Choosing consciously your birthing support.
What is birthing support and why is so crucial?
According to evidence based researches, there are three important factors that will influence your birth experience and even the outcomes:
1 - where you give birth
2 - when and how you give birth
3 - who is with you.
1 - Where: whatever is your choice to give birth: in a big maternity unity, in a small birth center, or at home, in terms of safety is proven to be equal. What change is the level of comfort and intimacy (that are crucial factors to a positive birth experience), and the chances to have medical interventions may be higher in a maternity unity.
2 - When and how: it refers to your the term of your pregnancy, and how your labor started (naturally or induced). Although it can be life-saving, for the big majority of healthy moms and healthy babies, induction is not the best option. It increases the risks of medical interventions and c-sections.
3 - Who: who is with you to support you during birth. This is not to be underestimated. Let's see in details:
a) Partner, friends or other family member: this is a choice motivated by the most primary need of the mother, that is having those who she loves and trust to be her emotional support. The birth companion should be aware about his/her crucial role and that this demands an important preparation, such as attending the best childbirth classes with the mother, reading books about the role of the birth partner, and getting some counselling with a birth professional. It's crucial that the birth partner learn to cope with her/his own emotions in a realistic way, because the emotional states, words and attitudes of those attending a birth will have a tremendous influence on the emotional state of the mother in labor and by consequent on the birth outcomes.
b) Staff of your birth place: If you are planning to have a clinic or hospital birth you will have a midwife or a nurse or a doctor who are likely to be kind and caring, but they will probably be very busy with the clinical aspects of birth which is their role. In big maternity units they will not be in the room throughout labor, as they have duties outside and other laboring women. They work in shifts so along your labor you can meet many different staff members. And of course, you may be lucky to have kind care givers in your labor, but their emotional support may not be exactly what you need.
c) A doula: comes from the ancient Greek, she was a female servant that would help women during birth and post-partum care.
Nowadays, a doula has a crucial rolein birth. She is the one who will connect with your, know your life-story, your fears and dreams concerning to your birth. She have the right balance between connection and the right distance to hold space for you to feel protected, safe and supported.
A doula is a qualified professional who is trained to give physical and emotional support during pregnancy, labor and birth. She knows a lot about birth physiology what can be very assuring. However, she is not a medical professional she does not replace the midwife. Their roles are different.
Considering to have a doula.
Childbirth is an natural event and we women are programmed by evolution to cope with it well. I can, however be intense, demanding and unpredictable. It can last few hours or more than one day. Even if you and your birth partner are well prepared, you may find difficult to apply in real situation what you had learned in the childbirthing education course. And if you didn't any or a very basic preparation so the challenges of labor can seems produce a lot of anxiety which ultimately can leads you to decisions that you would not take otherwise.
One of the most positive developments in maternity care is the addition of the birth doula who guides and support women and their partners continuously through labor, birth and until after the baby is born. The doula is trained and experienced in providing emotional support, physical comfort and non-clinical advise. The doula and the mother have built a closer relashionship during their prenatal meetings and this factor gives her a better knowledge about the feelings and emotional aspects of the mother wich enables her to truly empathize with the mother. Additionally she advises partner how he or she can help the mother, suggesting when to use particular positions and comfort measures.
The doula does not take the role of the partner, she rather help him or she to be the mother's best support, by guiding you to apply what you learned. Her presence allows you to take care of yourself too, eating, going to the toilet, taking a nap (you will need to save your energy for afterwords). Her knowledge reassures you and prevent you to misinterpretations about normal reactions to labor as being signs of something wrong. She can make photos and videos of both of you etc.
*many parts of the text are from the book The birth partner, Penny Simkin