
The Importance of Continuity of care
All women should have support throughout labour and birth and receive continuity of care. However, with increasing pressures, many midwives struggle to provide continuity of care, despite knowing of the benefits. “Up to 85% of mothers report not having previously met any of the midwives caring for them during labour, with 21% reporting that they were left alone at a time when they were worried during labour, or straight after birth.” (McLeish and Redshaw 2018). Fragmented care makes it impossible for a woman to have a personal relationship with her midwife. Giving birth is an intense and intimate experience. However, medicalised management of birth turns the labour room into a public viewing arena, with snippets of information handed over, as shifts change. (Kitzinger, 2006). Fragmented care can leave women anxious, confused and not feeling in control. These negative feelings can slow down labour and lead to negative birth experiences.
Continuity of care can reduce:
❤Intervention
❤Epidural/pain relief
❤C sections
Continuity of care can increase:
❤Breastfeeding
❤Maternal emotional wellbeing
Hodnett (2011) suggests that “continuous support was most effective when provided by a woman who was neither part of the hospital staff, nor the woman’s social network, which makes doulas ideal birthing partners”. Why would a doula help a woman labour more easily though? Well, one suggestion by Simkin (2018) states that one of their key strengths lies in their ability to match the mood of the labouring woman, communicating with her in a variety of nonverbal ways as her mental state changes throughout labour. These are skills that are much harder for a midwife to achieve whilst fulfilling all the other duties of a busy maternity unit. Doulas can build up trust during pregnancy and support the woman’s birth plan the best way that she can. They can be aware of what is going on in the broader environment and how this may be affecting the labour. Doulas can protect the mother from outside influences, an aspect of labour that Odent (2018) suggests is vital for a mother, as she prepares for birth.
If you are thinking about hiring a doula for continuous support, during labour and birth or if you would like to know more about what a doulas is, please contact me and we can have a free 30 minute consultation.
Julia x