Midwifery Communication for Childbirth: A Practical Approach.

During labor and birth, inadvertent negative suggestions from care givers and support people are common and may lead to negative experiences known as nocebo effects. Counteracting nocebo effects with the use of effective communication techniques can reduce distress, enhance birth experiences, and improve health outcomes. There are very few examples in the literature describing how effective communication techniques can be used by midwives and other birth attendants when providing care to individuals in labor and birth. This article provides a practical structured communication approach to facilitate effective communication during childbirth using greeting; rapport; expectation; addressing concerns; tacit agreement (GREAT) and listening; acceptance; utilization; reframing and suggestion (LAURS) frameworks. GREAT represents a communication structure for any interaction, whereas LAURS represents an approach that builds rapport and reshapes perceptions and behaviors by providing a learnable structure to facilitate the practice and teaching of intuitive (subconscious) communication. These techniques can thus enable midwives to optimize the birth experience and avoid inadvertent nocebo effects. With unprecedented rates of birth trauma, more attention to conscious and subconscious forms of communication is needed to facilitate positive and humanizing birth experiences.