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Birthing

Women have been supporting other women during the natural process of labor and birth since the beginning of time. Today, a professional who provides one-on-one support for women during pregnancy, labor and the postpartum period can have many names: Doula, Monitrice, Labor Companion, Childbirth Assistant or Midwife. They all imply a slightly different scope of practice, depending on the experience and education of the care provider.

What they all have in common is an understanding of and trust in the process of birth and a respect for its physical, emotional and spiritual components. This chapter addresses Childbirth Assistants and Doulas. The Midwifery chapter addresses Nurse Midwives and Licensed Midwives.

Childbirth Assistant

A Childbirth Assistant offers numerous ways of supporting both women and babies during the magic of pregnancy such as:

• Provides emotional support through reassurance, encouragement and being continually present during labor
• Shares information and stresses education in order to promote informed choices and support complementary options
• Offers physical support by suggesting positions, relaxation, breathing and other comfort measures, such as therapeutic bodywork
• Focuses on facilitation and advocacy during labor

Childbirth Assistants trust in the innate normalcy of the birth process. Women inherently possess wisdom that helps guide them through this experience. However, women and their families need and deserve a great deal of support during this time.

A woman's sense of safety and confidence can be greatly influenced by the people she chooses to be around during her labor and the place she chooses to give birth. A Childbirth Assistant can support a woman wherever she chooses to give birth: at home, in a birthing center, or in a hospital.

Doulas

A Doula's scope of practice varies slightly from the Childbirth Assistant. The Doula lends assistance throughout the pregnancy, labor, birth and postpartum process. She perceives her role as one who nurtures and protects the woman's memory of her birth experience. She recognizes birth as a key life experience that the mother will remember the rest of her life.

The benefits of care by a Doula include:

• Improved breast feeding
• Increased time spent with the baby
• More positive maternal assessment of the baby's personality, competence and health
• Decreased postpartum depression

Recent studies demonstrated the Doula's presence has very positive effects on the outcome of birth. Studies show that women who have the support of a Doula show a:

• 50% decrease in C-Sections
• 28% decrease in length of labor
• 40% decrease in the use of oxytocin
• 30% decrease in pain medications
• 30% decrease in forceps deliveries
• 60% decrease in epidurals
• Decrease in number of days in NICU

Sources: Jennifer Barr; Martha Oakes, CMAMB, Boulder CO; Terra Richardson, RM, Boulder CO; and Jennifer Stevenson, AAHCC, Slidell LA.

Also see Midwifery and Women's Health

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