The biggest news from ACOG’s latest Committee Opinion, was that women should have access to continuous labor support, professionally called a doula. This does not surprise many who have been following the trail of research since the 1990’s. They cite the now famous Cochrane Review, and an article that showed large decreases in c-sections and premature births when women use doulas. It also states that, “in addition to regular nursing care”, someone not employed by the hospital should offer labor support. This is good news for the professional doula, and one that New Beginnings applauds.
The Committee Opinion also gives other recommendations that will help to give women more choices and access to the support they need during labor and delivery. These include:
- Women who are low risk should be able to use intermittent auscultation and non-pharmacological methods of pain relief.
- If women and their babies are healthy, medical professionals need not admit them in early labor. Other support personnel can give them contact and support. Women can also use non-pharmacological methods of pain relief if desired.
- For PROM (prelabor rupture of membranes), women may use expectant management if no other complications are present.
- Healthy women need not have a routine amniotomy.
- Hospitals should provide training for using dopplers in low risk women.
- Nurses, doctors, and other support persons may use a coping scale rather than a pain scale.
- Women may use frequent position changes to support comfort and optimal fetal positioning.
- Women may push in whatever way they feel the most comfortable.
- Healthy women can rest before the start of pushing if desired.
Due to these new guidelines, New Beginnings recommends a renewed effort for professional doulas and medical personal to work together to help birthing women. Health care professionals and doulas should provide a collaborative team to give women the best evidence-based care. Non-pharmacological pain relief, support, coping scales, different pushing techniques, and position changes are all techniques familiar to most trained doulas. Because so many of these recommendations use techniques known by trained doulas, hospitals, medical professionals, and doulas should work together to provide support and non-pharmacological methods of pain relief if desired by the birthing woman.
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