Throughout history, women have supported each other through birth. Whether it’s been a grandmother, mother, sister, friend or midwife, labouring women have given birth at home, surrounded with familiar females. Only in our recent history have things changed in the western world.
When doctors decided that women should no longer have to bear ‘the pain of childbirth’, women were aneasthetised for childbirth at hospital. In order for doctors to easily tend women in labour, the common position adopted for labour was on the back, which not only works against gravity but also goes against women’s natural instincts to be mobile during labour (the literal meaning of the word obstetrics is ‘to stand before’).
Following this, came a variety of fads and birthing trends, all with the aim of reducing or eliminating pain for women during childbirth – sometimes even with the objective of making them forget the experience entirely (see Twilight sleep if you’re feeling strong-stomached). Suddenly, male doctors were present during labour, when just a few years previously, even husbands were not permitted into the labour room. Women trusted the doctors and felt compelled to go to the hospital to get the best ‘treatment’. Midwives were pushed aside and became less important. Even though anaesthetics for labour ceased after women began suffering post traumatic stress giving birth in hospital remained the normal thing to do, often surrounded by people unknown to the mother, in a strange and ‘harsh’ environment.
Gradually, as more generations gave birth in hospital environments, with medication, the knowledge of natural childbirth amongst women started to diminish. Horror stories about the pain of childbirth and things going wrong permeated into our society, and with this, spread fear of the unknown and an intrinsic mistrust in the female body to naturally birth our babies. More procedures and equipment were developed to help women give birth – episiotomies to make room for the baby, forceps and ventouse to pull the baby out, inductions, caesarean sections, epidurals, sintocinon, pethadin and many more medications all started to become commonly used, so much so that most women now doubt their own ability to birth their baby. Of course, we are lucky to have such medical procedures as in some circumstances they are lifesaving and absolutely crucial for the safety of mum and baby, however, it has now been proven that the more interventions occur during labour, the greater the chance of the birth ending up being a c-section, which in turn impacts on the chance of success of breastfeeding .
The pressure on staff in busy hospital wards has meant that midwives can rarely stay with a woman throughout her entire labour and as shifts change, so too does the midwife. A new person entering the room can significantly delay or slow down the labour. Our generation now, and future generations, may never have seen someone breastfeed a child, would most likely not have been breastfed themselves, and may have heard only negative and frightening stories about childbirth.
Having grandmothers and female relatives in the birthing room is now a rarity rather than the norm. Women have been labouring in brightly lit, unfriendly, sterile hospital rooms, with no continuous carer, the hostility of which has been shown to actually slow labour down as the hormones of birth and breastfeeding, namely oxytocin, flow best when the labouring woman is relaxed.
However, things have changed for the better in recent years. Birthing centres have been built, giving women who don’t wish to give birth in a hospital but who don’t feel confident in having a homebirth a positive alternative option. In birthing centres, doctors are absent unless medical intervention becomes necessary and only midwives and birthing partners are in attendance. These centres feel much more homely, and often don’t even contain beds but have couches and birthing pools along with other birthing equipment such as birthing chairs and balls. Home birth teams have sprung up, and low risk expectant mums are encouraged to give birth at home.
Doulas are becoming increasingly popular, taking the place of the female relative or friend that would have been present in the past. Doulas bring an air of comfort and relaxation into an otherwise hostile environment and provide continuous support throughout the duration of labour, wherever the mother may be giving birth. A doula can help by creating a more calming environment by providing continuous support, encouragement and quiet confidence to boost a mothers’ self-esteem. (Hofmeyr, Nikodem et al. 1991).
Doulas have been shown to be a form of pain relief (Hofmeyr, 1991). With continuous support, women are less likely to request epidurals or pain medication because they are statistically less likely to feel pain when they have a doula with them (Hodnett, 2011).
This in turn results in less risk of the other interventions that often go hand in hand with an epidural such as augmentation, electronic monitoring and c-sections. (Caton, Corry et al. 2002).