Great article called “What is the evidence for doulas?”

Ok, this is probably the most comprehensive explanation of why someone might want to hire a doula I have ever read, and it comes complete with a concept diagram of the whole thing!

Rebecca Dekker starts out by saying,

When I was pregnant with my first child, I briefly considered hiring a doula. I saw the doula flyers at Baby Moon, where I did prenatal yoga, and I thought it sounded kind of cool. But when I talked to my husband about it, he felt a little squeamish about the idea. We are both pretty private people (although you wouldn’t think it now that I blog about birth), and he didn’t want anybody else there. He just wanted it to be him and me. And he felt like he would do a good job of supporting me. At the time, it made sense. But hindsight, as they say, is 20-20.

Now all I can say is what were we thinking? How could it possibly be just him and me at the birth, anyways? We were planning to birth in a hospital! A teaching hospital, no less! Where there would be strange residents and students coming and going, and where we had no control over who we got as a labor and delivery nurse. And this was my first birth! It is so important to avoid a C-section in your first birth, because that sets the tone and risk level for all of the rest of your births (and we wanted to have at least 4 children, too). I knew on some mental level that doulas lower the risk of C-section, but I guess I just didn’t realize how important doulas are. Well, I do now. So today, I am going to talk to you about the evidence for having a doula present at your birth.

So true! I can relate because during my first pregnancy, I couldn’t imagine what I would need a doula for too. All that changed once I was in labour. To read my story you can go to Birth Stories.

Rebecca goes on to explain the randomized controlled trials that prove how effective doulas can be for improving labour and baby outcomes. To read the rest of the article, click read the article here.

The absolute craziest thing is how after so much research, the medical profession isn’t like totally promoting doulas to every pregnant woman. The fact is, if doulas were a drug, it would be unethical not to recommend them. But they’re not a drug. They’re people. And so, right now, only the people who already get it, are choosing to have a doula. I hope by the time my daughter is having kids, every pregnant woman is informed about doulas and exactly how they can help, so she can make an informed choice, instead of of what I usually hear, which is, “I wish I had known about doulas BEFORE I gave birth!”

How Emotions Affect Labor and Birth – Part 1

We all know things like poor nutrition, lack of exercise, smoking, alcohol and drugs can have negative effects on the course of pregnancy and the chances of having complications in labor and birth. We’ve also been told that we should try to reduce stress levels when we’re pregnant because stress can have a negative impact on the health of the pregnancy. But just how important is your emotional health to the health of your baby? And do emotions play a significant role in whether you have a smooth or complicated birth?

This is a relatively new field of study, but it is increasingly becoming evident that health in general, and in particular, health in pregnancy, birth and post-partum is not only influenced by physical factors, but by emotional factors as well. This is an important new perspective because it means that when we’re experiencing upsetting situations, it may be detrimental to our health to just “sweep it under the carpet”. Learning how to process emotions, resolve negative issues and promote positive emotions may be as important as eating well, exercising and avoiding smoking or alcohol.

How do Emotions Affect Labor and Birth? Many professionals in the field of birth, such as French Obstetrician, Michel Odent, have observed that when laboring women feel safe, supported, and respected, they tend to experience less pain, have less complications in labor, bond more easily with their infants, have fewer problems breastfeeding, and feel more positively about themselves as mothers. Laboring women who feel anxious, stressed, unsafe or unsupported tend to experience more pain, have more problems with their labors, take longer to bond, have more difficulty breastfeeding and have less confidence in their mothering.

Yup, you heard me right. Negative emotions can cause labor pain to feel wwwwaaaaaayyyyyyyy worse!

Negative emotions can cause complications in labor. What?! Are you kidding?!

Think about it. When we’re afraid, in danger or stressed, we produce Adrenalin, the fight or flight hormone. Adrenalin inhibits or slows down body functions that are not critical for immediate survival, fighting, or running away. When mammals are in labor and a predator is in the area, the mammal mom produces adrenalin which inhibits labor. This is helpful because 1. She can run away to a safer place, and 2. She wouldn’t want to have her baby near a predator who might then eat her baby.

Fear, or similar emotions, produce adrenalin. Adrenalin can slow down labor. So fear, anxiety or feeling unsafe can slow down or stop labor. You’ve probably heard of many women who had cesareans because they’re labors “weren’t progressing”. We don’t know if one of the causes could have been anxiety. More research into this needs to be done.

A recent study, featured in the Globe and Mail, shows that women who fear childbirth are more likely to have a cesarean. Click here if you want to read the article. What the article doesn’t explain is how to resolve those fears prior to birth.

Some useful questions to ask are, what causes fear and anxiety in labor (I’m sure you have a whole list in mind), and HOW do we resolve those negative emotions and promote positive ones? You can start your list about that too. We’ll talk about that in my next post How Emotions Affect Labor and Birth – Part 2.

Speaking of positive emotions, the flip side of this anxiety-adrenalin discussion is the love-oxytocin discussion. Interestingly, oxytocin, the hormone that starts and controls contractions in labor, is called the love hormone because it is also produced when breastfeeding, bonding with infants, falling in love, making love, getting a massage, thinking about something you love, talking to your best friend and who knows what other things.

Loving feelings, relaxation, relationship bonding promote the production of oxytocin. Oxytocin is necessary for effective contractions. Therefore it makes sense, and often is the case in practice, that women who feel loved, safe and supported have smoother labors. Obviously, women find it helpful to have their partners with them in the delivery room, assuming their partners are loving and relatively calm. That may also be one of the reasons that doulas are so effective at reducing the need for interventions in labor. Doulas provide continuous support throughout labor and are focused on mom’s emotional needs so she can resolve her anxiety and enhance her feelings of support.

So if you are pregnant, use this article as an excuse to do whatever it takes to feel good 🙂 And if you are upset or anxious about something, don’t sit with that for too long. Do whatever you do to feel better. Talk to your caregiver, talk to a friend, have a bubble bath, get a massage, go for a walk or talk to your doula.

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© copyright 2011 Kaurina Danu The Prenatal Journey