In order to answer this, let’s first look at what the research says about the different forms of labor support and how they compare.
One of the major research groups that analyses current research has found that women who receive continuous labor support (which means it is uninterrupted by other patients or tasks) were less likely to be dissatisfied, had shorter labors, and were less likely to have a c-section or instrumental birth (using forceps or a vacuum). It also showed that this was most effective when given by someone not employed by the hospital or already a part of the mother’s social network, and has been trained in labor support. Support from the spouse, family, or friend does increase satisfaction, but you do not see the other benefits.
According to a survey of mothers (links listed below), doulas also had the highest percentage of excellent support given followed by family member or friend, spouse, doctor, midwife, and then nursing staff.
Second, let’s look at the different types of support a woman can receive during labor and what roles they all play.
1) Doctor or midwife. Both of these will provide you with the medical care you need. They will monitor both you and your baby to make sure you are as safe as we can make it. They will do things such as perform tests, evaluate vital signs, monitor the baby, and prescribe medication if needed. Depending on the training, desire, and model of care they follow, they may also provide some labor support. This may be difficult to do even if they want to, though, if medical emergencies arise and safety must be attended to first.
2) Your nurse has similar responsibilities as your doctor or midwife, with the drawback that you can’t really choose your nurse. Some nurses are very good at labor support and others aren’t. Most nurses are not trained in natural ways to support labor other than a brief run down (and that’s not guaranteed). They also may have other patients and charting to care for.
3)Spouse or father of the baby. The connection you have with your baby’s father makes it very important to have them there at the birth. They also provide emotional support in a way that no one else can. Their exposure to birth may be limited, though, and they may need support themselves to work through the work of labor.
4) Mother or other experienced woman. These women may be helpful depending on many different factors. Having someone who has been through birth can be helpful emotionally and they can at least provide you with acceptance and love. Their exposure to birth may be limited to their own experiences, though, so that may affect what they view as normal.
5) Doula. This is a trained labor assistant. If they are certified, you know they have had some training that has provided them with different ways of supporting women. In my course they are taught ways to communicate with the medical staff and they learn how to work with different care providers. They also learn how to assess what is normal in a laboring woman and how to help them cope with anxiety, fear, and pain. They are exposed to numerous different ways that women give birth and have many ways of addressing the needs of laboring women.
Skills Check Off is a link to the skills list that my students have to pass off. If you can find an experienced mother that has learned these same skills plus works well with different care providers and has a basic knowledge of birth and labor, then you will probably get the same support as a certified doula.
Links to references:
Continuous Support Cochrane Review
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