The Importance of Birth and Postpartum Support

Ask any woman you know about bringing home her baby from the hospital and she will most likely be able to recount her experience with great detail and enthusiasm. I can clearly remember the day I excitedly carried my new son into my house for the first time. I celebrated the relief that the delivery was behind me and looked over his tiny fingers and toes. Then with my son in my arms, I sat down and cried.

Here was this fragile life that I had so anticipated for nine months. Now he was before me, totally dependant on me to do everything right. Even though I thought I knew all there was to know about caring for an infant, the enormity of the responsibility hit me.

At home there were no nurses coming in and out to help, no lactation consultant on hand, nor a nursery to place him in while I caught a brief nap in between feedings. It was just me now- exhausted, sore, scared, recovering me.

I feel it is a safe assumption I was not alone in how I felt that day or in the months that followed. All too quickly a new mother is sent home, barely having time to absorb the basics of baby care or having adequate rest. How does one care for their new baby if there is no one to teach and support her through the first daunting weeks? Recovering from birth is a feat in itself, especially if a c-section is involved. Hospitals who once required a more lengthy visit are now sending moms home in record time, leaving mom barely time to catch her breath before the marathon of around the clock feedings begin.  Throw household chores and a few other children into the mix and the joy that a new baby should bring becomes a very stressful experience leading mom to feel overwhelmed, isolated and often depressed.

The natural childbirth movement of the 1960s and 1970s recognized laboring woman's need for a support system both in the delivery room and after mom returned home. It took the old practice of women laboring alone, usually highly medicated, to a style that focused on a more nurturing methodology. For the first time ever, husbands and partners were brought into the delivery room to soften the sterility of birth. Although it added enormous comfort and ease to the mother-to-be to have a loving, familiar face present, it was soon realized that few of these individuals had experience with childbirth or were trained to offer relaxation and positioning techniques.

The broadening of the general understanding about the importance of social support in labor, along with proper post partum care accompanied the development soon after with a professional called a doula (a Greek term meaning "woman's servant"). Although labor support professionals had existed for years, it wasn't until an anthropologist, Dana Raphael, coined the word doula in the 1970s that the term began to catch on.

The doula recognizes that the birth experience is one a woman will remember her entire life and focuses her efforts on making it a positive memory. Use of a birth doula has been proven to have a 50% reduction of cesarean rate, a 25% shorter labor, a 60% reduction in epidural requests, a 30% reduction in analgesia use and a 40% reduction in forceps delivery.* It also found to have a soothing affect on the baby as well who appeared calmer at birth and who breastfed more successfully.

A doula begins by working with the expectant mother developing a "birth plan." This plan discusses items such as the mother's desires for or against certain commonly administered medications, her preferred relaxation methods, personal goals for the birth (such as natural childbirth), how they wish to handle medical interventions if necessary, etc. A doula then assists in keeping the mother gently on track with her plan to allow both mom and partner have a birth resembling what they had hoped for prior to the on-set of labor pains (when it's often difficult to remain clear-headed or to express your thoughts amidst a hectic admission into the hospital).

A doula also acts as the laboring mothers "constant companion" and serves as a source of encouragement and comfort using relaxation methods, offering suggestions on positioning, breathing techniques, massaging and even offering dad a much needed reprieve from time to time. After birth she assists in breastfeeding which is crucial for keeping the baby hydrated. Infants typically fall into a 24-hour deep sleep within an hour of their delivery making it difficult to rouse. The doula helps ensure the baby falls asleep properly nourished.

Another kind of doula, called a postpartum doula, can help to ease the transition period of bringing baby home from the hospital with the same comfort and companionship offered to the mother in the delivery room. Often times, if trained in both areas, it can be the same doula which is helpful because the parents have already bonded and developed a sense of trust with the individual who will now be caring for their newborn.

The doula helps ease the entire family through the adjustments and the changes a new baby brings by emotionally and physically helping the family during the postpartum period. "A mother's job for the first two weeks after birth is to stay in one place and nurse her baby," states Christie Flynn, R.N. and Certified Lactation Consultant "Ideally, she should be relieved of her regular responsibilities and focus on her recovery and her new baby." The post partum doula is a specialized support person who offers instructions in newborn care while keeping the rest of the household running smoothly. The doula essentially "mothers the mother" bringing her healthy meals, occupying the other children, running errands, keeping the laundry going, etc. She is a calming force offering encouragement and guidance wherever it is needed and a "voice of knowledge" when questions arise. She allows a new mom and her family time to enjoy all the wonderment of the much anticipate arrival of their new baby. A mother knows her child is in good care while she is resting based on the post partum's experience and training.

Editorial provided by Suzanne White, a certified Doula and the owner of Modern Miracles in Cleveland, OH. She is a member of DONA International and holds a BA from John Carroll University.