How Doulas Provide Pain Relief During Childbirth
Doulas facilitate oxytocin release, which decreases your stress, fear or anxiety and increases the effectiveness of your contractions. In addition, the calming effect of the doula’s presence increases the mother’s own natural pain-relieving hormones, also known as endorphins. All together, these things make labor feel less painful.
There are four different ways that doulas can affect pain management. These include physical support, emotional support, childbirth preparation/information, and advocacy.
Physical Support
Doulas are trained to provide physical support through the use of soothing touch and massage. They make sure that the laboring person is as comfortable as possible. This might include the use of movement and positioning, which we talked about in a different video, which is a very effective pain management technique. Physical support may also include the use of pressure on your back during contractions (called the counter-pressure), and helping to keep you nourished with ice chips, food and drinks. Other comfort measures may include fanning you if you get hot, giving you a cold, wet washcloth if you feel nauseous, providing you with pillows, ChapStick, music – anything you need to keep you comfortable.
Emotional Support
Doulas also provide emotional support, which helps the mother to manage pain during childbirth. Doulas work to create a calm birth environment. As we discussed in our video about painless birth and pain perception, the hospital birth environment today can cause stress, which can increase your perception of pain. Doulas work to help decrease that stress in the birth room. They give you encouragement and praise and remind you that you are safe and supported.
Doulas work with the birth partner (e.g., spouse, boyfriend, girlfriend, family member or friend) to help that birth partner better support you. Researchers have found that when people feel capable, confident and cared for, they feel less pain during labor. They perceive their pain as more manageable and they’re better able to cope.
Doulas also help mothers to interpret labor in a positive way, by reminding them that the sensations they’re feeling are productive and purposeful and that each wave or contraction is helping to bring the baby down and out. Research shows that when mothers view their contractions in this way, they’re more likely to perceive them as less painful.
Childbirth Preparation and Providing Information
Childbirth preparation is another way that doulas can help to decrease pain. Doulas help pregnant people and their partners prepare for childbirth through education, information, practicing coping skills and counseling at prenatal visits. They help them talk through their fears and suggest coping techniques that they can use such as breathing, relaxation, movement and changing positions.
Researchers have found that both childbirth classes and support from a doula help lower pain perception during labor. This mechanism of pain relief is called Central Nervous System Control, and we talk about it in detail in our overview video all about pain management during labor. Central Nervous System Control causes the mother to perceive pain as less unpleasant by activating the parts of the brain responsible for memory, emotions and reaction to pain.
Advocacy
Finally, advocacy is another way that doulas can help decrease pain. Doulas typically don’t speak up for you, rather, they encourage you to speak up for what you want. This advocacy technique may be helpful in relieving your pain. For example, if a mother is coping well in an upright mobile position and the care provider insists that she get back in bed even though things are progressing normally, the doula could facilitate communication between the woman and the care provider by asking the woman which position she prefers.