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I am reading Expecting Better, a book about evidence based pregnancy and in it, there are passages about the high rates of C-sections and why it might be. The conclusion was that one medical intervention, whether by drugs or over-monitoring, usually leads to another and another and you end up with a C-section. Non C-section births have better outcomes. So you want to avoid it if you can. The book also mentions that the use of a doula can reduce rates of C-sections to less than 10% from modern U.S. rates of 30%. That is very impressive. Why and how?
I interviewed a professional doula and just asked quite plainly how does her service provide such a dramatic decrease in C-sections. Her personal experience if she is to be believed, is in line with the 10% figure. Her answer is that by being an advocate for the mother and delaying any unnecessary medical intervention in the delivery room, and by providing a calm and coping environment for the mother, she is able to have better outcomes. This means not bringing the mother to the hospital too early.
The way she described it was that the delivery room is a high stress situation where there are doctors and nurses who are supposed to be doing something, and when nothing is happening, they tend to make things happen, when the right thing to do is just wait. Doulas often go to your home before you are in active labor and bring you to the hospital no earlier than you have too. This is the key, by going to the hospital too early you are increasing your chances of having some medical intervention.
So the take away is that there is good evidence that doulas are effective and do so by:
Without claiming that it is directly relevant to the question, let me quote Atul Gawande, from "The Score: How childbirth went industrial"
Gawande is great. Collect them all. Also, Lewis Thomas.