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A randomized control trial of continuous support in labor by a lay doula
Della A Campbell1, Marian F Lake, Michele Falk
1Study on Sleep & Functional Performance in Heart Failure at the University of Medicine and Dentistry of New Jersey, School of Nursing, Newark 07101-1709, and Division of Maternal Fetal Medicine, Saint Peter's University Hospital, New Brunswick, NJ, USA.
Objective:
To compare labor outcomes in women accompanied by an additional support person (doula group) with outcomes in women who did not have this additional support person (control group).
Design:
Randomized controlled trial.
Setting:
A women's ambulatory care center at a tertiary perinatal care hospital in New Jersey.
Patients/Participants:
Six hundred nulliparous women carrying a singleton pregnancy who had a low-risk pregnancy at the time of enrollment and were able to identify a female friend or family member willing to act as their lay doula.
Interventions:
The doula group was taught traditional doula supportive techniques in two 2-hour sessions.
Main Outcome Measures:
Length of labor, type of delivery, type and timing of analgesia/anesthesia, and Apgar scores.
Results:
Significantly shorter length of labor in the doula group, greater cervical dilation at the time of epidural anesthesia, and higher Apgar scores at both 1 and 5 minutes. Differences did not reach statistical significance in type of analgesia/anesthesia or cesarean delivery despite a trend toward lower cesarean delivery rates in the doula group.
Conclusion:
Providing low-income pregnant women with the option to choose a female friend who has received lay doula training and will act as doula during labor, along with other family members, shortens the labor process.
