periences (in high-, middle-, and low-income countries) have led
to calls for a return to continuous, one-to-one support by women
for women during labour (Klaus 2002). Common elements of
this care include emotional support (continuous presence, reassurance
and praise), information about labour progress and advice regarding
coping techniques, comfort measures (such as comforting
touch, massage, warm baths/showers, promoting adequate fluid
intake and output) and advocacy (helping the woman articulate
her wishes to others).
Two complementary theoretical explanations have been offered
for the effects of labour support on childbirth outcomes. Both explanations
hypothesise that labour support enhances labour physiology
and mothers’ feelings of control and competence, reducing
reliance on medical interventions. The first theoretical explanation
considers possible mechanisms when companionship during
labour is used in stressful, threatening and disempowering clinical
birth environments (Hofmeyr 1991). During labour, women
may be uniquely vulnerable to environmental influences; modern
obstetric care frequently subjects women to institutional routines,
high rates of intervention, unfamiliar personnel, lack of privacy
and other conditions thatmay be experienced as harsh.These conditions
may have an adverse effect on the progress of labour and on
the development of feelings of competence and confidence; this
may in turn impair adjustment to parenthood and establishment
of breastfeeding, and increase the risk of depression. The provision
of support and companionship during labour may to some extent
buffer such stressors.