Missing Support During Birth Linked to Higher Stress, Dartmouth Study Finds

Dartmouth's study reveals that lacking emotional support during childbirth significantly increases stress levels, comparable to a cesarean section.

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Missing Support During Birth Linked to Higher Stress, Dartmouth Study Finds

Childbirth is a complex, life-altering event that often involves a mix of physical, emotional, and psychological experiences. For most of human history, individuals have been supported during this process by trusted companions, often family members or other women within the community. This emotional support has been a central element in easing the stress and challenges of childbirth. However, in recent years, particularly during the COVID-19 pandemic, many pregnant individuals have faced restrictions that prevented them from having the support people they desired present during their labor and delivery. A recent study from Dartmouth College sheds light on the significant impact these restrictions have had, particularly on the stress levels experienced by people giving birth.

The Dartmouth-led study, published in Evolution, Medicine, & Public Health, examined the psychological impact of missing emotional support during childbirth. The researchers discovered that pregnant individuals who were unable to have their desired emotional support people—such as their partner, mother, or doula—present during childbirth were more likely to experience higher levels of perceived childbirth stress. The stress levels observed in these individuals were comparable to the increase in stress typically associated with a Cesarean section delivery. This finding underscores the importance of emotional support during childbirth and highlights the profound impact that the absence of such support can have on an individual’s well-being during this critical time.

The Role of Emotional Support in Childbirth

Emotional support during childbirth has long been recognized as an essential component of a positive birth experience. Research has consistently shown that having emotional support during labor can lead to numerous benefits, including shorter labor durations, reduced use of pain medications, and better overall outcomes. These outcomes are often linked to lower levels of stress hormones, such as cortisol, and higher levels of oxytocin—commonly known as the “love hormone.” Oxytocin plays a critical role in stimulating uterine contractions during labor and helps with pain relief by promoting relaxation and a sense of well-being.

In addition to its role in labor, oxytocin also supports the postpartum period by facilitating breastfeeding and bonding between parents and their newborns. The presence of a trusted companion can trigger the release of oxytocin, providing calming effects that can help manage pain and anxiety. This is particularly important in a hospital setting, where the clinical environment can often feel impersonal or overwhelming. For individuals giving birth, having a trusted support person can make a significant difference in how they experience labor and delivery.

The Impact of COVID-19 on Birth Support

The COVID-19 pandemic introduced an unprecedented challenge to the healthcare system, especially for those giving birth. In 2020, as hospitals scrambled to manage the surge in cases, many instituted strict visitation policies to minimize the spread of the virus. These policies often meant that pregnant individuals could not have their desired support people with them during labor. In some cases, hospital restrictions limited patients to only one support person, and in others, people were forced to give birth alone. This situation was exacerbated by the overwhelming nature of the pandemic and the heightened stress it caused for pregnant individuals.

The Dartmouth study utilized data from the COVID-19 and Reproductive Effects Study, which surveyed 1,100 pregnant people about their experiences during the pandemic. None of the participants indicated that they wanted to give birth alone, yet hospital policies forced many to do so. Approximately 30% of survey participants reported that at least one support person they had hoped to have present was unable to attend their birth. For many, the absence of key support figures such as partners, doulas, or mothers created a significant emotional burden during an already stressful time.

Participants in the study were clear that their stress levels were directly tied to the absence of these support persons. Many individuals expressed frustration and anxiety about not being able to have their trusted companions with them in the delivery room, which was compounded by the general uncertainty of the pandemic. This inability to have emotional support during labor left many individuals feeling isolated, vulnerable, and unsupported during an experience that should ideally be filled with care and reassurance.

Stress Levels Comparable to Cesarean Section

The findings of the Dartmouth study suggest that the absence of emotional support during childbirth can have serious implications for mental health. The researchers found that the increase in stress levels caused by the absence of emotional support was comparable to the stress experienced by individuals undergoing a Cesarean section. Cesarean deliveries are often associated with higher levels of stress due to the surgical nature of the procedure, recovery time, and the potential risks involved. For many, a Cesarean section represents a stressful and sometimes traumatic birth experience.

The fact that missing emotional support during labor can cause similar stress levels highlights the importance of social and emotional factors in childbirth. The physical aspects of childbirth are well-documented, but the emotional experience is often just as significant. The stress experienced during labor and delivery can have lasting effects, not only on the individual giving birth but also on the infant. High levels of stress during labor have been linked to negative outcomes such as increased pain perception, longer labor, and higher rates of interventions, including Cesarean sections.

Disparities in Birth Support Access

While the study primarily focused on the impact of COVID-19 restrictions, it also highlighted the broader issue of access to emotional support during childbirth. The research found that individuals with higher levels of education were more likely to experience higher levels of childbirth stress, which may be indicative of the greater expectations they have for their birth experience and the potential mismatch between those expectations and the reality of hospital policies. Additionally, some participants noted that their healthcare providers seemed distracted, busy, or unavailable during labor, further contributing to their stress levels.

It’s important to note that the sample used in the study was predominantly composed of white participants, meaning that the findings may not fully reflect the experiences of marginalized groups. However, the study does suggest that access to emotional support may be even more crucial for individuals who face discrimination or mistreatment in the healthcare system. People from marginalized communities, particularly those who experience racism or bias within healthcare settings, may be more likely to feel unsafe or unsupported during childbirth. For these individuals, having a trusted companion present may be even more critical to ensuring a positive and supportive birth experience.

The Importance of Support for Maternal and Child Health

The Dartmouth study underscores the importance of emotional support for both maternal and child health. The findings align with existing research showing that making people feel safe, secure, and supported during labor can lead to better outcomes for both the mother and the child. Emotional support not only alleviates stress but can also improve physiological responses during labor, making the process smoother and less likely to require medical interventions.

Furthermore, emotional support can play a key role in the postpartum period, helping new parents navigate the challenges of recovery and early infant care. This period can be particularly stressful, as individuals adjust to the demands of parenthood while also recovering from childbirth. Having a supportive partner or family member available during this time can improve mental health outcomes and foster bonding between the parent and child.

Moving Forward: Prioritizing Emotional Support in Childbirth

As the world continues to navigate the COVID-19 pandemic and its impact on healthcare, the Dartmouth study serves as a critical reminder of the importance of emotional support during childbirth. The research highlights the need for policies that prioritize the presence of support people during labor, even in the face of public health emergencies. While safety measures such as mask-wearing and social distancing may be necessary, the emotional well-being of pregnant individuals should not be overlooked.

In the future, it is essential that healthcare systems recognize the value of emotional support during labor and make efforts to ensure that pregnant individuals have access to trusted companions whenever possible. This includes revising hospital policies to allow for the presence of multiple support persons, particularly when the mother’s emotional well-being is at stake. Additionally, healthcare providers should be mindful of the emotional needs of their patients and work to create an environment where individuals feel cared for, supported, and respected during one of the most significant experiences of their lives.

The Dartmouth-led study sheds light on the significant impact that missing emotional support during childbirth can have on stress levels and overall birth experiences. With the COVID-19 pandemic highlighting the challenges many individuals face in accessing their desired support people, this research emphasizes the need for policies that prioritize emotional well-being during labor. As the medical community continues to work toward improving maternal and child health, the lessons learned from this study could help shape the future of childbirth support, ensuring that every individual has access to the care and support they need during this critical time.