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Continuous support for women during childbirth

  1. Ellen D Hodnett1,*,
  2. Simon Gates2,
  3. G Justus Hofmeyr3,
  4. Carol Sakala4

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 15 JUL 2013

Assessed as up-to-date: 29 JUN 2013

DOI: 10.1002/14651858.CD003766.pub5


How to Cite

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5.

Author Information

  1. 1

    University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, Toronto, Ontario, Canada

  2. 2

    Division of Health Sciences, Warwick Medical School, The University of Warwick, Warwick Clinical Trials Unit, Coventry, UK

  3. 3

    University of the Witwatersrand, University of Fort Hare, Eastern Cape Department of Health, Department of Obstetrics and Gynaecology, East London Hospital Complex, East London, Eastern Cape, South Africa

  4. 4

    Childbirth Connection, New York, USA

*Ellen D Hodnett, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario, M5T 1P8, Canada. ellen.hodnett@utoronto.ca.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 15 JUL 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Breart - Belgium 1992 {published data only}
  • Breart G, Garel M, Mlika-Cabanne N. Evaluation of different policies of management of labour for primiparous women. Trial B: Results of the continuous professional support trial. In: Kaminski M editor(s). Evaluation in Pre-, Peri-, and Post-Natal Care Delivery Systems. Paris: INSERM, 1992:57-68.
  • Breart G, Mlika-Cabane N, Kaminski M. The evaluation of different policies for the management of labour. Proceedings of 3rd European Health Services Research Meeting; 1991 Dec 13-14; London, UK. 1991.
  • Breart G, Mlika-Cabane N, Kaminski M, Alexander S, Herruzo-Nalda A, Mandruzzato P, et al. Evaluation of different policies for the management of labour. Early Human Development 1992;29:309-12.
  • Breart G, Mlika-Cabane N, Thornton J, Trakas D, Alexander S, Mandruzzato P, et al. European trials on artificial rupture of membranes and professional support during labour. Journal of Perinatal Medicine 1992;20(Suppl 1):37.
Breart - France 1992 {published data only}
  • Breart G, Garel M, Mlika-Cabanne N. Evaluation of different policies of management of labour for primiparous women. Trial B: Results of the continuous professional support trial. In: Kaminski M editor(s). Evaluation in Pre-, Peri-, and Post-natal Care Delivery Systems. Paris: INSERM, 1992:57-68.
  • Breart G, Mlika-Cabane N, Kaminski M. The evaluation of different policies for the management of labour. Proceedings of 3rd European Health Services Research Meeting; 1991 Dec 13-14; London, UK. 1991.
  • Breart G, Mlika-Cabane N, Kaminski M, Alexander S, Herruzo-Nalda A, Mandruzzato P, et al. Evaluation of different policies for the management of labour. Early Human Development 1992;29:309-12.
  • Breart G, Mlika-Cabane N, Thornton J, Trakas D, Alexander S, et al. European trials on artificial rupture of membranes and professional support during labour. Journal of Perinatal Medicine 1992;20(Suppl 1):37.
Breart - Greece 1992 {published data only}
  • Breart G, Garel M, Mlika-Cabanne N. Evaluation of different policies of management of labour for primiparous women. Trial B: Results of the continuous professional support trial. In: Kaminski M editor(s). Evaluation in Pre-, Peri-, and Post-Natal Care Delivery Systems. Paris: INSERM, 1992:57-68.
  • Breart G, Mlika-Cabane N, Kaminski M. The evaluation of different policies for the management of labour. Proceedings of 3rd European Health Services Research Meeting; 1991 Dec 13-14; London, UK. 1991.
  • Breart G, Mlika-Cabane N, Kaminski M, Alexander S, Herruzo-Nalda A, Mandruzzato P, et al. Evaluation of different policies for the management of labour. Early Human Development 1992;29:309-12.
  • Breart G, Mlika-Cabane N, Thornton J, Trakas D, Alexander S, et al. European trials on artificial rupture of membranes and professional support during labour. Journal of Perinatal Medicine 1992;20(Suppl 1):37.
Bruggemann 2007 {published and unpublished data}
  • Bruggemann OM, Parpinelli MA, Osis MJD, Cecatti JG, Neto ASC. Support to woman by a companion of her choice during childbirth: a randomized controlled trial. Reproductive Health 2007;4:5.
