A Help for Fathers
During the Labor and Birth of Their Child
Our culture is one of the few that does not provide continuous supportive care for the laboring woman. Even though men are choosing to take active roles in the birth of their children, they are often put in a very uncomfortable situation. They attend childbirth and parenting classes and remain with their partners during the birth process, but often feel that they are expected to be the "labor authority" when they do not feel qualified for that role. No matter how good the childbirth education class was that he attended, his experience attending births is very limited, and, for the first time father, non-existent. Many fathers realize that they need reassurance, support, and guidance, also.
The father is in even a more precarious position if the mother has special needs. The mother who is laboring after a previous cesarean birth is emotionally vulnerable and may need constant support and encouragement about her ability to birth her baby vaginally. The father may be experiencing doubts, too. Fathers who must travel as part of their job, such as fisherman, off shore oil workers, and salesmen with territories out of town, often express concern about the possibility that their partner may not be able to reach them in time for them to be there to support her throughout the entire labor and birth experience. Parents who choose to involve their older children in the birth experience are often worried that it will be too great a burden for the father to support both mother and children. Parents expecting twins or triplets are both concerned about the differences that this may bring to their labor as well as their birth.
Professional labor assistants are able to bridge these gaps and provide that support and guidance for both the mother and father. Professional labor assistants may also be called doulas or monitrices. The word doula comes from the Greek; means "in service of" and in our culture denotes a person who provides continuous emotional and physical support for the laboring mother. The word monitrice comes from the French and means "to watch over attentively." Although their skill levels are different, the primary role of both of them is to provide continuous supportive care. Quite often people make the incorrect assumption that the labor assistant takes the place of the father and/or nurse. This is not true. The labor assistant is there to help the father help the mother, not replace him. The labor and delivery nurse has many duties other than supportive care, and is not able to be there continuously during labor and birth. She must leave when her shift is over as well as the fact that she is also
responsible for charting, medication administration, maternal and fetal assessment, and administrative duties. The doula or monitrice is the perfect person to help bridge the gaps. Research studies by Klaus, Kennel, Hofmeyr, and others regarding doula care are showing a significant decrease in the request for epidural anesthesia, the use of forceps or vacuum extraction, length of labor, and cesarean section. The 1986 Klaus and Kennel study showed that, with standard hospital care, the cesarean rate was 17%, and when a doula was present continuously during labor, the cesarean rate was 7%. The 1991 study revealed that without a doula present the cesarean rate was 18%; with the presence of an observer, the rate was 13%, and with a doula present, the rate was 9%. The 1993 study also showed that the epidural rate was 27.9% with standard care and 14.7 with the addition of a doula.
When hiring a doula, fathers often comment that they want someone to be there to help take the pressure off them so that they can focus on being involved with their partner and the birth experience. They are also reassured knowing the doula will be present continuously if they must be absent at some time during the labor or birth. They now know that with the presence of the doula, that if their last birth ended in a cesarean, they have someone, in attendance, who will be able to help both of them over the emotional and physical hurdles of delivering vaginally after a previous cesarean.
The doula usually meets the mother and father prior to labor and is someone chosen by them, not just assigned to the case. She is someone known to both the mother and father, and can facilitate rapport with the hospital staff. In the book Special Women, one mother comments that she wanted someone that she chose to be with her, not someone she had never met before, and who might have to leave before she gave birth.
The mother with a multiple pregnancy relies on the doula to be the one person who is there just for her, as the nurse's tasks of assessing more than one baby may take up most of her time and concern. The doula also assists those families who want to involve their older children in the birth experience by her constant presence.
The doula or monitrice provides an initial consultation, prenatal, labor and birth support, and postnatal support. The initial consultation is usually 1-2 hours in length, and provides a time for the doula to develop a rapport with the father and mother to determine their needs and expectations. She is available for question and answer support via telephone, referrals to childbirth educators, pediatricians, lactation educators, lactation consultants, and postpartum doulas. In some cases, the doula may provide some of those services such as breastfeeding education, childbirth education, and postpartum doula support. During the labor, she is with the couple continuously and provides both physical and emotional support as well as acting as a liaison with the hospital staff and the primary care giver. During the immediate postpartum period, the doula encourages bonding with the infant and assists in initial breastfeeding. She also provides a follow-up visit either in the hospital or at the home.
For fathers or mothers who want more information on how a doula or monitrice can help them during labor, visit the following websites or contact the author via e-mail at firstname.lastname@example.org.
Doula of North America
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Last Updated: June 2003