Doulas in the delivery room. Metro Detroit Doula, Doulas of Michigan

DOULAS AND ACOG 

Yesterday ACOG, American Congress of Obstetrics and Gynecologist, released a new statement about low risk pregnancies and medical intervention. Here is a recap of that and what ACOG has to say about Doulas in the delivery room! 

LOW RISK PREGNANCIES AND INTERVENTIONS 

ACOGS new statement is about helping OB/GYN'S, Midwives and patients work together to help achieve a safe and desirable birth outcome for the expecting family. We can all agree that medicine is very important but some women prefer to utilize it only when needed and not as standard of care when it comes to birthing their babies. Whether it's waiting to go into labor, allowing their waters to break on their own or using no intervention at all. ACOG says that in low risk pregnancies it is safe to allow women to choose their birth preferences and let labor take its course. 

“Practitioners always put the best interests of moms and babies at the forefront of all their medical decision-making, but in many cases those interests will be served with only limited intervention or use of technology,” said Committee Opinion author, Jeffrey L. Ecker, M.D., chief of the Obstetrics & Gynecology department at Massachusetts General Hospital. “These new recommendations offer providers an opportunity to reexamine the necessity of obstetric practices that may have uncertain benefit among low-risk women. When appropriate, providers are encouraged to consider using low-intervention approaches that have been associated with healthy outcomes and may increase a woman’s satisfaction with her birth experience.” - ACOG
 

WHAT DOES LOW INTERVENTION MEAN?

  • Allowing labor to start spontaneously.
  • Allowing the waters to release on their own as long as internal monitoring isn't needed.
  • Intermittent fetal heart rate monitoring instead of continuous.
  • Allowing laboring women to choose the position she pushes in.
  • Frequent position changes for comfort and optimal fetal positioning.
Other recommendations for low-risk pregnancies include the option of intermittent instead of continuous use of fetal heart rate monitoring when appropriate; frequent labor position changes for increased comfort and optimal positioning of the baby; and encouraging women to use their own preferred pushing technique.
— ACOG

WHAT ACOG SAYS ABOUT DOULAS

Doulas provide the family and laboring women with continuous emotional and physical support. That key ingredient can take a person from suffering to coping with the intensity of labor and delivery. 

The recommendations also suggest that women benefit from continuous emotional support and the use of non-pharmacologic methods to manage pain. Support offered by trained labor coaches such as doulas has been associated with improved birth outcomes, including shortened labor and fewer operative deliveries. In addition to considering use of medications or epidural anesthesia to manage pain in labor, practitioners are encouraged to offer women coping techniques, such as massage, water immersion in the first stage of labor, or relaxation techniques. Recognizing that the complete absence and elimination of pain is not what all women value, use of a coping scale rather than pain scale is recommended to evaluate the multifactorial experience of labor - ACOG
 

Doulas support all types of birth. Unmedicated, medicated or C-section. We bring comfort and value to each scenario.

“Techniques such as an epidural can relieve pain but may not ease anxiety or suffering,” said Tekoa L. King, CNM, MPH, ACNM liaison committee member and lead author. “Providing emotional support and coping mechanisms have proven positive outcomes, therefore, it’s recommended that providers consider instituting policies that allow for the integration of support personnel in the labor experience. This strategy may be beneficial for patients and cost effective for hospitals due to an association with lower cesarean rates. It is important that midwives, ob-gyns and other care providers collaborate to support women both emotionally and physically over the course of labor.”