This Integrative Health tool includes information to support an Integrative Health approach to childbirth.  Research is reviewed regarding continuous support during labor, high-touch, and noninvasive measures, and pain relief approaches including waterbirth, sterile water papules, positioning, acupuncture, hypnosis, other mind-body techniques, and warm packs.

Continuous Support During Labor

“Historically, women have been attended and supported by other women during labor. However, in recent decades in hospitals worldwide, continuous support during labor has become the exception rather than the routine.  Concerns about the consequent dehumanization of women's birth experiences have led to calls for a return to continuous support, by women for women, during labor.”¹  To come to this conclusion, Cochrane reviewed over 27 trials of continuous support during labor, which included 15,858 women.  This support should include continuous presence of a birth companion who provides hands-on comfort and encouragement.²

Studies have shown that continuous support during labor improves outcomes for women and infants, including:

·         Reduces the chances of having a caesarean section

·         Reduces epidural or other analgesic use

·         Reduces use of oxytocin (Pitocin)

·         Reduces the duration of labor

·         Reduces the use of forceps and vacuum extraction

·         Reduces the chances of health complications and hospitalizations

·         Reduces dissatisfaction with the birth experience

Interestingly, continuous labor support was also found to be of even greater benefit when the support provider was not a member of the hospital staff, when the support began early in labor, and when labor occurred in settings in which epidural analgesia was not routinely available.²  In most hospitals around the country, it is the labor and delivery nurse, a member of the hospital staff, who provides support to the laboring woman.  This support cannot be continuous by the very nature of hospital nursing duties.  Even if each patient has her own nurse, shift change occurs, and nurses have increasing demands on their time, including chart documentation, blood draws, and vital signs.  They are also required to keep the physician, who is almost always absent from the bedside, up-to-date with regard to the patient’s progress.  Doulas and midwives are other options, and both are likely to be beneficial in the current hospital environment.