Choosing Birth Companions

Related books: Preparing for Birth: Mothers Best Labour Possible The New Active Birth Related articles: Birth

During labour and birth, having an extra helper to assist can make labour more comfortable. A spare pair of hands to massage, hold and comfort a labouring woman can be very welcome, as it enables the baby's father to take a break from time to time to re-energise and enables the sharing of practical tasks and responsibilities. The presence of supportive birth companions has been shown to reduce a woman's need for painkilling drugs and to shorten the length of labour.

Think carefully about whom you could invite to fulfil this role - the pregnant woman should be the one to issue the invitation, as you need to be comfortable working with those who will accompany you through the birth experience. Some women, in addition to the baby's father, like to choose a close friend or relative, perhaps their mother or sister. Other parents seek the help of their childbirth educator. It is not necessary for support people to have given birth themselves, although having people around who had positive birth experiences can be reassuring.

There are practical considerations as well:

• Will the helper be available - can they get time off work if necessary, or arrange babysitting quickly for their own children?

• What is their attitude to birth? Do they see it as a normal, natural event or are they full of anxieties and fear, perhaps stemming from their own experiences?

• Do you and the baby's father feel very comfortable with this person? Women sometimes want to be naked, and to use the toilet or vomit, and it is important that these instinctive behaviours are not seen as offensive or alarming by birth companions.

• Would you feel comfortable asking this person to leave, if you felt it was not working out well?

• Are they prepared to really help and support, not just to be a witness? Would they be willing to attend pre-natal classes to learn useful comfort techniques for the labour?

It is helpful to spend some time with the extra support people during the pregnancy to discuss everyone's role and the practical assistance they can offer. Being a birth companion is a statement of commitment to a woman and her family - a real honour and privilege, and this should be understood by everyone concerned. It should not be seen as a service, for which payment is required.

In many communities, women are surrounded by other women from the village, including close relatives. The birth of a baby is a bonding experience for those present, who feel closer to the baby and also the labouring woman. It is also a traditional way to learn about birth. This involvement of significant others not only underlines the social nature of birth, but ensures that the baby has close connections to other women, who may step in and provide foster care if necessary.

The modern approach to paying for companionship during birth (the American "doula" phenomenon) undermines this social aspect of birth and is an example of the medicalisation of social support. It is sad to think that societies have become so fragmented and disjointed that a woman is unable to find a friend or relative who would be with her during labour and must relay on paid strangers to perform this intimate and vital service. The advent of the paid "doula" adds another layer of health professional to the hierarchy and adds significantly to the parent's cost of having a baby.