Campbell 2006 {published and unpublished data}
Cogan 1988 {published and unpublished data}
  • Cogan R, Spinnato JA. Social support during premature labor: effects on labor and the newborn. Journal of Psychosomatic Obstetrics and Gynaecology 1988;8:209-16.
Dickinson 2002 {published and unpublished data}
Gagnon 1997 {published and unpublished data}
Hemminki 1990a {published data only}
  • Hemminki E, Virta AL, Koponen P, Malin M, Kojo-Austin H, Tuimala R. A trial on continuous human support during labor: feasibility, interventions and mothers' satisfaction. (Trial A - Pilot study with volunteered midwifery students). Journal of Psychosomatic Obstetrics and Gynaecology 1990;11:239-50.
Hemminki 1990b {published data only}
  • Hemminki E, Virta AL, Koponen P, Malin M, Kojo-Austin H, Tuimala R. A trial on continuous human support during labor: feasibility, interventions and mothers' satisfaction. (Trial A - Pilot study with volunteered midwifery students). Journal of Psychosomatic Obstetrics and Gynaecology 1990;11:239-50.
Hodnett 1989 {published and unpublished data}
Hodnett 2002 {published and unpublished data}
  • Hodnett ED, Lowe NK, Hannah ME, Willan AR, Stevens B, Weston JA, et al. Effectiveness of nurses as providers of birth labor support in North American hospitals. A randomized controlled trial. JAMA 2002;288(11):1373-81.
  • Muir HA, Hodnett ED, Hannah ME, Lowe NK, Willan AR, Stevens B, et al. The influence of continuous labor support on the choice of analgesia, ambulation and obstetric outcome [abstract]. Anesthesiology 2002;96(Suppl 1):P44.
Hofmeyr 1991 {published and unpublished data}
  • Chalmers B, Wolman WL, Hofmeyr GJ, Nikodem C. Companionship in labour and the mother-infant relationship: preliminary report of a randomised trial. Proceedings of the 9th Conference on Priorities in Perinatal Care; 1990 March; Johannesburg, South Africa. 1990:139-41.
  • Chalmers B, Wolman WL, Hofmeyr GJ, Nikodem C. Companionship in labour: effect on the mother-infant relationship. Proceedings of the International Conference on Primary Care Obstetrics and Perinatal Health; 1991; Utrecht, The Netherlands. 1991:50.
  • Gulmezoglu AM, Chalmers BE, Nikodem VC, Wolman WL, Hofmeyr GJ. Companionship in labour: do the personality characteristics of labour supporters influence effectiveness?. Proceedings of the 11th Conference on Priorities in Perinatal Care in South Africa; 1992 March; Caledon, South Africa. 1992:115-6.
  • Hofmeyr GJ, Nikodem C, Gulmezoglu M, Wolman WL. Companionship to modify the clinical birth environment: long-term effects on mother and child. Proceedings of the 11th Conference on Priorities in Perinatal Care in South Africa; 1992 March; Caledon, South Africa. 1992:113-4.
  • Hofmeyr GJ, Nikodem C, Gulmezoglu M, Wolman WL. Companionship to modify the clinical birth environment: long-term effects on mother and child. Proceedings of the 26th British Congress of Obstetrics and Gynaecology; 1992 July 7-10; Manchester, UK. 1992:34.
  • Hofmeyr GJ, Nikodem VC, Chalmers BE, Kramer T. Clinically orientated care during labour reduces the chance of successful breastfeeding. Proceedings of the 10th Conference on Priorities in Perinatal Care in South Africa; 1991 March 12-15; Eastern Transvaal, South Africa. 1991:107-9.
  • Hofmeyr GJ, Nikodem VC, Mahomed K, Gulmezoglu AM, Lawson M, Van Der Walt LA, et al. Companionship to modify the clinical birth environment: no measurable effect on stress hormone levels. Journal of Obstetrics and Gynaecology 1995;15:178-81.
  • Hofmeyr GJ, Nikodem VC, Wolman WL, Chalmers BE, Kramer T. Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding. British Journal of Obstetrics and Gynaecology 1991;98:756-64.
  • Nikodem VC, Nolte AG, Wolman W, Gulmezoglu AM, Hofmeyr GJ. Companionship by a lay labour supporter to modify the clinical birth environment: long-term effects on mother and child. Curationis 1998;21(1):8-12.
  • Trotter C, Wolman WL, Hofmeyr J, Nikodem C, Turton R. The effect of social support during labour on postpartum depression. South African Journal of Psychology 1992;22(3):134-9.
