Why are doulas important?
A Short History of Labor Support
For most of human history, labor support was given by grandmothers, aunts, sisters, and friends. Loved ones would gather around the woman in labor and provide for her needs.
With the industrial revolution and the expansion of hospitals, birth was removed from community settings. Families became dispersed, large cracks in our knowledge base of normal birth began to form, and the passed-down generational wisdom of birth was forgotten.
Though some benefits did emerge from birth moving to hospitals, we have also experienced alarming unintended consequences.
The Sad State of Modern US Maternity Care
*Trigger Warning* It may surprise you to know that the United States has some shocking maternity care outcomes.
According to the CDC, about 700 women die each year in the United States as a result of complications during the perinatal period. The US has higher rates of maternal deaths than 45 other countries and is the only developed country with a consistently rising maternal mortality rate. Almost all of these deaths are preventable.
We also have troubling racial disparities, with black and brown women being 2 to 3 times more likely to die from pregnancy-related causes than white women. (This is even when controlling for education and socioeconomic factors.)
- Sadly, the issues with modern American maternity care continue. In recent years, largely spurred by the #MeToo Movement, more and more women are exposing their birth trauma. Obstetric violence, the term used for abuse in childbirth, is a trend that has many perinatal professionals concerned. There are documented issues with our medical malpractice system. Even in this most joyous time of life, sadly, birthing people are not safe from malpractice and mistreatment.
- Pregnancy Mortality Surveillance System, CDC, https://www.cdc.gov/reproductivehealth/maternal-mortality/
- Every Mother Counts, https://everymothercounts.org/giving-birth-in-america/
- Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths, CDC, https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html
- CBS News finds medical boards often fail to discipline doctors for malpractice, CBS, https://www.cbsnews.com/video/cbs-news-finds-medical-boards-often-fail-to-discipline-doctors-for-malpractice/
That is a scary list of issues. It’s at once shocking and sobering. Not to mention, the mere process of childbirth alone is enough to send many people to a place of discomfort and panic.
But these challenges are not insurmountable. We know how to reverse these trends and create change for the better.
Better Birth In the US Is Possible: Doulas Improve Outcomes
The good news is that many organizations, physicians, nurses, and midwives are working to address our maternal health crisis. (More on those good folks below!)
But while we're thinking about professional labor support, here's another piece of good news: doula care improves health outcomes!
Science backs up the benefits of doulas. A collective of studies found:
"Evidence suggests that, in addition to regular nursing care, continuous one-to one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Benefits found in randomized trials include shortened labor, decreased need for analgesia (epidural), fewer operative (forceps, vacuum) deliveries, and increased maternal satisfaction post-labor."
- Position Statement: Doulas and Birth Outcomes, March of Dimes, https://www.marchforbabies.org/
On a personal note, these kind words from a past client paint a very beautiful picture of what doula care looks like in action, and how care improves outcomes:
"Highly Recommend! Victoria was amazing before birth, during birth and during postpartum care!
Being my first preganancy, my husband and I were nervous about the entire process. The unknown can be really scary! Victoria walked us through every step of the way to prepare us for the entire experience. She was highly knowledgeable of our hospital policies including what equipment/materials the hospital had available so we could request them when we arrived.
I had a high risk preganancy that quickly moved to an induction due to a fetal growth restriction. My induction was verrryyy slow (72 hours!). Victoria checked in along the way and gave suggestions with positioning and comfort. When she arrived at the hospital, she quickly jumped into gear and began collborating with the L&D nurses. She was a great asset to the team and took the lead on positioning (after 3 days in the hospital, I was ready to get up and moving). During birth, she provided suggestions to my midwife and made sure I remained comfortable. The one thing I kept talking about was how I wanted a Jimmy Johns turkey sandwhich. As soon as I gave birth, she had my order waiting! It's the small things that make such an impact!
Not only is Victoria a great doula, but she's also a wonderful person that does so much for our community."
You can see that doulas truly make a difference! If you want to learn more about doula care for any reason, schedule a 30 min call with me below.
Pioneers Leading the Way to Better Birth
Of course, doulas can't do it alone! Here are links to some of our favorite individuals and organizations who are committed to improving birth outcomes on the daily.
- Perinatal Quality Collaboratives
- Kentucky's Perinatal Quality Collaborative KyPQC
- Dr. Neel Shah, MD, MPP, FACOG
- Dr. Heather Irobunda, MD, FACOG
- Simone Curd, CNM 'The Melanated Midwife'
- Mandy Irby, RN 'The Birth Nurse'
What About You?
What about you? What’s your role in healing maternity care? Maybe it’s as a parent making the intentional decisions, maybe as a social media awareness-raiser, maybe as a positive birth storyteller, perhaps as a policymaker or grassroots volunteer, or maybe even as a care provider – I believe that all of us working together will make a change.
It’s our time to decide that in ten years, our birth community will be healthier than we found it.
In this video, shared with permission, walk step by step through an *actual* birth story and see a doula at work.
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