In this final installment of the 3 Keys series, we will discuss how labor support adds to your best birth experience.
Key 3- Support that Aids the Process of Labor and Birth
You have chosen your maternity care provider, and are planning everything for when baby arrives. But the question still remains, who will you have at your birth? Your Partner, family members, friends, a doula? If you have never given birth it may be hard to determine who will be most helpful to you during your labor, a process you have never experienced yourself. There may be people who want to be there to welcome your baby, or provide assistance, but it will be helpful to determine far ahead of time who you want in your birth space.
You get to decide if you want your birth/delivery room to be like a party or a more private, intimate experience. There is no "right" way to give birth, just the best way for each individual woman. Birth tends to function best when a woman feels safe, supported, and unjudged. What that looks like is different for each woman. If you are a private person who feels better when given space and alone time, having fewer people at your birth may feel safer. Or if you are someone who seeks a community of support during difficult times, likes distraction to keep your attention in a more comfortable place, and feels safe when surrounded by people, having a more people at your birth may feel better. It is a commonly held belief that the fewer people, the easier the birth will be, but I have seen women who don't fit in this box, and so it is important to honor what unique needs each woman may have.
The day you give birth to your baby is all about you. What you want to see, hear, smell, taste, and feel. Everything that is done can be geared towards your comfort and ease. This extends to the people in your birth space. If they don't have a role (emotional support, hands-on comfort and pain relief, child wrangling, etc) and are just there to watch, consider for yourself how that might feel. Being observed affects some people more than others during labor. If you invite spectators, consider having a plan in place that allows you to change your mind should you find that their presence takes away from your ability to focus on the task of moving a human being through your body and out into the world.
It may feel easier to say yes to someone you don't want at your birth to avoid tension, but it could have long lasting effects.
Birth also tends to work best when the laboring woman is an an environment that she deems comfortable. If people aren't getting along, she may feel a need to act as a go between to keep the peace, or not speak up for what she really needs in the moment. Women may fall into a stress response called "tend and befriend". It is physiologic response that we have little control over and is akin to "fight or flight". When in labor, a woman may prefer not to fight and doesn't have the option to run away. The stress response has her trying to change the environment to make herself feel safer. She wants/needs the people in the room to be getting along with her and with each other (befriend) and she needs to know everyone in taken care of and comfortable so that she doesn't have to serve them (tend). When everyone is getting along and is taken care of, she can then focus on the work of giving birth. If she is unable to change the situation or remove herself from it, her body may "freeze" from all the extra adrenaline she is producing.
Since "tend and befriend" is a stress response, it limits the amount of oxytocin being produced (which is required for labor to proceed) and gives precedence to stress hormone production. This can cause labor to slow or stop, create a dysfunctional labor pattern, increase perceptions of pain, and blunt or prevent the fetal ejection reflex, which is designed to help a woman push her baby out. (To learn more about stress and how it affects the hormones of labor, go here.) People often want to be helpful so if you would prefer they not be in your birth room, give them things to do that will be helpful to you, like watching older children outside the labor room, prepping the house, caring for pets, or running errands. If you are thinking about having friends or family members at your birth, consider having them attend a prenatal visit or some childbirth classes with you so they are better prepared to support you.
Doulas are another option for support. Birth, especially for first time parents, can feel overwhelming at times. Having someone who is dedicated entirely to your physical and emotional comfort, as well as helping you gain needed information for decision-making, can be essential to a positive birth experience. Doulas have been praised in many arenas, including by the American Congress of Obstetricians and Gynecologists (ACOG). " One of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula." (ACOG- Prevention of the Primary Cesarean ) A Cochrane literature review, stated that doulas offer a more comprehensive range of benefits that were more impactful than nurses, hospital staff, or the woman's friends or family. In that same report the many benefits of doulas were shown to be the following:
Decreased likelihood of:
1. Cesarean Section
2. Epidural and pain medication
3. Vacuum or forceps delivery
4. Negative birth experience
5. Postpartum depression
Increased likelihood of:
1. Shorter labor
2. Breastfeeding for a longer period of time
3. Spontaneous vaginal birth
A doula is there to support the mother and the partner, should there be one. A good doula never takes the place of a partner who wants to be involved, she helps facilitate a partner's involvement so that they feel confident in their support. The doula is the gap filler. She does what the partner does not want to do or feels uncomfortable doing. Some women may feel that because they are having a homebirth or a hospital-based midwife that they may not need a doula. It is my belief that all women deserve a doula, no matter where and with whom they intend to give birth. A doula is the one person who is there entirely for the woman. She has no other duties, she is not attached to any outcome other than the mother's satisfaction, and if complications occur she is vital to the mother's emotional support and well being. Here is a place to get started learning more about doulas and how they can add to your birth experience.
As you begin the process of deciding who will accompany you during labor, ask yourself these questions: Who do you truly, deeply want at your birth? And why? Do they make you feel comfortable and at ease? Are they supportive and non-judgmental? When you envision them at your birth do you feel safe? What will they add to your experience? What experiences and stories about birth do they carry with them? If they have experienced difficult or traumatic births, what have they done to resolve and release them? Do they know what will help you during labor and birth? Do you feel comfortable showing tough emotions that may surface? Who can you be uninhibited with? When you are in the hardest parts of labor and may want to give up, who will boost you up and hold space for you to dig deep and find the parts of yourself you may not know were there?
Having a baby can be one of the most rewarding and challenging experiences most people will experience in their lifetime. Your choice of provider, who you surround yourself with, and the personal work you do before the birth can greatly affect your experience of birth. Feeling supported, listened to, and truly cared for are some of the most important factors in a positive experience of birth.
If you have questions regarding the information above or would like to discuss doing personal work, processing previous experiences and/or preparing emotionally for birth, feel free to contact me at Sacredbirthspace@gmail.com.