Birth is Not a Spectator Sport, But You May Need a Coach

My sister’s husband travels a considerable amount for business, which meant that while she was pregnant, I stepped in to do a lot of the support activities. I toured the birthing center of the hospital with her, attended an emergency ultrasound when she was no longer feeling the baby kick ( and found out my nephew was turned backwards and indeed kicking his mother’s spine), and went with her to a few childbirth classes. My favorite thing I heard during this experience was when a woman asked how many people were permitted in the delivery room at the time of birth. Her attending midwife replied, “birth is not a spectator sport.”

Fortunately, others in the room giggled so my laughter did not seem so inappropriate. The midwife smiled and told us each mother was allowed to have two people in the birth room, including a doula. I seemed to be the only one who did not know what a doula was, but when I asked my sister after class, she told me a doula is a birth coach. I was confused. Wasn’t coaching the whole reason a woman has her husband in the room with her when she is laboring and delivering? What could a doula do that a husband, sister, or mother couldn’t?

Doulas are highly trained laywomen; this means that they do not fill a medical capacity but rather are in place solely for the purpose of providing ongoing physical and emotional support for women during labor and delivery. Studies have indicated that this level of support is not just nice for the mother, it is actually incredibly helpful. During randomized studies, access to continued physical and emotional support during the labor and delivery process resulted in shorter, less difficult labors and the need for fewer medical interventions. Women who were attended by doulas during their labor were far less likely to need pain medication or oxytocin and were far more likely to deliver vaginally and without the need for vacuum or forceps assistance.

During the early postpartum period, mothers who had doula support reported a more satisfying birth experience and described the birth as less difficult and less painful than did mothers without such support. In the long term, doula-supported mothers had lower instances of depression and low self-perception, were more likely to breastfeed exclusively, and were shown to be more sensitive and responsive to the needs of their babies. What was particularly interesting about these studies was the lack of evidence demonstrating support by fathers to have any of the same benefits during the actual birth or the postpartum period.

Source: KATHRYN D. SCOTT, PHYLLIS H. KLAUS, and MARSHALL H. KLAUS. The Obstetrical and Postpartum Benefits of Continuous Support during Childbirth, Journal of Women's Health & Gender-Based Medicine. December 1999, 8(10): 1257-1264. doi:10.1089/jwh.1.1999.8.1257.