Labor support by first-time fathers: direct observations with a comparison to experienced doulas

Abstract

Continuous labor support provided by female labor companions (doulas) in randomized controlled studies has previously been shown to decrease the incidence of Caesarean sections and perinatal complications. Since fathers provide labor support for four out of five women in the United States, we examined the behaviors of 14 couples during low-risk labors. Fourteen 1-h observations of early and late labor were analyzed for fathers' presence and activities during labor. For all behaviors, except talking which increased during late labor, fathers were more involved physically and were closer to their partners during early labor than during late labor. Fathers' behavior patterns were compared to those of three doulas with 27 laboring women and were found to be significantly different for all behaviors. Fathers remained significantly farther from mothers and talked and touched significantly less. Fathers' participation was rated by mothers as increasing the meaning of the labor experience and by the couple as strengthening their relationship. All of the women supported by a doula would choose to have a doula support them through their next labor and delivery. Because the behaviors of fathers and doulas in this study were so different, the question remains whether fathers' support also decreases the incidence of Caesarcan sections and perinatal complications as effectively as doula support.