  • Wolman WL, Chalmers B, Hofmeyr J, Nikodem VC. Postpartum depression and companionship in the clinical birth environment: a randomized, controlled study. American Journal of Obstetrics and Gynecology 1993;168:1388-93.
Kashanian 2010 {published data only}
  • Kashanian M, Javadi F, Haghighi MM. Effect of continuous support during labor on duration of labor and rate of cesarean delivery. International Journal of Gynecology & Obstetrics 2010;109(3):198-200.
Kennell 1991 {published and unpublished data}
  • Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. Continuous emotional support during labor in a US hospital. JAMA 1991;265:2197-201.
  • Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. Medical intervention: the effect of social support during labour. Proceedings of Annual Meeting of the American Pediatric Society/Society for Pediatric Research; 1988 May; USA. 1988.
  • Kennell J, McGrath S, Klaus M, Robertson S, Hinkley C. Labor support: what's good for the mother is good for the baby. Pediatric Research 1989;25:15A.
  • Martin S, Landry S, Stellman L, Kennell J, McGrath S. The effect of doula support during labor on mother-infant interaction at 2 months. Infant Behaviour and Development 1998;21 Supp1:556.
Klaus 1986 {published and unpublished data}
Langer 1998 {published and unpublished data}
  • Campero L, Garcia C, Diaz C, Ortiz O, Reynoso S, Langer A. "Alone, I wouldn't have known what to do": a qualitative study on social support during labor and delivery in Mexico. Social Science and Medicine 1998;47:395-403.
  • Langer A, Campero L, Garcia C, Reynoso S. Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers' wellbeing in a Mexican public hospital: a randomised clinical trial. British Journal of Obstetrics and Gynaecology 1998;105:1056-63.
Madi 1999 {published and unpublished data}
McGrath 2008 {published data only}
Morhason-Bello 2009 {published data only}
  • Morhason-Bello IO, Adedokun BO, Ojengbede OA. Social support during childbirth as a catalyst for early breastfeeding initiation for first-time Nigerian mothers. International Breastfeeding Journal 2009;4:16.
  • Morhason-Bello IO, Adedokun BO, Ojengbede OA, Olayemi O, Oladokun A, Fabamwo AO. Assessment of the effect of psychosocial support during childbirth in Ibadan, south-west Nigeria: a randomised controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology 2009;49(2):145-50.
  • Ojengbede O, Morhason-Bello I, Adedokun B, Becker S, Oni G, Tsui A. Psycho-social support in labour, as a catalyst for contraceptive uptake in Nigeria: preliminary analysis of a randomised controlled trial. International Journal of Gynecology & Obstetrics 2009;107(Suppl 2):S623-S624.
Thomassen 2003 {published data only}
  • Thomassen P, Lundwall M, Wiger E, Wollin L, Uvnas-Moberg K. Lakartidningen. Doula--a new concept in obstetrics [Doula--ett nytt begrepp inom forlossningsvarden]. Lakartidningen 2003;100(51-52):4268-71.
Torres 1999 {published data only}
  • Kopplin E, Torres-Pereyra J, Peña V, Salinas R. Impact of psychosocial supports during childbirth: the decrease of caesarean and bonuses of the process. Pediatric Research 2000;47:834.
  • Torres J, Kopplin E, Pena V, Klaus M, Salinas R, Herrera M. Impact of emotional support during labour in the decrease of caesarean sections and satisfaction with the process [Impacto del apoyo emocional durante el parto en la disminucion de cesareas y gratificacion del proceso]. Revista Chilena de Obstetricia y Ginecologia 1999;64(5):405-12.
Yuenyong 2012 {published and unpublished data}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Bender 1968 {published data only}
  • Bender B. A test of the effects of nursing support on mothers in labor. ANA Regional Clinical Conferences 1967 Philadelphia/Kansas City. New York: Appleton-Century-Crofts, 1968:171-9.
Bochain 2000 {published data only}
  • Bochain SS. Induced labor intervention for self-efficacy: a nursing intervention for women prone to an unpredictable labor pattern [thesis]. Rhode Island: University of Rhode Island, 2000.
Brown 2007 {published data only}
Dalal 2006 {published data only}
  • Dalal R, Rathnakumar, Santamani. Birth companion and mother - a preliminary report [abstract]. 49th All India Congress of Obstetrics and Gynaecology; 2006 Jan 6-9; Kerala State, India. 2006:140. [8E10.0007M]
Gordon 1999 {published data only}
