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. PMID: 16881989
Della A Campbell, Marian F Lake, Michele Falk, Jeffrey R Backstrand
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.
Article Published Date : Jul 01, 2006
Impact of doulas on healthy birth outcomes.
J Perinat Educ. 2013;22(1):49-58
Authors: Gruber KJ, Cupito SH, Dobson CF
Birth outcomes of two groups of socially disadvantaged mothers at risk for adverse birth outcomes, one receiving prebirth assistance from a certified doula and the other representing a sample of birthing mothers who elected to not work with a doula, were compared. All of the mothers were participants in a prenatal health and childbirth education program. Expectant mothers matched with a doula had better birth outcomes. Doula-assisted mothers were four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding. Communication with and encouragement from a doula throughout the pregnancy may have increased the mother's self-efficacy regarding her ability to impact her own pregnancy outcomes.
PMID: 24381478 [PubMed]
After praise and encouragement: emotional support strategies used by birth doulas in the USA and Canada.
Midwifery. 2011 Aug;27(4):525-31
Authors: Gilliland AL
OBJECTIVE: to describe in detail the emotional support techniques employed by birth doulas during labour.
DESIGN: grounded theory methodology was utilised in collecting and analysing interviews given by doulas and mothers who had doula care. By using both informants, a clearer picture of what constitutes emotional support by doulas emerged.
PARTICIPANTS: 10 mothers from three different states in the Midwestern USA and 30 doulas from 10 different states and two Canadian provinces were interviewed. Two doulas worked in hospital-based programmes whereas the others had independent practices. Doulas usually attended births in hospitals where medical attendants spent little focused time with the mother.
FINDINGS: nine different strategies were distinguished. Four strategies (reassurance, encouragement, praise, explaining) were similar to those attributed to nurses in published research. Five were original and described as only being used by doulas (mirroring, acceptance, reinforcing, reframing, debriefing).
CONCLUSIONS: emotional support by professional birth doulas is more complex and sophisticated than previously surmised. Mothers experienced these strategies as extremely meaningful and significant with their ability to cope and influencing the course of their labour.
IMPLICATIONS FOR PRACTICE: the doula's role in providing emotional support is distinct from the obstetric nurse and midwife. Professional doulas utilise intricate and complex emotional support skills when providing continuous support for women in labour. Application of these skills may provide an explanation for the positive 'doula effect' on obstetric and neonatal outcomes in certain settings.
PMID: 20850916 [PubMed - indexed for MEDLINE]
Nurses and doulas: complementary roles to provide optimal maternity care.
J Obstet Gynecol Neonatal Nurs. 2006 Mar-Apr;35(2):304-11
Authors: Ballen LE, Fulcher AJ
Staff in maternity-care facilities are seeing an increase in doulas, nonmedical childbirth assistants, who are trained to provide continuous physical, emotional, and informational labor support. The long-term medical and psychosocial benefits are well documented. In this article, misconceptions about the doula's role are corrected, and suggestions are offered on ways to improve communication between health care providers and doulas. Together, nurses and doulas can provide birthing women with a safe and satisfying birth.
PMID: 16620259 [PubMed - indexed for MEDLINE]