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Study proves benefit of the presence of doulas during labor

The role of doulas during pregnancy is increasingly common. Responsible for providing emotional and physical support to women, from the beginning of prenatal care and, especially, during labor, these professionals help mothers to have a positive birth experience and, consequently, better results – such as reduced birth rate. rate of cesarean sections, less use of medications, fewer reports of pain.

Now, Brazilian research shows that continuous support from doulas also interferes with the amount of serotonin released by women immediately after giving birth, which can be reflected in a better beginning of the connection between mother and child.

The pilot study was carried out as the psychologist’s master’s thesis Eleonora de Deus Vieira de Moraes , in the Postgraduate Program in Gynecology and Obstetrics at the Faculty of Medicine of the University of São Paulo (USP), in Ribeirão Preto, in the interior of SP. After working as a doula for more than 17 years, Moraes decided to investigate whether the continued presence of this support during labor would also have a physiological impact on the woman, in addition to the physical and emotional benefits.

For the study, carried out at the Reference Center for Women’s Health in Ribeirão Preto, women in labor were divided into two groups: one that received continuous support from doulas since the beginning of labor and another that did not have the presence of these professionals during the process, only from the woman’s chosen companion.

The researcher collected blood samples from the volunteers to measure the amount of serotonin during three phases of labor: active, expulsive and immediate postpartum (also called “golden hour”, in free translation), when the baby has already been born and is in skin-to-skin contact with the mother). Published in the Brazilian Journal of Gynecology and Obstetrics, the results showed a significant increase in serotonin dosage in the postpartum period in the group of women in labor accompanied by doulas.

Why serotonin?

The choice of serotonin to be dosed in pregnant women was not random: the molecule acts systemically as a hormone and acts in the central nervous system as a neurotransmitter, regulating mood and motivation. “We know that serotonin has an influence on mood, but animal studies have shown that it initiates and maintains the maternal behavior of cuddling puppies, maintaining this bond between mother and baby”, explains Eleonora Moraes.

According to the psychologist, science still knows very little about the effect of serotonin on human labor, so it is not possible to define exactly the mechanism involved in the changes of this molecule in the body. “In this sense, this study is unprecedented because it shows how the serotonin curve behaves during labor and immediately after the baby is born,” she notes.

The drop in hormone levels that occurs shortly after the end of pregnancy, associated with physical fatigue due to sleep deprivation and the emotional stress that the newborn generates in women, usually has a major impact and alters the mother’s mood, which can result in postpartum depression. The problem is extremely common – it is estimated that between 20% and 25% of women will have postpartum depression, and around 80% will experience symptoms of the so-called baby blues, which is a set of confusing and fleeting feelings that do not need to be avoided. of treatment.

According to the USP researcher, although the study shows the high concentration of serotonin during the “golden hour” period, it was not possible to make a direct relationship with postpartum depression, because the study did not reassess serotonin levels after the birth. birth of the child, when the disorder could manifest itself. “It’s just a guess, because of the moment in which we measure serotonin. We know about the important role of the molecule in postpartum depression, but other studies are needed to make the statement”, ponders the USP researcher.

In the opinion of Rita Sanchez, gynecologist and obstetrician at Hospital Israelita Albert Einstein and coordinator of the Adequate Birth project, the study brings interesting results by pointing out the physiological benefits of the presence of doulas. She highlights that patients “reclaimed” the role of doulas, who have been gaining more and more space with pregnant women both in the Unified Health System (SUS) and in the private system.

“Labor is long, it brings pain, and having someone with you to help and provide emotional support to continue is very important. In relation to postpartum, we know that serotonin is the hormone that ‘lifts’ a woman, so much so that those with depression use medication to increase serotonin levels. Immediately postpartum, women experience a lot of physical fatigue, a lot of anxiety about the care to come, and having higher serotonin levels at that moment, without a doubt, can help reduce what we call puerperal blues”, comments the doctor, when It is important to highlight that it is important to produce serotonin during labor and that having a postpartum support network at home is also essential.

The obstetrician reinforces that the role of doulas is very important, as long as they are well aligned with the nursing team and the medical team at the hospital where the birth will take place. “It must be clear that all professionals form a great team to support women and there should not be ‘competition’ between the doula and the doctor. I really believe in emotional support and the use of non-pharmacological methods to relieve pain during the process, but everyone needs to be aligned and have scientific knowledge of what works and what doesn’t”, highlights the doctor.

Love hormone

According to the USP researcher, oxytocin is the main hormone associated with the connection between mother and child, which is why it is also called the “love hormone”. “The biggest peak of oxytocin in a woman’s life will be at golden hour”. It is this hormone that will make the attachment between mother and baby instinctive, as well as social. We are still discovering the influence of serotonin, but it certainly also has a positive impact on bonding”, says the study author.

The Einstein gynecologist agrees and adds that, if the woman had a good birth experience (and this includes the emotional support received from the doula), she will undoubtedly have a good connection with her baby. “Traditionally, it is oxytocin that causes this connection. Whether serotonin also does this, we are not sure. We need more studies. But, just the fact that the patient had a good birth experience and is in good mental health will certainly be able to make a faster and deeper connection,” she concludes.

Doulas form a support network for pregnant women

Source: CNN Brasil

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