Labour Support

Divya Deswal
CLD, CCCE, HBCE CAPPA India Doula Trainer, Mentor

The concept of support in birth is as old as birth itself

Traditionally, women birthed with support from other women: a family member or an experienced woman from within the community.

A scene from Sahana Bhattacharyas film Fables of Birth

Clips from Shritis birth video

This role may evolve along with the changing face of childbirth, and perhaps even because of it.

However, the spirit of labour support remains unchanged


Labour Support means to serve the woman, meet her needs in labour and birth.

 This support would then need to be explored and understood as we move through various cultures, communities, socio-economic groups, families, expectant couples and individual women.

 At some point we may need to drop our idea of natural and medical birth to define for every woman a birth that feels most normal, natural and safe to her.

 Creating a new system that supports each woman, would need to balance safe birth and her individual personality, creating HER good birth

A Good Birth
A good birth is not just a matter of safety, or of achieving the goal of a live and physically healthy mother and baby. Childbirth has to do with emotion, as well as sheer mechanics of descent , rotation and delivery. It is bound to be so since it is a major transition in the life of the mother, the father and the whole family . - Sheila Kitzinger, Birth Your Way

Providing emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman/family to get the information they need to make an informed decision And accepting and respecting this decision

Recognizing birth as a key experience the mother will remember all her life.

Nurturing and protecting the woman's memory of the birth experience

Creating and holding the space where sheer mechanics of birth and the emotional needs of a woman work well together.

Facilitating communication Between the labouring woman, her partner, their family and the clinical care providers. Also being mindful and listening for cues for any change in the plan.

Empowering the woman to birth her baby in an environment of love, joy and trust.

Encouraging the partner and family to participate comfortably

Labour Support is a labour of love, With empathy, patience and commitment we make a difference and can make a change.

Continuous support in labour increased the chance of a spontaneous vaginal birth, had no harm, and women were more satisfied.
Continuous support for women during childbirth (Review) Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, Weston J Copyright 2011 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

ABSTRACT Background Historically, women have been attended and supported by other women during labour. However in hospitals worldwide, continuous support during labour has become the exception rather than the routine. Objectives

Primary: to assess the effects of continuous, one-to-one intrapartum support compared with usual care.
Secondary: to determine whether the effects of continuous support are influenced by: (1) routine practices and policies; (2) the providers relationship to the hospital and to the woman; and (3) timing of onset.

Search strategy We searched the Cochrane Pregnancy and Childbirth Groups Trials Register (31 December 2010). Selection criteria All published and unpublished randomized controlled trials comparing continuous support during labour with usual care. Data collection and analysis We used standard methods of the Cochrane Collaboration Pregnancy and Childbirth Group. Two authors independently evaluated methodological quality and extracted the data. We sought additional information from the trial authors. We used random-effects analyses for comparisons in which high heterogeneity was present, and we reported results using the risk ratio for categorical data and mean difference for continuous data.

Main results
Twenty-one trials involving 15061 women met inclusion criteria and provided usable outcome data. Results are of random-effects analyses, unless otherwise noted.

Women allocated to continuous support were more likely to have a spontaneous vaginal birth (RR 1.08, 95% CI 1.04 to 1.12) and less likely to have intrapartum analgesia (RR 0.90, 95% CI 0.84 to 0.97) or to report dissatisfaction (RR 0.69, 95% CI 0.59 to 0.79).
In addition their labours were shorter (mean difference -0.58 hours, 95% CI -0.86 to -0.30), they were less likely to have a caesarean (RR 0.79, 95% CI 0.67 to 0.92) or instrumental vaginal birth (fixed-effect, RR 0.90, 95% CI 0.84 to 0.96), regional analgesia (RR 0.93, 95% CI 0.88 to 0.99), or a baby with a low 5-minute Apgar score (fixed-effect, RR 0.70, 95% CI 0.50 to 0.96).

Authors conclusions Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth.

CAPPA's mission has been to offer comprehensive, evidence-based education, certification, professional membership and training to childbirth educators, lactation educators, fitness educators, labour doulas, antepartum doulas and postpartum doulas. CAPPA is proud to provide new and expectant families access to these professionals here in India.
www.cappaindia.com Divya Deswal CAPPA Trainer and Mentor

CAPPA INDIA