Continuous Emotional Support During Labor in a US Hospital. A Randomized Controlled Trial

JAMA. 1991 May 1;265(17):2197-201.

Abstract

The continuous presence of a supportive companion (doula) during labor and delivery in two studies in Guatemala shortened labor and reduced the need for cesarean section and other interventions. In a US hospital with modern obstetric practices, 412 healthy nulliparous women in labor were randomly assigned to a supported group (n = 212) that received the continuous support of a doula or an observed group (n = 200) that was monitored by an inconspicuous observer. Two hundred four women were assigned to a control group after delivery. Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; and control group, 18%) and forceps deliveries. Epidural anesthesia for spontaneous vaginal deliveries varied across the three groups (supported group, 7.8%; observed group, 22.6%; and control group, 55.3%). Oxytocin use, duration of labor, prolonged infant hospitalization, and maternal fever followed a similar pattern. The beneficial effects of labor support underscore the need for a review of current obstetric practices.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Epidural
  • Anesthesia, Obstetrical
  • Cesarean Section / statistics & numerical data*
  • Female
  • Humans
  • Interpersonal Relations
  • Labor, Obstetric / psychology*
  • Middle Aged
  • Obstetrics and Gynecology Department, Hospital / statistics & numerical data
  • Oxytocin / therapeutic use
  • Pregnancy
  • Pregnancy Outcome / psychology
  • Prenatal Care
  • Social Support*
  • Texas
  • Time Factors

Substances

  • Oxytocin