How does this relate to BF?  Well, it helps when the mother 'is alert and
actively participates in labor':-)

Anna Swisher
Austin, TX
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      Female Comforter During Labor Benefits Both Mother and Infant
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      SAN FRANCISCO (Reuters Health) Feb 16 - Having a "doula" present to
offer comfort and reassurance during labor and delivery provides significant
benefits for both mother and baby, according to a series of studies
described Friday. "Doula" is the Greek word for a woman experienced in
childbirth who supports a mother-to-be.

      What's more, a doula alone is more beneficial than having the father
as the sole source of emotional support, according to findings presented at
the annual meeting of the American Association for the Advancement of
Science. When both doula and father are present, the doula provides
reassurance to him as well, according to Dr. John H. Kennell, professor and
pediatrician at Case Western Reserve University, Cleveland, Ohio.

      "If doulas were a medication or a device, I expect there would be a
stampede" to use them, Dr. Kennell said. "Just because having a doula
present makes good common sense does not decrease its importance."

      Based on a combined analysis of six trials - in which women were
randomly assigned to a doula or not - the rate of cesarean deliveries
decreases by 50% when births are attended by doulas, Dr. Kennell said. The
use of forceps decreases by 40%, requests for epidural analgesia by 60%, the
need for pain medication by 30%, the use of oxytocin to hasten delivery by
40%, and labor duration by 25%.

      Studies show that the father-to-be provides support to 80% of laboring
women in the United States. To study whether the father eliminates the
benefits of a doula, 555 healthy women were randomly assigned to be attended
by the baby's father and a doula or only by the father. Among women assisted
only by a male partner, 22.5% required cesarean delivery, Dr. Kennell said,
compared with only 14.2% of those assisted by the father and the doula.

      Moreover, doula-supported mothers bond more quickly to their new
baby - 2.9 days versus 9.8 days for non-doula mothers - and spend less time
away from them. They are also more likely to rate their baby as better than
the average baby, Dr. Kennell said.

      Exactly why doulas are helpful is unknown, but touch may play a role.
While support from the father-to-be is rated highly by new mothers,
systematic observations show that fathers tend to touch their partners less
during late labor compared with a doula, Dr. Kennell said. Fathers also
routinely leave their place at their laboring partner's side when hospital
personnel enter the room for any reason.

      Dr. Kennell noted that the role of doula has existed for centuries, as
women have historically given birth at home surrounded by caring female
family members. He also observed that in several animal species, including
the elephant, whale, dolphin, bat and cow, a female remains close by the
laboring mother-to-be, which may provide animal models for study of the
doula effect.




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