Long Term Benefits of Doula Support During Labor

I’ve been reading The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth. It’s quite good so far, and I would like to review the book as a whole once I finish it. However, I found the chapter entitled, “Longer-Term Benefits of Doula Support” particularly fascinating.

I have heard before many of the benefits of having a doula in labor. According to a meta-analysis of ten randomized trials of continuous doula support completed by the authors of The Doula Book, doula support in labor:

• Reduces the cesarean rate by 45%
• Reduces length of labor by 25%
• Reduces use of oxytocin by 50% 
• Reduces use of pain medication by 31%
• Reduces the need for forceps by 34%
• Reduces the request for epidurals by 10-60%.

Add in the idea that being loved and supported during labor makes mom’s experience much more secure and pleasant, as well as the fact that all of these reductions could create major monetary savings for individuals, insurance companies, and the health industry as a whole (pp 97-98). Who wouldn’t want a doula?!?

However, I was astonished to discover that the benefits of doula care don’t stop right after the birth. Several studies show that doula care has multiple long term benefits. Mothers were observed at various points after the birth of their babies (with the observers not knowing who did or did not have a doula during labor) and surveyed about their perception of their labor, themselves, their babies, and their relationship with their new family. Following is a summary of the authors’ findings regarding the long-lasting effects of doula care.

Immediately After the Birth:

Moms who had a doula during labor “showed more affectionate interaction with their infants, with more smiling, talking, and stroking than mothers who did not have a doula” in the first 25 minutes after leaving the delivery room (pp 102-103).

24 Hours After the Birth:

Mothers with doulas reported less pain during labor and at 24 hours after. They also spent less time away from their newborns (p 103).

At 6 Weeks:

Mothers who had doula support were much more likely to be exclusively breast-feeding (51% vs. 29% -and for more days than non-doula groups) and demand feeding (81% vs. 47%). Mothers without doula support were far more likely to be feeding food other than breast milk (53% vs. 18%) and be experiencing feeding problems (63% vs. 16%) (p 104).

Interestingly enough, mothers who had doula support reported far less health problems with their infants at 6 weeks than mothers without doulas. Perhaps it was only a difference in perception, but perhaps it was also from the doula-group moms breast-feeding more following the birth (getting the babies off to a good, healthy start) (p 105).

Doula supported moms spent less time away from their babies per week than those without doula support (1.7 hours vs. 6.6 hours on average). They were also more likely to pick up their babies when crying and bring their babies with them to their 6 week postnatal visit.

At 6 weeks, moms who had a doula reported less anxiety than those without a doula (28% vs. 40%), higher self esteem (74% vs. 59%), and less signs of depression (10% vs. 23%) (p 106).

Moms who had a doula reported greater satisfaction with their partners birth immediately after the birth as well as since the baby was born (p 107).

Finally, “A higher percentage of supported mothers not only considered their babies beautiful, clever, and easy to manage but also believed their infants cried less than other babies…”  and, “support group mothers also percieved themselves as closer to their babies, as managing better, and as communicating better with their babies than control group mothers did” (p107).

At 2 Months:

A study was performed in which observers (who didn’t know which mothers had doulas and which ones did not) met with mothers in their homes and observed their interaction with their infants. Mothers did not know which aspects of care the observers were looking for. It was found that mothers who had a doula during labor “had a remarkably positive level of affectionate interaction with their infants compared to the other mothers two months after delivery” (p 109).

Amazing! What in the world causes all these long term benefits to doula support during labor? The authors question if it could be sustained hormonal and behavioral responses caused by receiving continuous support during labor, or if perhaps these responses could be inhibited by elevated stress and anxiety during labor.

No one knows for sure what actually causes all of these differences between doula-supported moms and those who didn’t have a doula during labor. However, I think that most mothers could attest to the fact that labor is an extremely emotional experience that you never forget. Grandmothers and great-grandmothers who might have a hard time remembering their schedule for the week often can relate their memories of the day they birthed their babies.

I believe (and I’m not the first to think this) that labor has a profound effect on mothers. It stretches them to their limits and reveals weaknesses and, more importantly, strengths that they didn’t know they had. What if feeling supported and cared for during this trying time had such a profound effect on the labor that it actually strengthened the mother as a whole person? Conversely, what if a mother was treated so poorly and made to feel so afraid during labor that this momentous event had a traumatizing effect on her life?

Disclaimer:

I realize that not all doulas are created equal, and they are not the superheroes of the labor and delivery room. That’s mom’s role.

Also, I do not believe that having a good labor makes you a good mom and a bad labor makes you a bad mom. Quite the opposite- no matter what the labor experience, moms can always develop a beautiful, caring relationship and a bond like superglue with their infants.

(By the way, I did not have an official doula during my labor. However, I did have wonderful support.)

I simply wonder- could a doula help a mother to perceive the difficulties of the postpartum period more calmly? Could a labor companion’s gentle care throughout birth help to ease a woman into motherhood? Could the doula’s belief in the mom increase her self confidence not only during delivery, but also in the following days, weeks, and even years? Could continuous support in a mother’s most difficult and intense hour make an impact on that mom as a whole person?

These are just some thoughts. I hope you found the information as intriguing as I did. What do you make of the long term benefits of doula care during labor?