During labor, the continued presence of a doula – an experienced non-medical female companion who provides continuous labor support – has significant beneficial effects for middle- and upper-class women in childbirth, even when they have their male partner or other family member with them, according to a new study in the journal Birth.
Over a 5-year period, 224 of a group of 420 pregnant women in their third trimester were randomized to have a doula accompany them during labor, and 196 women did not receive this intervention. Cesarean delivery rates decreased by 12%, the need for an epidural dropped by 11%, and the need for a cesarean after induced labor decreased by 46% when a doula arrived shortly after hospital admission and remained with the woman throughout her labor and delivery when compared with the group without a doula.
Support from the doula included close physical proximity, touching, and eye contact with the laboring woman, and teaching, reassurance, and encouragement of the woman and her partner during the birth. On questionnaires administered the day after delivery, 100% of couples with doula support rated their experience with the doula positively.
“The assistance provided by new fathers, while extremely important for other reasons, does not have the same positive impact on perinatal outcomes as does that of experienced doulas,” conclude study authors Susan K. McGrath, PhD, and John H. Kennell, MD, of Case Western Reserve University. “Continuous support by a doula during labor is a risk-free, low-cost method of reducing cesarean delivery rates that should be available to all women.”
- Susan K. McGrath PhD, John H. Kennell MD. A Randomized Controlled Trial of Continuous Labor Support for Middle-Class Couples: Effect on Cesarean Delivery Rates. Birth, 35 (2) , 92%u201397 DOI: 10.1111/j.1523-536X.2008.00221.x
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