Simply put, women need continuous support during labor. Your husband or partner is an important source of support; in postpartum interviews, women recall the father's presence as more helpful than a nurse's. But there are other studies that suggest that female companionship during labor comes with a whole host of benefits - it enhances the mother's memory of the experience, strengthens mother-infant bond, increases breastfeeding success, and reduces many types of medical intervention.
Looking to family or friends is a great place to start, but it may be a difficult decision, especially if your birth place has a policy on attendees. Many hospitals limit the number of guests to two or three people, which may help take the pressure off when dealing with the others' expectations.
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When choosing your labor support team, there are five qualities each person should have:
1. They should focus on you and only you. Obviously, it's okay if they have to run to the bathroom or eat a sandwich during labor, but don't pick someone who will take pictures or post on social media when you're in the middle of a contraction.
2. They make you feel confident. If they can see you naked, bloody, moaning, and crying, and they still make you feel good about yourself, then that's who you want. Feeling like you have to put on a show for someone can slow down your progress.
3. They make you feel calm. Mandy, a professional doula from Virginia, said, "My advice would be to have the mothers only choose people to attend their birth that will bring a calming influence and not stress her out. I have had to tell family members to leave the room because their presence was hindering the birth process."
4. They are on board with your birth plan. They can't advocate for you if they don't agree with you, and you want someone who is going to help you stick to your birth plan by coaching you through the difficult parts.
5. They have some knowledge about or experience with birth. Whether it's from a birth class or personal experience, they know what to expect, what stage of labor you're in, and most importantly, how you feel. Mary, a parent of one from Arkansas, was grateful to have her mother there for her first birth. "My mother was a simple comforting presence…knowing she had done what I was doing six times helped me push through the pain."
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If you do want to invite everyone on your side of the family to be there, that is your right, but make everyone aware of your wishes ahead of time. "It is okay to ask them for some space and allow [you] to labor alone for a little while," Mandy added.
There are also practical considerations in choosing your birth team. It can be helpful to have someone to pass the baton with your husband or partner, especially if complications arise.
Jennifer, a mother of one in Virginia, began experiencing severe pain under her rib cage, which was later diagnosed as HELLP syndrome. By the time their daughter was born after an induced labor, her husband hadn't eaten or slept in almost two days. "I wish that someone else had been there to switch off with him so that he could go home and rest. I think it was really overwhelming for him because it was a scary situation, and there wasn't anyone there to support him through it all."
What about professional support? It can be tempting to assume that the hospital nurse will be there for you every step of the way, but studies have found that labor and delivery nurses spend very little time providing supportive care to women. One researcher found that an average maternity nurse spends only 15 minutes of an eight-hour shift providing labor support. While some nurses may be more attentive than this, it might be better to bring your own team with you.
Hiring a doula is an attractive option because, unlike a nurse, she can stay with you for the duration of the whole birth, and she doesn't have other patients to check on. Plus, the research is very supportive that the presence of a continuous support person who is not part of your network and has some training, such as a doula, positively impacts birth outcomes and the baby's health.
But will a doula compete with your husband or your partner? Mary explained that having a doula there to coach and make suggestions helped both her and her husband feel at ease with the process. "I would say it was definitely a lead-follow situation for my doula and husband. She would lead and guide, and he would follow. Without her prompts, he would have been much more stressed as to how to help his wife," she said.
Your needs during labor may vary, depending on your birth plan, your pregnancy, and your personality, but every woman deserves to be cared for and supported during labor and birth. Find those people who will be there to give you assurance, rub your back, and advocate for you. Find those people who will love and cherish you as you bring your baby into the world.