Continuous support for women during childbirth

Area of Science:

• Obstetrics and Gynecology
• Maternal and Child Health
• Evidence-Based Midwifery

Background:

• Historically, continuous labor support by women for women was standard practice.
• Modern hospital settings often lack continuous intrapartum support, leading to concerns about dehumanized birth experiences.
• There is a growing movement to reinstate continuous support during labor.

Purpose of the Study:

• To evaluate the impact of continuous, one-to-one intrapartum support on mothers and newborns compared to usual care.
• To investigate if factors like birth environment policies, caregiver affiliation, and timing of support initiation modify its effects.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Central Register of Controlled Trials.
• Included 15 RCTs involving 12,791 women, analyzing both published and unpublished data.

Main Results:

• Continuous intrapartum support reduced the likelihood of intrapartum analgesia and operative birth.
• Women receiving continuous support reported higher satisfaction with their childbirth experience.
• Benefits were more pronounced when support was provided by non-hospital staff, initiated early in labor, and in settings without routine epidural analgesia.

Conclusions:

• Continuous support throughout labor and birth is recommended for all women.
• The findings support the integration of continuous labor support as a standard of care.
• Optimizing the conditions for continuous support can maximize positive birth outcomes.