I’m a Danger to Pregnant Women and Their Babies…
…according to this sign posted at an OB clinic in Utah.
Too bad they don’t know the truth:
“”Continuous support during labour should be the norm, rather than the exception. All women should be allowed and encouraged to have support people with them continuously during labour. In general, continuous support from a caregiver during labour appears to confer the greatest benefits when the provider is not an employee of the institution, when epidural analgesia is not routinely used, and when support begins in early labour.”
(Hodnett and colleagues 2004).” ~Childbirth Connection
Also from that same site:
This largest and most recent systematic found that when compared to women who did not receive continuous support, those who received continuous support were:
- less likely to have an epidural or other “regional” analgesia
- less likely to use any type of pain medication (including narcotics)
- less likely to give birth by cesarean section
- less likely to give birth with vacuum extraction or forceps
- less likely to be dissatisfied with or give a negative rating to their childbirth experience (Hodnett and colleagues 2004).
Several reviews have found that the type of person providing the care appears to make a difference. Labor support provided by caregivers who come to the labor setting expressly to provide this care appears to offer women more benefits than labor support provided by nurses or other clinical caregivers from that setting (Hodnett and colleagues 2004, Simkin and O’Hara 2002, Scott and colleagues 1999).
In the most recent and largest review, when compared to women who did not receive continuous support, those who received continuous labor support from someone present just for this purpose were
- 26% less likely to give birth by cesarean section
- 41% less likely to give birth with vacuum extraction or forceps
- 28% less likely to use any pain medications and
- 33% less likely to be dissatisfied with or negatively rate their birth experience (Hodnett and colleagues 2004).
The reviews identified several other factors that seem to make a difference. Benefits of continuous labor support appear to be greater when women receive it
- beginning earlier rather later in labor (Hodnett and colleagues 2004, Simkin and O’Hara 2002)
- in settings that do not allow them to bring companions of choice (versus settings that do allow husbands, friends, etc.) (Hodnett and colleagues 2004, Simkin and O’Hara 2002)
- in settings where epidural analgesia is not routine (versus settings where epidural is routine) (Hodnett and colleagues 2004).
These patterns suggest that the more labor support a woman receives and the better its quality, the greater is its favorable impact. Because of this, women who work with a trained doula in usual (non-study) conditions may experience even greater benefits than the studies show. [emphasis mine]
Usual conditions include choosing a compatible labor companion, meeting with her during pregnancy to develop a relationship and discuss preferences and concerns, working together continuously from early labor onward, and – in many cases – having face-to-face and/or phone contact after the birth.
Not to mention the old faithful Klaus, Kennel, and Klaus statistics from 1993:
- 50% Reduction in the cesarean rate.
- 25% Shorter labor.
- 60% Reduction in epidural requests.
- 40% Reduction in analgesia use.
- 40% Reduction in forceps delivery.
- Improved breastfeeding.
- Decreased post-partum depression
- Greater maternal satisfaction.
- Enhanced mother/baby bonding.
So. Exactly how is having a doula at a birth dangerous? I think the burden of proof rests on the OB.