per naixements sense violència / por nacimientos sin violencia/ for childbirth without violence
         per naixements sense violència / por nacimientos sin violencia/ for childbirth without violence    

Support during Labour

An important part of my job is to provide clear and reliable information so that you as a mother/couple/family can take a responsible decision on the location you prefer for your child's birth (NICE, 2014, Butchart et al, 2007).

Every woman should get the necessary support regardless of where she wants to give birth, since labour and birth will progress best wherever she feels safest (Downe, 2007).

Many women prefer to go to hospital to give birth to their children, for several reasons. However this does not stop them, if they so wish, from starting labour in their own homes until they no longer feel safe, or until labour is well advanced.

Scientific evidence shows us that a woman's experience of the latent phase of labour (or pre-labour) and of the onset of labour can have a major impact on the duration of labour and the second stage: the delivery of the baby (Baxter, 2007).

Often, both women and their partners are misinformed or little prepared to deal with these early stages (Larsson et al, 2019;
Cheyne et al, 2007) because our society is not used to seeing women in labour and there is a belief that pain should be managed in hospitals (Camann, 2002) or else they do not have a birth professional offering support, safety, trust, knowledge and information (Larsson et al, 2019; Edmonds et al, 2018; Perriman et al, 2018).

Many women go to the hospital too early for several reasons: because the pain is less bearable than they expected, because of pressure from friends, family and their partner (Edmonds et al, 2018; Barnett et al, 2008), and because their experiences differ from what they have read, or heard in childbirth education classes and from the experiences of family and friends (Edmonds et al, 2018; Hundley and Ryan, 2004).

When women do not receive adequate support during early stages of labour, they are more likely to go too early to the hospital (Edmonds et al, 2018), which increases the chances of unnecessary medical interventions (Rota et al, 2017; NICE, 2014; Bailit et al, 2005; Klein et al, 2003, Holmes et al, 2001). Many women are unaware that going to the hospital too early might mean that they are not admitted and are told to return home (Barnett et al, 2008). This results in fatigue and increased anxiety levels that increase the perception of pain (Cheyne et al, 2007) due to a lower level of oxytocin in the presence of catecholamines and cortisol, which can also leave women feeling demoralized, discouraged and exhausted (Carlsson et al, 2007). This in turn means that these women need more psychological and physical support (Rota et al, 2017; Simkin and Ancheta, 2000).

That is why I offer this support during the very beginning of labour. My childbirth physiology knowledge allows me to offer the right advice for every situation to mothers and their partners, especially in the presence of pain (Fox, 2007). A woman is more able to relax when she is given reassuring support from a woman with knowledge and experience on childbirth, helping her to find her own strategies to deal with each situation (Larsson et al, 2019; Cheyne et al, 2007). Continuous support from a trusting person with experience increases de possibilities of having a physiological birth, increases maternal satisfaction (Perriman et al, 2018; Sosa et al, 2018; Lunda et al, 2018; Bohren et al, 2017; Forster, 2016; Ross-Davie and Cheyne, 2014) and reduces the risk of asking for analgesia (Larsson et al, 2019; Bohren et al, 2017;  Sydsjö et al, 2015; Iliadou, 2012; Hofmeyer et al, 1991), of having and instrumental birth, of having a low APGAR score at 5 minutes (Bohren et al, 2017; Sandall et al, 2016; Hodnett et al, 2012) and reduces the risk of having a delivery by C-section (Bohren et al, 2017; Hodnett et al, 2012). Every woman is more likely to give birth physiologically if she stays longer in her own home (Rota et al, 2017; NICE, 2014; Bailit et al, 2005; Klein et al, 2003, Holmes et al, 2001).



What do I offer as a childbirth professional?

  • Visits in week 10, 16, 25, 28, 34, 36, 38, 40, 41 and 42 (NICE, 2008).
  • Being on call 24 hours from week 37 to 42.
  • Telephone support (or presential support if essential), in early labor or latent stage.
  • Being at home with the mother once labour has begun.
  • Ensure the house temperature is favourable.
  • Ensure there are no distractions or external stimuli.
  • Promoting high levels of oxytocin.
  • Removing/avoiding elements and situations that cause stress, and therefore high levels of adrenaline and cortisol in mother and baby.
  • Physical and emotional support.
  • Monitoring the well-being of mother and baby.
  • Monitoring the progess of labour.
  • Promoting mother’s hydration and nutrition.
  • Only if the mother requires, offering the use of non-invasive analgesic methods such as water in a bath, shower or birthing pool, mobilization and changing positions, massage, use of analgesic breathing, visualizations and aromatherapy.
  • Accompaning the mother when transfering to the hospital when she so wishes or when clinically necessary to give birth in hospital or when detecting an abnormality in the process.
  • Once in the hospital, the health centre staff will take care of all woman’s and baby's needs.
  • Being accessible by telephone for minimum 10 days after birth or until being ready for discharge
  •       Visiting the mother and baby at home, on days 1, 3, 5, 10 and/or until discharge. I adapt my visits to the                situation, specially if there are complications or specific needs.
  •        Pelvic floor evaluation before discharge with ergonomy, habits and carrying baby supervision. Personalized exercises              recomendation according to each situation.