Tuesday, July 20, 2010

The Labor Support Battle

The one thing I always hear when I recommend a woman hire a doula is, “Why can’t my husband just do it?” And from the men, “If there is a doula there, I won’t be needed, so why should I even go?”

Men are very protective by nature. They protect their wives, provide for their wives, are there for their wives, all because they love and support her. When a woman comes along saying a woman should get a doula for support during her labor, it can be a threat to the husband’s masculinity and protective nature. If he can’t protect and support his wife, what role does he truly play?

The couple has probably taken childbirth classes, and feel decently prepared for labor and birth.

The one problem: Neither person has been present at birth before (this is the majority, a few have actually attended and helped a births before they themselves have children).

No matter how much you prepare, the woman will more than likely be completely centered inward and trying to work through her labor and won’t remember much from the classes. Her body will instinctively tell her what positions work and what don’t by decreasing her pain, but she will still be in some level of discomfort.

What husband do you know isn’t concerned when his wife is in pain? What husband would be completely okay with seeing their wife in the most discomfort she has been in in her entire life, and working harder than she has ever worked? I know very few that are completely level-headed when their wives are in pain. Even if they truly want to help, sometimes their protective nature overcomes their logic and they try to control the problem rather than work with it.

Another problem is that when you are in the heat of the moment, you forget the important things. In labor, you are tired, hungry, and worried. The husband forgets what positions are good for labor and pushing, what things help with pain relief, what can truly help their wives or partners get through labor and birth the way they want to.

In addition to forgetting this, what partner truly knows the ins and outs of every intervention and pain medication that a doctor would advise so as to make an informed decision with the laboring woman?

There is truly a difference between preparing for labor and truly experiencing labor. You do not know how your contractions will feel or what will help you the most. It is a completely new sphere.

With that being said, a doula is not there just to help the mother cope with her labor. The doula is also there to help the partner or husband so that he is able to completely help his wife or partner in the way that is best suited to him.

A doula can help a husband by:

1. Reaffirming that labor truly is normal. The body does an incredible amount of work during labor and delivery. The uterus contracts at amazing strengths to dilate and push a baby out. If you have never experienced labor before, the strength and power of the contractions can quickly overcome anyone and have them wonder if this truly is normal. A doula makes sure the couple knows that this truly is a normal, natural body function and also recognizes when things truly do get out of hand.

2. Helping keep the privacy of the room during labor by dealing with the hospital staff. In the hospital, most nurses and doctors will not knock before entering a room. Imagine you are in the bathroom at your house and someone you probably do not know just walks in in the middle of you having a bowel movement. You would be very embarrassed and most likely unable to finish while they are there. It is the same during labor. If you are interrupted during this process, it can slow or stop completely. Another issue is nurses or doctors trying to talk to a laboring woman during a contraction, whether it is just beginning or just ending it is still distracting. If you lose your concentration during a contraction, it is incredibly hard getting it back. The doula can occupy the nurse’s or doctor’s time during the contraction so the woman isn’t interrupted (and the husband can help without worrying about the nurse or doctor) and after they can discuss the options the nurse or doctor came to talk about.

3. Showing how best he can support the mother. A husband wants to help his wife, but sometimes gets stuck wondering which comfort measure can help his wife during her stage of labor. A doula, being trained in comfort measures during labor, can show the husband how best he can help his wife. This will give the husband confidence he is doing what will help rather than hinder his wife, and know that he is the one truly helping her during her labor.

4. Giving him a break during labor. Labor can last hours or even days. Even if the woman has no interest in eating, the husband still has to keep up his strength, not to mention have sleeping and bathroom breaks every once in awhile. If the woman and husband are the only two there, if he leaves, the woman will be completely alone during her labor, whether it is early labor or transition. If they have a doula with them, the husband can take breaks as needed without worrying if the laboring woman will be alone.

5. Providing truly trained “labor sitting”. Before labor and delivery moved to the hospital, doctors and midwives provided support through all of labor, not just during the last few pushes of labor. This practice has gone by the wayside so the woman is left with just her and her partner alone in a room with nurses coming every few hours to check on them. A doula provides the labor sitting that has become a forgotten art. Even if the couple has everything under control, the doula can sit by and wait until they are needed. And even if they aren’t needed to help cope with labor, they have read multiple labor and birth books so they can give trained advice and know the risks and benefits of every procedure.

6. Making sure the mother’s wishes are honored. There is a common joke with a lot of obstetricians that if a woman brings a birth plan, she is on the fast track to a cesarean section. Even if this isn’t a joke in your hospital or with your doctor, it is very hard to ‘fight’ for what you want during labor and have your wishes truly honored. A doula can help keep your birth plan. They can peacefully keep your wishes in mind of the doctor and nurses so that they do not unnecessarily do something you did not wish for, and you do not have to fight for it.

7. Knowing many comfort measures that can be used during labor. Since this is their job, they research constantly and know a plethora of comfort techniques. Even if the husband studies thoroughly, he won’t be as invested as a doula. Having a greater knowledge of comfort can only help the laboring woman and her husband.

8. Doulas have an incredible record for keeping down interventions and helping the woman have a better birth experience. The presence of a doula results in:

• Reduced cesarean birth rates by 50%
• Reduced length of labor by 25%
• Reduced use of Oxytocin by 40%
• Reduced requests for pain medication by 30%
• Reduced the rate of Epidural usage by 60%
• Babies had fewer health problems at six weeks than the infants of women who had not had a doula present during labor.
• Babies had fewer neonatal complications
• Babies had fewer workups for sepsis

This just truly stands on its own two feet.

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A doula truly is not there just for the laboring woman. They are hired by the couple, to help the couple meet their baby for the first time the way they want to. Labor and delivery is an intimate time between two people, and a doula can keep that privacy and intimacy so your baby is greeted in the atmosphere best for the family.

Even though I am a doula, I won’t ever labor without one in the future. Knowing what I know about labor and delivery, I would not go into labor without a trained professional at my side.

You hire a professional to do your hair, to install your cable, and to help you ‘deliver’ your baby. Why not hire one to help you through the hardest work you have ever had to do?

1 comments:

enjoybirth said... [Reply to comment]

Great post about sharing the benefits of a doula. You were smart to point out how doulas benefit the dads too!

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