The Doula's Role in Cesarean Births: Supporting Mothers and Partners Through Surgery

Introduction

Cesarean deliveries, whether planned or unplanned, are significant events that can bring about a range of emotions for both the birthing woman and her spouse/birthing partner.. While medical professionals focus on the surgical aspects, the emotional and psychological support during this time is equally crucial. Doulas, trained professionals who provide continuous physical, emotional, and informational support, play a vital role in enhancing the cesarean birth experience for both mothers and their partners.​

Understanding the Importance of Continuous Support

The American College of Obstetricians and Gynecologists (ACOG) emphasizes the value of continuous labor support in reducing cesarean rates. In their consensus statement on the safe prevention of primary cesarean delivery, ACOG notes that "continuous labor support, including support provided by doulas, is one of the most effective ways to decrease the cesarean rate."  While this highlights the role of doulas in potentially preventing unnecessary cesareans, their support remains invaluable even when a cesarean becomes necessary.​

How Doulas Support the Birthing Woman During a Cesarean

1. Prenatal Preparation and Planning

   Doulas assist expectant mothers in preparing for the possibility of a cesarean birth. They provide information about the procedure, help in formulating birth plans that include cesarean scenarios, and discuss preferences such as immediate skin-to-skin contact or delayed cord clamping. This preparation empowers women to make informed decisions and reduces anxiety about the unknown.

2. Emotional Support Before and During Surgery

   The period leading up to a cesarean can be filled with apprehension. Doulas offer calming techniques, reassurance, and a steady presence to help alleviate fears. During the surgery, if hospital policies permit, doulas can be present in the operating room, providing continuous support, holding the mother's hand, and offering words of comfort. Their presence ensures that the mother feels seen and supported throughout the procedure.

3. Immediate Postoperative Assistance

   After the surgery, doulas assist with the initial bonding process between mother and baby. They facilitate skin-to-skin contact, support the initiation of breastfeeding, and ensure that the mother's immediate needs are met. This support is crucial in promoting a positive postpartum experience and aiding in recovery.

Supporting the Spouse/Partner During a Cesarean

Spouses/Partners often experience their own set of emotions during a cesarean birth, including anxiety, helplessness, and concern for both the mother and baby. Doulas provide guidance and support to partners, helping them navigate the surgical environment and encouraging active participation in the birth experience.​

1. Providing Information and Reassurance

   Doulas educate partners about what to expect during the cesarean procedure, explaining medical terminology and the sequence of events. This knowledge helps demystify the process and reduces anxiety. During the surgery, doulas offer reassurance, keeping partners informed and engaged.

2. Facilitating Partner Involvement

   Doulas encourage partners to participate in the birth experience by suggesting ways to support the mother, such as holding her hand, speaking soothing words, or participating in initial bonding with the baby. This involvement fosters a sense of connection and shared experience.

3. Postoperative Support

   After the surgery, doulas assist partners in understanding the mother's needs and how best to support her during recovery. They also help spouse/partners process their own emotions, providing a space to discuss their experiences and feelings. Doulas are also able to stay with the mom if dad needs to go be with baby, in case of baby needing medical support after delivery.

Conclusion

Doulas play a multifaceted role in supporting both the birthing woman and her partner during cesarean deliveries. Their continuous presence, emotional support, and guidance contribute to a more positive and empowering birth experience. As ACOG highlights, the inclusion of doulas in the birth team is an effective strategy in improving outcomes and should be considered an integral part of maternity care.

References

American College of Obstetricians and Gynecologists, & Society for Maternal-Fetal Medicine. (2014). Safe prevention of the primary cesarean delivery: Obstetric care consensus No. 1. American Journal of Obstetrics and Gynecology, 210(3), 179–193. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210674/

DONA International. (n.d.). Five reasons you may want a birth doula during your cesarean birth. https://www.dona.org/five-reasons-you-may-want-a-birth-doula-during-your-cesarean-birth/

Lamaze International. (n.d.). How a doula supports you during cesarean birth. Giving Birth with Confidence. https://www.lamaze.org/Giving-Birth-with-Confidence/GBWC-Post/how-a-doula-supports-you-during-cesarean-birth-1

Watson, K., Cooke, A., & Aitken, L. M. (2020). Volunteer doulas’ experiences supporting women and their families during caesarean section births: A qualitative study. Midwifery, 90, 102821. https://doi.org/10.1016/j.midw.2020.102821