Gone is the stark delivery room and administration of heavy duty anesthetics. Parents now have more choices than ever as to the environment into which their babies will be born.
With the growing openness of medical staff to complementary and alternative therapies, now often called integrative medicine, moms-to-be are investigating and choosing new options for delivering their babies. As a result, parents now have more birthing choices than ever before.
A doula, or birth assistant, is a professional woman, or at times a man, hired privately by parents to attend their child's birth. A doula serves the role as support and coach for the laboring woman. The doula does not replace the role of partner, and, very importantly, is not a member of the healthcare team. A doula is present solely to attend to the laboring mom. Usually trained and experienced in childbirth, doulas can serve as a stand-in when dad is not available. But doulas can be an asset for any mother. Many parents hire doulas even if dad is present.
Since doctors may not have worked with a birth assistant before, most doulas accompany moms to a prenatal visit in order to meet the doctor before the big day. Once the medical staff knows the doula is there for support and not to replace or interfere with them, they are likely to welcome this additional member of the team.
Doulas can be available weeks in advance to help an anxious mother before delivery by answering questions. They can also be helpful after the mother and infant come home. They help new mothers with feeding, recovery, and newborn care. A postpartum doula helps with the transition a family faces with a new baby in the home. A doula's presence in the home has helped reduce rates of postpartum depression.
A review of several studies found that doulas have an overall positive effect. The review highlighed a reduction in alternative birth methods, such as cesarean sections, use of pain medications, and an improvement in the overall experience.
Water can smooth away aches, drain off tension, and float us into a state of bliss. It's no surprise, then, that many moms who labor and/or deliver their babies in a birthing pool say that they experience less pain and greater relaxation.
These benefits may be passed on to the infant as well. It is considered safe, but there is no evidence supporting that it is better than a conventional birth. Water-immersion birth benefits may include:
Despite its increasing popularity, the American Congress of Obstetricians and Gynecologists (ACOG) does not support water-immersion birth. The concern is rare, but serious complications that can occur during the birth of the baby. Because there haven't been enough studies to find any benefit with water-immersion births, ACOG feels that more research needs to be done before they can endorse it. If you want to have a water-immersion birth, talk to your doctor about the benefits and potential risks involved.
The bad news is that labor will probably hurt. The good news is that there are many nonpharmaceutical options when it comes to managing the discomfort.
The first step to pain management is relaxation. The tenser you are, the higher the sensation of pain.
Relaxation starts with the environment. Even in the hospital, you can dim the lights, play soft music, light candles, or use aromatherapy to create a safe feeling. Aromatherapy may reduce the perception of labor pain. Other relaxation techniques include massage, showers, and baths.
The mind is one of the most effective pain-fighting tools available. Hypnotism, visualization, and imagery are all methods moms have used for pain relief, and there is some scientific support for their use.
Acupressure and acupuncture have been studied as natural treatments for reducing labor pain. Each of these methods may offer some benefits, but more research is needed.
Although red raspberry is an herb traditionally used during pregnancy and labor, a double-blind, placebo-controlled trial evaluating the effects of red raspberry in 192 pregnant women failed to find benefit.
The herb blue cohosh is sometimes recommended by midwives, but it is a toxic herb and should not be used.
When planning your baby's birth, investigate the options and be realistic about your personality and desires. Work with your doctor or midwife early on, and check policies of the hospital or birthing center you've selected. For example, some may allow only family members in the delivery room, or may have policies against candles or other open flames. Be flexible. Remember that even the best laid plans can go awry. After all, babies have their own ideas about the way things should turn out.
Canadian Women's Health Network
Women's Health Matters
American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. Committee opinion no. 679: immersion in water during labor and delivery. Obstet Gynecol. 2016;128(5):e231-e236.
Comfort measures (nonpharmacologic) during labor. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114734/Comfort-measures-nonpharmacologic-during-labor. Updated August 22, 2016. Accessed June 22, 2017.
Having a doula: Is a doula for me? American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/having-a-doula. Updated September 2, 2016. Accessed June 22, 2017.
Scott KD, Klaus PH, Klaus MH, et al. The obstetrical and postpartum benefits of continuous support during childbirth. J Womens Health Gend Based Med. 1999;8:1257-1264.
Management of routine labor. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T905272/Management-of-routine-labor. Updated June 1, 2017. Accessed June 22, 2017.
Postpartum doula. American Pregnancy Association website. Available at: http://americanpregnancy.org/planning/post-partum-doula. Updated March 21, 2017. Accessed June 22, 2017.
Pregnancy support. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated July 25, 2012. Accessed June 22, 2017.
4/29/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114734/Comfort-measures-nonpharmacologic-during-labor: Hjelmstedt A, Shenoy ST, Stener-Victorin E, et al. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol Scand. 2010;89(11):1453-1459.
Last reviewed June 2017 by Michael Woods, MD, FAAP Last Updated: 6/22/2017