partner:
If you and your partner are both comfortable with the idea of him attending your labor and birth, s/he can be the most valuable source of emotional support and comfort.

Loving partners are one of the strongest tranquilizers and most effective pain relievers available. Their nurturing presence may also encourage the flow of oxytocin, a hormone which helps labor to progress more quickly. For many fathers, the involvement in birth gives them a chance to nurture and care for their partner like never before, which is great practice for nurturing their new baby.

• If a partner is worried about his ability to be helpful during birth (e.g. worrying about fainting):
  • Education about what to expect can be very helpful, especially attending childbirth ed classes and watching videos of births.
  • Talking with friends who've attended a loved one's birth can also be helpful.
  • Some couples may also want to have an additional support person (see below) to take some of the burden of responsibility off his shoulders, reduce anxiety, and make him more available to support mom.
  
  
• After the birth, partners may worry that they were not useful. Nurturing and supporting you can feel passive, and they may feel like they didn't do enough. Learning about birth ahead of time may help them realize how vital relaxation and reassurance can be to labor progress and pain relief.
  
  
• Some fathers feel overwhelmed by their laboring partner's discomfort and the feelings of helplessness it causes. Again, knowing ahead of time what to expect, and how to help is useful. Also, birth education may help to normalize that the pain of labor is productive, and isn't something to be fought against, just something to be soothed with loving attention.
  
  
• If you're worried about your partner's ability to be helpful during birth, especially if there are problems in your relationship, you might be nervous about your partner's presence at your birth. You can involve additional support people, if that would be helpful. You may want to seriously consider seeking out counseling to resolve some of your issues before the baby's birth, as the stresses of parenting can strain even the healthiest relationship.
  
  

Friends and Family Members

• Benefits: Familiar faces can be comforting, helping you to stay calm and relaxed. They can provide support for you and your partner. The more educated and/or experienced they are with labor and birth, the more effectively they can support you with concrete ideas for comfort and for helping labor to progress.
  
  
• Disadvantages: Sometimes friends and family members have a difficult time seeing a loved one in pain, and rather than being able to reassure you that you're doing well, they may convey their anxiety to you in messages like "wouldn't it be better to use pain meds?"
  
  The more you can talk to them in advance about your desires for your labor and birth, the more aware they will be of what would be helpful for them to do, and what would not be helpful.

Doula:
A Doula (a.k.a. monitrice, a.k.a. labor support professional) is a professionally trained labor support companion. They have completed education about the normal labor and birth process, medical interventions, techniques to minimize pain and aid labor progress, and emotional needs during labor. They provide information, advocacy, emotional support, physical comfort, and suggestions to the laboring woman and her partner.

Doulas do not replace the partner; instead, they help the partner to be as supportive as possible by reducing his anxiety, giving ideas for how he could be more supportive, and giving positive feedback to him for the support he is giving.

A Doula provides a continuous presence throughout labor. Typically, the mother informs the doula when labor begins, and then they stay in contact, and the doula will join the laboring mom at whatever point in labor the mother and her partner decide that extra support is needed, and then the doula stays throughout the labor until one or two hours after the baby is born.

The fee for a doula's services varies depending on her skills and experience, and the degree to which she relies on her Doula work to support herself versus the degree to which it simply supplements other income. A typical fee would be $300-550, which includes a prenatal visit, labor support, and postpartum follow-up. Sliding scale fees are often available for low-income mothers. For more info: www.dona.org , Pacific Association for Labor Support (PALS) and www.doulaworld.com