Doula Support.

Research evidence shows that having the support of a doula during your labor and delivery is both highly-effective in improving birth outcomes and without risk or harm. Twenty-six different randomized trial studies have researched the effects of having continuous labor support. Results of these studies have shown that those who receive continuous labor support are less likely to have pain relief medication, negative feelings about their childbirth experience, and cesarean sections. Results also show that those with continuous labor support are more likely to have a normal vaginal birth, shorter labors, fewer birth complications for the baby, and less likelihood of a NICU admission. Furthermore, some of these studies showed even stronger support for positive birth outcomes when the continuous support during labor was provided by someone who was not part of hospital staff and not part of the birthing person’s social network--- when the continuous support was provided by a trained, professional doula.

Cesarean Rates.

The research on the relationship between doula support and cesarean rates is astounding. Studies show that having a doula on your birth team reduces your chance of having a cesarean birth by 28-56%! When labor is induced, it puts a woman at higher risk of needing a cesarean section. Doulas assist clients in avoiding the need for labor induction, thus lessening their chance of cesarean section, in an array of ways including:

• educating clients on various induction measures (risks, benefits, and alternatives to each)

• normalizing the natural start of labor (whenever that may be)

• assisting clients in avoiding epidurals (which increase the likelihood of the need for cesarean if administered during early labor)

• encouraging and assisting clients to labor at home until the Active Labor stage

• differentiating between medically necessary and elective cesarean as often times providers lead women to believe they NEED to have a cesarean when in reality it is not medically necessary at the time it is being suggested

• helping clients choose providers or birth places based on that provider’s cesarean rate (studies show that birth centers and home births present lower rates of need for cesarean birth).

Lactation Support.

Certified Lactation Counselors are educated and trained to clinically assist and support nursing individuals in an array of ways, including but not limited to, facilitating proper latch, education around healthy production, instruction of pumping, or pain management. According to the CDC, mothers who receive ongoing professional lactation support via in-person counseling or tele-counseling have a higher success rate in breastfeeding for 6 months. Furthermore, the CDC reports that combining ongoing lactation support with educational components such as a breastfeeding course have shown to be even more effective in extending breastfeeding duration.

Placentophagy.

Placentophagy, or the consumption of the placenta, is a practiced observed by many cultures around the world for various reasons. It’s believed that the nutrients and hormones in the placenta are essential in restoring healthy function of the postpartum body, supporting healthy lactation, and improving postpartum mood through hormone re-balance. A 2016 study that analyzed nutritional content of placenta did find placenta capsules to contain moderate amounts of iron (about ¼ of the necessary daily intake for a breastfeeding person). The study also found that no harmful or toxic levels of elements were found in the capsules. A related study explored the levels of hormones present in placenta capsules, finding that the levels of progesterone and estrogen in the placenta capsules were high enough such that they could potentially have physiological effects on the person consuming them. A study focused on whether or not placentophagy has any effect on postpartum depression is currently underway!

People of Color.

Black women are more likely than white women to have a cesarean birth, preterm birth, have an infant with low birth weight, and experience infant loss. Various studies on the racial disparities in maternal and infant outcomes account for factors such as substance use, health insurance coverage, income, and education level yet studies continue to show unequal outcomes for black women and babies. Socioeconomic and health factors do not provide explanation for this inequity. It has been suggested that institutional and individual racism are to blame. Experiencing life-long discrimination and racism creates stress and trauma that can negatively affect pregnancy and birth in a major way. Cross generational trauma may compound this stress. Doula initiatives aimed at addressing this have been successful in showing that women of color who participated in their program had lower rates of preterm birth and low infant birth weight.

Sources.

1. Guise JM, Palda V, Westhoff C, et al. The effectiveness of primary care-based interventions to promote breastfeeding: systematic evidence review and meta-analysis for the U.S. Preventive Services Task Force. Annals of Family Medicine 2003;1(2):70–8.

2. Thomas, M. P., Ammann, G., Brazier, E., et al. (2017). Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population. Maternal and child health journal, 21(Suppl 1), 59–64.

3. Giscombé, C. L. and Lobel, M. (2005). Explaining Disproportionately High Rates of Adverse Birth Outcomes Among African Americans: The Impact of Stress, Racism, and Related Factors in Pregnancy. Psychological Bulletin, 131(5), 662-683.

4. Young, S. M., Gryder, L. K., David, W. B., et al. (2016). Human placenta processed for encapsulation contains modest concentrations of 14 trace minerals and elements. Nutrition Research 36(8): 872-8.

5. Young, S. M., Gryder, L. K., Zava, D., et al. (2016). Presence and concentration of 17 hormones in human placenta processed for encapsulation and consumption. Placenta 43: 86-9.

6. Gryder, L. K., Young, S. M., Zava, D., et al. (2017). Effects of human maternal placentophagy on maternal postpartum iron status: A randomized, double-blind, placebo controlled pilot study. Journal of Midwifery and Women’s Health 62:68-79.

7. Muza, Sharon (2017). “The Doula Difference: Lowering Cesarean Rates”. DONA.org.

8. Dekker, Rebecca (2017). “Evidence on: Doulas”. evidencebasedbirth.com/doulas.