What is pregnancy coaching

A pregnancy coach, or doula or pregnancy assistant, is a person who supports a mother during labor and the birthing process. Pregnancy coaches are trained to provide care and emotional support to the birthing person and their partners. They also keep them well-informed about changes to expect, medical processes, and health methods to follow for reducing risks across the pregnancy and post-partum period.

History

Pregnancy coaching has been practiced across the world over centuries. It was once customary for pregnant women to be attended and supported by other women at this vulnerable and important time of their lives. [1] Over time, this practice became accessible only to the privileged layer of society. Formalized pregnancy coaching programs started rising a few decades ago when doctors started researching it’s positive effects. In recent years, the World Health Organization (WHO,) in its childbirth checklist has recommended pregnancy coaching to reduce risks. The American College of Obstetricians and Gynaecologists (ACOG) mentions that pregnancy coaches are associated with improved outcomes for women in labor.

History

01. Reduced caesarean deliveries.

Pregnancy coaching was observed to lead upto a 32% decrease in Cesarean deliveries. [1][2][3]

02. Reduced pregnancy related depression.

Empathy and guidance from pregnancy coaches, empowers mothers to increase inner capabilities psychologically, and physically. Overall confidence of a mother was raised in women who went through pregnancy coaching. [4] Increased confidence from pregnancy coaching can therefore reduce the chances of perinatal depression. According to the American Heart Association, "women who had postpartum depression had a nearly 70% higher risk of developing heart attack, stroke and heart failure." Suicide, surprisingly, the rising largest cause of death in the pregnancy period, also has its roots in pregnancy related depression.

03. Decreased labor time.

Shorter labor time by 41 minutes on average is mentioned by different sources.

4. Reduced pain medication.

A study in India concluded that pregnancy coaching was highly effective in reduction of pain by upto 10%. [6] A recent study in Iran found that mothers who received support from a pregnancy coach had less anxiety and lower average pain scores during labor. [7]

What Pregnancy Coaches Do

1. They help mothers practice preventive health methods which help reduce pregnancy risks, along with reassurance, empathy, encouragement. They help mothers understand medical jargon, positions, risks, the pregnancy process, labor, nutrition, lactation, partner management and post-partum mother and child care, lactation. By persuading mothers, to follow a doctor's advice, they support doctors as well.

2. A pregnancy coach is not a gynecologist or a medical personnel, and hence, she does not perform any medical procedures, prescribe any medication, or provide clinical services.

Pregnancy coaching bodies programs include CAPPA (Childbirth and Postpartum Professional Association), LAMAZE, DONA International, ICEA (International Childbirth Education Association). Pregnancy coaching has been rising as a full-time career and source of income to women across the world.

SCIENCE BEHIND PREGNANCY COACHING

Pregnancy coaches go through rigorous multi-level programs and assist with births, to be certified for practice.

According to researcher, Kristin Uvnas Moberg the positive psychological effects from a pregnancy coach enhances oxytocin release which decreases stress reactions, fear, and anxiety; increases contraction strength, and mother’s own natural beta endorphins, which helps labor feel less painful. Increased control over contractions and self-control helps increase chances of natural birth and reduce chances of cesarean and instrumental birth.

PREGNANCY COACH or partner/relative

Pregnancy coaches ease the effort required from partners who have their own priorities, emotional journey and daily routines. Pregnancy coaches form the ideal child support team with the mother’s partner. Pregnancy coaches help partners, increase knowledge about birth, medical procedures, or what goes on in a hospital, and beyond childbirth.

"WITH SO MUCH OF CLINICAL RESEARCH SUPPORT AND POSITIVE FEEDBACK ON PREGNANCY COACHING, IT IS TIME FOR NATIONAL HEALTH SYSTEMS AND PARENTS ACROSS THE WORLD TO CONSIDER PREGNANCY COACHING AS A MUST HAVE FOR EVERY MOTHER. A DIGITAL SOLUTION WILL HELP MOTHERS ACCESS PREGNANCY COACHING WITHIN THE COMFORT OF THEIR HOMES."

dr. Nandita Palshetkar, Past President,

Federation of Gynaecologist Societies of india

REFEreNCES

[1],[2] Jacqueline H. Fortier, Marshall Godwin, (2015). Doula support compared with standard care. Hodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C. (2012). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.cd003766.pub4 [3] Mcgrath, S. K., & Kennell, J. H. (2008). A Randomized Controlled Trial of Continuous Labor Support for Middle-Class Couples: Effect on Cesarean Delivery Rates. Birth, 35(2), 92–97. doi: 10.1111/j.1523-536x.2008.00221.x [4] Hofmeyr, G. J., Nikodem, V. C., Wolman, W.-L., Chalmers, B. E., & Kramer, T. (1991). Companionship to modify theclinical birth environment: effects on progress and perceptions of labour, and breastfeeding. BJOG: An International Journal of Obstetrics and Gynaecology, 98(8), 756–764. doi: 10.1111/j.1471-0528.1991.tb13479.x [5] Gilliland, A. L. (2002). Beyond Holding Hands: The Modern Role of the Professional Doula. Journal of Obstetric, Gynecologic & Neonatal Nursing, 31(6),762–769. doi: 10.1177/0884217502239215 [6] JayaPradha, D., Annie Annal, M. and Renuka, K. (2017). A Study to Assess the Effectiveness of Lamaze Breathing Exercise on Labour Pain. IJIRR: International Journal of Information Research and Review. 4(9), 09, 4491-4495. [7] Comparison of the Effects of Using Physiological Methods and Accompanying a Doula in Deliveries on NulliparousWomen's Anxiety and Pain: A Case Study in Iran. Health Care Manag Frederick). 2017 Oct/Dec;36(4):372-379. doi:10.1097/HCM.0000000000000188. [8] Ravangard R1, Basiri A, Sajjadnia Z, Shokrpour N. (2017). A randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates. Health Care Manag (Frederick). 2017 Oct/Dec;36(4):372-379. doi: 10.1097/HCM.0000000000000188. https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-andpostpartum-care/care-during-childbirth/who-recommendation-companionship-duringlabour-and-childbirth https://www.acog.org/clinical/clinical-guidance/committeeopinion/articles/2019/02/approaches-to-limit-intervention-during-labor-and-birth