With optimal labor support, women can birth with a sense of pride, confidence and fulfillment. This week, Penny Simkin, inspirational author, childbirth educator, birth counselor and co-founder of DONA, joins the Mother’s Advocate blog to discuss the value of love, encouragement and support during labor.
MA: Can you speak to the importance of having supportive loved ones present during labor?
PS: Women need to feel safe during labor, and in today’s maternity care climate, the hospital is a rather strange place for most people — full of machinery and beeping machines. But also, there isn’t much continuity of care. She may not have a doctor that she knows, or may not have a midwife that she knows if she’s having a hospital birth — the nurses come and go. And so, there’s not continuity. Having her loved one nearby gives her that continuity.
MA: What roles can familial labor support play?
PS: The role that the partner, the father or loved one would play really depends on how the two of them perceive his or her role, but also how comfortable he (or she) is. It can be anything. From being a companion who is assisting her with every breath she takes — in terms of being present and being in the rhythm of her breathing. To sitting by and encouraging maybe a doula or someone else to do most of the labor support. But as far as I’m concerned, a woman who is alone in labor feels alone. Even with a partner who isn’t very present for her. She’s very unlikely to feel very fulfilled in her birth experience.
MA: How does labor support affect birth outcomes?
PS: The importance of labor support can’t be overestimated. We have studies of doula support — many of them — like 17 of them. Randomized control trials comparing women — the outcomes of women who have a doula with them with women who have no doula but usual care. In a nutshell, all the studies have found benefit — benefit in shorter labors, less requirement for pain medications, more satisfaction with the birth, and in some cases, better newborn outcomes. Some have also found less postpartum depression six weeks later, and better breastfeeding incidence. And, it seems strange that some of those postpartum outcomes would be improved by having a doula present during the birth, or having excellent labor support during the birth. But I think what we find is that a woman has great emotional needs during labor. If those are not met, she’s depleted. She may become depressed — we’ve found that there’s more depression in women who have not had adequate labor support. So this can have ramifications that go far beyond the birth experience. When she feels well supported, valued, respected, cared for, nurtured, guided — she feels empowered. And after a birth like that, she’ll say, “I did it.” She knows that she has that strength. I would hope for every woman, however she chooses to give birth, that she comes out of it feeling the sense of power, capability — accomplishment.
MA: Your DVD, “Comfort Measures For Childbirth” offers more than 40 ways a laboring woman and her partner can work together to achieve a comfortable birth. Can you one of these measures with us?
PS: I’ll show you an easy but very appealing hand massage. This is something that might be particularly useful if a woman has been gripping the sheets, or her partner’s ears (laughs), or the side of the bed in the need to fight through the contractions — it isn’t a good way to use her energy. So, her partner or her doula might say, “May I massage your hand?” — because she’s getting something out of this squeezing of her hands together. So, have her relax her arm. Place your two thumbs above her wrist and the rest of your fingers below, in (clasping) her palm. Put pressure on her palm, and increase pressure until she says it’s enough. Now, do a friction rub over the top of her hand, maintaining pressure on the palm and stroking firmly over the top of her hand. Many women will say that when you do that, the tension just kind of — you can feel it going away right up your arm. And so, that’s something that could be done during contractions or between, but I always look — if a woman is gripping, there is a purpose for that. There’s stimulation of her palms, but (with this massage) I can do it for her and she can relax.
MA: Any words of wisdom for expectant mothers?
PS: The birth of a baby is a lot more than the birth of a baby. It’s the birth of a mother, father, grandparents, siblings, etc. When a woman approaches birth, I think she probably has very little idea of how important that’s going to be to her, in her development as a human being. But the birth experience brings the woman to some of the deepest, most profound physical sensations and emotions that she’ll ever have. It’s a mix of joy, anticipation, excitement, pain, exposure, vulnerability. And, I think in going through that rite of passage and coming out on the other side, a woman is transformed. She’ll never be the same. And of course, we’re all hoping for every woman that she will have a satisfying, fulfilling birth experience that she can look back on with great joy, but also one that will give her a sense that — well, some women have said, “I can do anything after having a baby.” So that’s what I hope that we can look forward to for many women, and that’s what I see as part of my role is — to be a part in preparing her for that.
Penny Simkin, PT, is a physical therapist who has specialized in childbirth education and labor support since 1968. She estimates that she has prepared more than 10,000 women, couples and siblings for childbirth, and has assisted hundreds of women and couples through childbirth as a doula. She is the author of many books and articles on birth for parents and professionals, co-founder of DONA International, and member of the editorial staff of the journal, “Birth.” Today, her practice consists of childbirth education, birth counseling and labor support, combined with a busy schedule of conferences and workshops. Penny is married, the mother of four, and grandmother of eight.
This interview, originally video-taped for Mindful Mama, was transcribed and re-purposed with permission from Mindful Mama.
Who was on your labor support team? What comfort measures did your loved one(s) and/or doula provide?