Historically, physical and emotional support was provided by other women as a woman gave birth at home.
When childbirth moved from the home to the hospital setting, the role of the traditional helper began to disappear, and support during labour was given mainly by labour room nurses and more recently, by the father.
There has been a rebirth, however, of the role of the traditional helper who offers additional support.
The mother's partner is often the person who knows and understands her best, and she may choose her partner as her main source of help and support.
Many couples attend prenatal classes, in which they learn about labour and coping strategies in preparation for the birth.
Some women and their partners feel they benefit from the objective support of a trained helper, such as a childbirth assistant or doula (from the ancient Greek word that means 'woman's servant').
Usually a mother herself, the doula has some formal training in labour support and is paid by the couple for her services.
Ultimately, a woman should choose the helper she feels will best meet her needs - whether it's her partner, best friend, a relative, a doula or a combination of these.
Women who have continuous support throughout labour tend to have shorter labours with fewer interventions. There also seems to be a connection between the level of the mother's anxiety and her progress during labour.
Things a helper can do to alleviate anxiety are providing reassurance, reminding the mother to change position often, walking with her, rubbing her back and using other forms of gentle touch.
The helper also can talk to medical staff on behalf of the labouring woman.
The birth partner, helper and health care professionals can work together with the mother during childbirth. Each has a specific role, and complement each other. A positive birth experience and the mother's well-being and wishes should be guiding factors.
The people working with you need to know your birthing plans, so decide early on the kind of support you want to have during labour and birth.
If you choose a trained helper such as a doula, get to know her and feel comfortable with her. If the first person is not a good match, find someone else.
Let your prenatal health care provider know if you plan to use a trained helper, to make sure there are no surprises when everyone arrives at the birth setting.
Women without a spouse or partner should talk to their prenatal care provider about community services that offer support, such as a volunteer birth companion program.
Nurses in the hospital labour and birth area are skilled in providing physical and emotional support. LB
Katherine Crowe and Deborah Archibald are with the City of Ottawa, Community Services. Crowe is supervisor, Reproductive Health Program. Archibald is Service Manager, Family Health.
As proponents of breastfeeding, Ms. Archibald and Ms. Crowe disassociate themselves from any advertising in this magazine that does not support breastfeeding.
Published in March 2007