The Obstetrical and Postpartum Benefits of Continuous Support during Childbirth
- 1 December 1999
- journal article
- review article
- Published by Mary Ann Liebert Inc in Journal of Women's Health & Gender-Based Medicine
- Vol. 8 (10), 1257-1264
- https://doi.org/10.1089/jwh.1.1999.8.1257
Abstract
The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.Keywords
This publication has 16 references indexed in Scilit:
- Effects of providing hospital-based doulas in health maintenance organization hospitalsPublished by Ovid Technologies (Wolters Kluwer Health) ,1999
- The doula: an essential ingredient of childbirth rediscoveredActa Paediatrica, 1997
- Continuous labor support from labor attendant for primiparous women: A meta-analysisObstetrics & Gynecology, 1996
- Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeedingBJOG: An International Journal of Obstetrics and Gynaecology, 1991
- Continuous emotional support during labor in a US hospital. A randomized controlled trialPublished by American Medical Association (AMA) ,1991
- A trial on continuous human support during labor: feasibility, interventions and mothers' satisfactionJournal of Psychosomatic Obstetrics & Gynecology, 1990
- Effects of continuous intrapartum professional support on childbirth outcomesResearch in Nursing & Health, 1989
- Childbirth in Cross-Cultural PerspectiveMarriage & Family Review, 1988
- Effects of social support during parturition on maternal and infant morbidity.BMJ, 1986
- The Effect of a Supportive Companion on Perinatal Problems, Length of Labor, and Mother-Infant InteractionNew England Journal of Medicine, 1980