A historical review of the concept of labor support in technocratic, humanistic and holistic paradigms of childbirth

BACKGROUND: In the past century, maternal support during childbirth has been changed according to the different approaches suggested by various health care paradigms. OBJECTIVE: The aim of this review was to argue the maternity supportive care paradigms of the past century and to closely analyze each paradigm. METHODS: This is a historical review, in which published articles were retrieved from databases including Scopus, Science Direct, PubMed and Google Scholar. Sage Journals and Springer’s publications were also searched due to the high citation rate of their articles. The keywords entered were “Labor support”, “Normal delivery”, “Birth attendance”, “Supportive approaches”, “Health care paradigms”, and “Midwifery models of care”. They were entered alone or in combinations using “AND”. Also, Persian articles were searched in local databases including Irandoc, SID, IranMedex, and Magiran using the above-mentioned keywords in Persian. Sixty articles met inclusion criteria. RESULTS: The review revealed four main themes including the definitions of continuous labor support, the technocratic paradigm, the humanistic paradigm and the naturalistic paradigm as models of labor support. According to the evidence, labor support has changed from technocratic to humanistic and holistic approaches, which in turn, caused some changes in midwifery models of care used by midwives in the practice. CONCLUSION: Labor support based on the holistic approaches and the naturalistic paradigms could bring about remarkable outcomes, the most important being satisfied with the birth experience, increased mother’s self-confidence, enhanced mother’s ability in childbirth and better completion of the childbirth process.