A Randomized Control Trial of Continuous Support in Labor by a Lay Doula

Authors

  • Della A. Campbell,

    Corresponding author
    1. Della A. Campbell, RN, CNA-BC, APRN-C, is a research coordinator for the Study on Sleep & Functional Performance in Heart Failure at the University of Medicine and Dentistry of New Jersey, School of Nursing, Newark, NJ.
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  • Marian F. Lake,

    1. Marian F. Lake, RNC, MPH, CCRC, is a research nurse manager in the Division of Maternal Fetal Medicine at Saint Peter's University Hospital, New Brunswick, NJ.
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  • Michele Falk,

    1. Michele Falk, MSW, is a research coordinator in the Department of Obstetrics & Gynecology at Saint Peter's University Hospital, New Brunswick, NJ.
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  • Jeffrey R. Backstrand

    1. Jeffrey R. Backstrand, PhD, is an associate professor, Urban Health Systems, University of Medicine and Dentistry of New Jersey, School of Nursing, Newark, NJ.
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Address for correspondence: Della A. Campbell, RN, CNA-BC, APRN-C, University of Medicine and Dentistry of New Jersey, School of Nursing, 65 Bergen Street, Suite 1112, P.O. Box 1709, Newark, NJ 07101-1709. E-mail: della.campbell@verizon.net.

Abstract

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. JOGNN, 35, 456–464; 2006. DOI: 10.1111/J.1552-6909.2006.00067.x

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