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Options: Labor Support
Who can give me support during labor and birth? How do my options for labor support compare? What kind of care can I expect if I choose a doula? Can I get supportive care from my partner alone? Can I rely on nurses, midwives, and doctors to meet my need for supportive care in labor? Can a relative or friend meet my need for supportive care in labor? Given these challenges, does it make sense to consider inviting a friend or relative to provide labor support? Who can give me support during labor and birth?
How do my options for labor support compare?The table below can help you think through your options for labor support. It shows which types of personnel are most likely to be able to offer specific aspects of supportive care. Although the ratings are generally accurate, there will always be exceptions.
Table adapted with permission from the ICEA Position Statement: The Role and Scope of the Doula, (1999) published by International Childbirth Education Association (ICEA), PO Box 20048, Minneapolis, Minnesota 55420 USA 952/854-8660. Original table by Penny Simkin, PT, CD (DONA). A growing body of better quality research is clarifying that the impact of labor support companions varies, by type of companion. To learn about effects of a person from the woman's social network versus a member of the hospital staff versus someone such as a doula who is present solely to provide labor support, see the Best Evidence page. What kind of care can I expect if I choose a doula?As is clear from the table above, a trained labor support specialist is likely to to be your best option for optimal labor support. A doula stays with you throughout labor. According to your wishes, she may be close to you, if not in actual physical contact, nearly all of the time. She offers comfort measures such as cool cloths, massage, and handholding. She gives emotional support, including reassurance, encouragement, and honest praise. She can suggest ways to improve progress or ease discomfort. She can explain what is happening or interpret what hospital personnel have said. She can also help you communicate your needs to hospital staff and support decisions that you and your partner have made.A doula looks after your partner as well, acting as a resource and guide and making sure your partner's needs are met. Some couples wonder if having a doula will disturb the privacy and intimacy of labor and birth; in fact, a doula can help to protect privacy and create an intimate atmosphere in a busy, institutional setting. A doula usually meets with you before labor to learn your personal preferences, priorities, or concerns, and stays with you until an hour or so after the birth of your baby to help get breastfeeding started. Most doulas are also available before labor and in the days after the birth of your baby to provide information, reassurance, nonmedical advice, and, when appropriate, referrals. Can I get supportive care from my partner alone?Giving your partner responsibility for supporting you through labor puts pressure on someone who may have little or no prior familiarity with birth, and who may have strong emotional needs of his or her own during the experience. Some partners do not have temperaments suited to this physically and emotionally nurturing role. The lack of privacy and the impersonal atmosphere in the hospital may inhibit others.Partners can benefit by having someone with more experience mentor them through, offer practical ideas for helping with your comfort, reassure them, and look after their needs. Having an additional person allows partners to take a needed break and relieves pressure to meet your every labor support need. If labor is intense, you may welcome having more than one person to help you. For example, you may want one person in front of you talking you through each contraction while the other is behind you pressing on your lower back. If labor is long, members of your support team can relieve one another so that you always have someone relatively refreshed working with you. The Tips & Tools: Labor Support page offers ideas to help your partner prepare to support you in labor. Can I rely on nurses, midwives, and doctors to meet my need for supportive care in labor?Hospital-based practitioners and staff may have difficulty providing optimal labor support for several reasons:
These factors are less likely to be a problem at out-of-hospital ("freestanding") birth centers. They would rarely have an impact on home birth care. Can a relative or friend meet my need for supportive care in labor?When all or most births took place in homes, women learned about birth and cared for other laboring women as a central part of family and community life. This knowledge was lost when birth moved into the hospital and women were isolated from their loved ones during childbirth. Few women today are in an optimal position to assist a laboring woman, even if they have given birth themselves, for several reasons:
Given these challenges, does it make sense to consider inviting a friend or relative to provide labor support?The essence of labor support is to "mother the mother." A calm, nurturing person with a basic understanding and respect for birthing processes can provide helpful labor support. A friend or relative who takes on this role can offer a special gift to you, and can experience the great privilege of participating in this important event in your life. The Tips & Tools page in this section offers help choosing a family member or friend to provide labor support. The Resources page offers books and videos to help your labor support companion prepare for your birth.Most recent page update: 11/16/2012
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality and value of maternity care through consumer engagement and health system transformation. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families. |
News and Features
Listening to MothersSM III: New Mothers Speak Out (June 2013) reports on new national surveys about issues women face in the postpartum period and their views about maternity care.
Access the full report and supplementary materials  Listening to MothersSM III (May 2013) is the third national survey exploring women's experiences in pregnancy and childbirth. Commissioned by Childbirth Connection, conducted by Harris Interactive, and funded by the W.K. Kellogg Foundation, the survey polled 2,400 women who gave birth in U.S. hospitals from 2011 to 2012. Results show that medically intensive experiences are typical, and evidence-based practices are underutilized. Childbearing women need better support and knowledge to navigate their maternity care. Access the full report and supplementary materials New Report: Maternity Care and Liability Go to report and supporting materials New Report: The Cost of Having a Baby in the United States Go to report and supporting materials New Cesarean Resources: Go to Best Evidence Report Go to web pages and booklet for women 
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