Today is Universal Children’s Day.
I strongly believe that giving children the best possible start in life means giving their mothers the best chance of a healthy and positive birth experience that is free of unnecessary intervention and disruption - birth can have a big impact on a child’s current and future health. Health and mortality rates for children in the neonatal period in the UK is good by global standards, but that doesn’t mean we can’t improve. Intervention rates during birth, and associated antibiotic usage, are very high and in contrast, breastfeeding rates are very low.
By providing women with loving support during labour and in the immediate postnatal period, doulas lead to better outcomes for mothers and babies, with fewer interventions needed and more success breastfeeding. We know that interventions such as induction of labour, caesarean section, and assisted deliveries - although sometimes very necessary - can also have associated negative health outcomes for both mothers and babies. It’s not simply the physical health of the child that could be impacted but also the development of a child’s secure attachment to a significant other. A negative birth experience for the mother could lead to postnatal illness which could impact on the early relationship with her baby. Insecure attachment have been seen to influence the developing brain, which in turn affects future interactions with others, self-esteem, self-control, and the ability to learn and to achieve optimum mental and physical health.
The very fact that doulas can make such a positive difference in reducing the need for intervention and increasing breastfeeding success rates shows us clearly that birth and neonatal outcomes aren’t just linked to the mother’s health or physiology, or the baby’s position or latch. It strongly suggests that better health outcomes - for mothers and for children - could absolutely be achieved in maternity services through more continuity of care and more individualised, empathetic support for new parents. Postnatal doula support for new families provides parts of that lost village which we all know it takes to raise a child.
This idea isn’t by no means new. We know continuity of care can play a vital role in improving outcomes. The Cochrane Review found that “women who received midwife-led continuity of care were less likely to have an epidural. In addition, fewer women had episiotomies or instrumental births. Women’s chances of a spontaneous vaginal birth were also increased and there was no difference in the number of caesarean births. Women were less likely to experience preterm birth, and they were also at a lower risk of losing their babies. In addition, women were more likely to be cared for in labour by midwives they already knew.” It concludes that most women should be offered midwife-led continuity of care. Yet, we know that this is not always the case - the care offered to women varies hugely depending on their location, their hospital, and on their “risk” status. The very fact that doulas are a growing phenomenon with an growing number of working doulas in the UK shows that women and their families are looking outside of the NHS to get the support they want. The Doula UK Access Fund, which offers doula support to women who are unable to pay for a doula, is increasingly finding it difficult to keep up with the demand from women who desperately look for that continuity of support.
I would like to see continuity of care become the norm and I would like to see all women treated with compassion, empathy and humanity throughout their maternity care and beyond. I would like to see all children given the best possible start in life, right from their first breath. Because I am certain that the more we listen to, nurture, and empower women during pregnancy, childbirth and parenthood, the better outcomes we will see for their children. This in turn will have an impact on the whole world!
Kicki Hansard is a member of Doula UK, however any opinions expressed on this blog are personal views and not necessarily the view of Doula UK.