A randomized control trial of continuous support in labor by a lay doula

J Obstet Gynecol Neonatal Nurs. 2006 Jul-Aug;35(4):456-64. doi: 10.1111/j.1552-6909.2006.00067.x.


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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Apgar Score
  • Continuity of Patient Care / organization & administration
  • Cost-Benefit Analysis
  • Curriculum
  • Delivery, Obstetric / methods
  • Delivery, Obstetric / statistics & numerical data
  • Family / psychology
  • Female
  • Friends / psychology
  • Humans
  • Labor, Obstetric* / physiology
  • Labor, Obstetric* / psychology
  • Midwifery / education
  • Midwifery / organization & administration*
  • New Jersey
  • Nursing Evaluation Research
  • Parity
  • Poverty
  • Pregnancy
  • Pregnancy Outcome*
  • Program Evaluation
  • Role
  • Social Support*
  • Time Factors