  • Gordon NP, Walton D, McAdam E, Derman J, Gallitero G, Garrett L. Effects of providing hospital-based doulas in health maintenance organization hospitals. Obstetrics & Gynecology 1999;93:422-6.
Hemminki 1990c {published data only}
  • Hemminki E, Virta AL, Koponen P, Malin M, Kojo-Austin H, Tuimala R. A trial on continuous human support during labor: feasibility, interventions and mothers' satisfaction. (Trial C - Pilot study with lay women). Journal of Psychosomatic Obstetrics and Gynaecology 1990;11:239-50.
Lindow 1998 {published data only}
  • Lindow SW, Hendricks MW, Thompson JW, van der Spuy ZM. The effect of emotional support on maternal oxytocin levels in labouring women. European Journal of Obstetrics & Gynecology and Reproductive Biology 1998;79:127-9.
McGrath 1999 {published data only}
  • McGrath S, Kennell J, Suresh M, Moise K, Hinkley C. Doula support vs epidural analgesia: impact on cesarean rates. Pediatric Research 1999; Vol. 45, issue 4:16A.
Orenstein 1998 {published data only}
  • Manning Orenstein G. A birth intervention: the therapeutic effects of doula support versus Lamaze preparation on first-time mothers' working models of caregiving. Alternative Therapies in Medicine 1998;4(4):73-81.
Pinheiro 1996 {published data only}
  • Pinheiro RT, Sousa PLR, Horta B, de Souza RM, de Sousa MGR, de Sousa FR. Male and female young doulas - effective on labour? [abstract]. Xth World Congress of Psychiatry; 1996 August 23-28; Madrid, Spain. 1996.
Ran 2005 {published data only}
  • Ran KQ, He AM, Han QR, Tang ZL, Lei FH. Comfortable nursing and the mental state in parturient women. Chinese Journal of Clinical Rehabilitation 2005;9(32):62-3.
Scott 1999 {published data only}
Sosa 1980 {published data only}
  • Sosa R, Kennell J, Klaus M, Urrutia J. The effect of a supportive woman on mothering behavior and the duration and complications of labor. Pediatric Research 1979;13:338.
  • Sosa R, Kennell JH, Klaus MH, Robertson S, Urrutia J. The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. New England Journal of Medicine 1980;303:597-600.
Trueba 2000 {published and unpublished data}
  • Trueba G, Contreras C, Velazco MT, Lara EG, Martinez HB. Alternative strategy to decrease cesarean section: support by doulas during labor. Journal of Perinatal Education 2000;9(2):8-13.
Tryon 1966 {published data only}
Zhang 1996 {published data only}
  • Zhang CL, Yu ZJ, Feng AH. Study of psychological nursing to ease pain during labour. Chinese Journal of Nursing 1996;31(6):311-3.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Dong 2009 {published data only}
  • Dong X, Qi H, Hu L, Luo X, Zhu Y, Cai J. The effects of air sac combined with nitrous oxide and Doula companying delivery in vaginal delivery. International Journal of Gynecology and Obstetrics 2009;107:S158-S159.
Huang 2003 {published data only}
  • Huang XH, Xiang XY, Shen RG, Shang Q, Zhu LP, Qian X, et al. Study on intrapartum service model during normal labor. Chung-Hua Fu Chan Ko Tsa Chih [Chinese Journal of Obstetrics & Gynecology] 2003;38(7):385-7.
Orbach-Zinger 2012 {published data only}
  • Orbach-Zinger S, Ginosar Y, Sverdlik J, Treitel C, Mackersey K, Bardin R, et al. Partner's presence during initiation of epidural labor analgesia does not decrease maternal stress: a prospective randomized controlled trial. Anesthesia and Analgesia 2012;114(3):654-60.
Riley 2012 {published data only}
  • Riley L, Hutchings Y, Lieberman E. The effect of doula support on epidural use among nulliparous women in tertiary care centers. American Journal of Obstetrics and Gynecology 2012;206(Suppl 1):S70-S71.
Safarzadeh 2013 {published data only}
  • Safarzadeh A, Beigi M, Salehian T, Khojasteh F, Rigi SN, Buryri T, et al. Effect of doula support on labour pain and outcomes in primiparous women in Zahedan, southeastern Iran: a randomized controlled trial. Evidence Live; 2013 March 25-26; Oxford, UK 2013.
Sangestani {published data only}
  • Sangestani G. The influence of doula on the parturient anxiety in delivery ward, 2011. http://www.irct.ir/searchresult.php?id=6827&number=2 (accessed 10 March 2012).
Shen {published data only}
  • Shen XF. Doula combined latent phrase epidural analgesia in primiparous women (DCLEAP). http://clinicaltrials.gov/ct2/show/record/NCT00664118 (accessed 7 March 2012).
Wan 2011 {published data only (unpublished sought but not used)}
  • Wan H, Hu S, Thobaben M, Hou Y, Yin T. Continuous primary nursing care increases satisfaction with nursing care and reduces postpartum problems for hospitalized pregnant women. Contemporary Nurse 2011;37(2):149-59.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Janssen {published data only}
  • Janssen P. Impact of doula support on intrapartum outcomes for women undergoing a vaginal birth after cesarean (vbac). http://clinicaltrials.gov/ct2/show/record/NCT01216098 (accessed 15 February 2012).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Anim-Somuah 2011
Avan 2010
  • Avan B, Richter LM, Ramchandani PG, Norris SA, Stein A. Maternal postnatal depression and children's growth and behaviour during the early years of life: exploring the interaction between physical and mental health. Archives of Disease in Childhood 2010;95(9):690-5.
AWHONN 2002
  • Association of Women's Health, Obstetric, Neonatal Nurses. Professional nursing support of laboring women. http://www.awhonn.org (accessed 2002).
Caton 2002
  • Caton D, Corry MP, Frigoletto FD, Hopkins DP, Lieberman E, Mayberry L, et al. The nature and management of labor pain: executive summary. American Journal of Obstetrics and Gynecology 2002;186(5):S1-S15.
Declercq 2002
  • Declercq ER, Sakala C, Corry MP, Applebaum S, Risher P. Listening to mothers: report of the first national US survey of women's childbearing experiences. New York: Maternity Center Association, October 2002.
Declercq 2006
  • Declercq GD, Sakala C, Corry MP, Applebaum S. Listening to mothers: report of the second national U.S. survey of women's childbearing experiences. New York: Childbirth Connection, 2006.
Higgins 2011
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Hodnett 1997
Hodnett 2002a
  • Hodnett ED. Pain and women's satisfaction with the experience of childbirth: a systematic review. American Journal of Obstetrics and Gynecology 2002;186(5):S160-S172.
Klaus 2002
  • Klaus MH, Kennell JH, Klaus PH. The doula book: how a trained labor companion can help you have a shorter, easier and healthier birth. 2nd Edition. Cambridge, MA: Perseus Books, 2002.
Lederman 1978
  • Lederman RP, Lederman E, Work BA, Jr, McCann DS. The relationship of maternal anxiety, plasma catecholamines, and plasma cortisol to progress in labor. American Journal of Obstetrics and Gynecology 1978;132(5):495-500.
Lederman 1981
  • Lederman E, Lederman RP, Work BA Jr, McCann DS. Maternal psychological and physiologic correlates of fetal-newborn health status. American Journal of Obstetrics and Gynecology 1981;139(8):956-8.
McGinnis 2001
  • McGinnis S. On being a doula. MIDIRS Midwifery Digest 2001;11(3):362-4.
MIDIRS 1999
  • MIDIRS and the NHS Centre for Reviews and Dissemination. Support in labour: informed choice for professionals leaflet. Midwives Information and Resource Service. Bristol, England, 1999.
NICE Intrapartum Care 2007
  • National Collaborating Centre for Women’s and Children’s Health. Section 4.3. Support in labour. Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth. London: RCOG press, September 2007:73-5.
Pascali-Bonaro 2010
  • Pascali-Bonaro D. Global labor support trends. Personal communication 5 June 2010.
RevMan 2011 [Computer program]
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Simkin 2007
  • Simkin P. The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and Other Labor Companions. 3rd Edition. Boston: Harvard Common Press, 2007.
SOGC 1995
  • Society of Obstetricians and Gynaecologists of Canada. SOGC policy statement: fetal health surveillance in labour. SOGC News 1995:41-5.
WHO 2010
  • Labour companionship: every woman's choice. WHO Reproductive Health Library (http://apps.who.int/rhl/videos/en/index.html) [accessed 2010].

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. References to ongoing studies
  5. Additional references
  6. References to other published versions of this review
Hodnett 2003
  • Hodnett ED, Gates S, Hofmeyr G J, Sakala. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2003, Issue 3. [DOI: 10.1002/14651858.CD003766]
Hodnett 2011
Hodnett 2012