Doula Care, Early Breastfeeding Outcomes, and Breastfeeding Status at 6 Weeks Postpartum Among Low-Income Primiparae
Article first published online: 16 MAR 2009
© 2009 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 38, Issue 2, pages 157–173, March/April 2009
How to Cite
Nommsen-Rivers, L. A., Mastergeorge, A. M., Hansen, R. L., Cullum, A. S. and Dewey, K. G. (2009), Doula Care, Early Breastfeeding Outcomes, and Breastfeeding Status at 6 Weeks Postpartum Among Low-Income Primiparae. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38: 157–173. doi: 10.1111/j.1552-6909.2009.01005.x
- Issue published online: 16 MAR 2009
- Article first published online: 16 MAR 2009
- Accepted December 2008
Objective: To examine associations between doula care, early breastfeeding outcomes, and breastfeeding duration.
Design: Prospective cohort.
Setting: Regional hospital in northern California.
Participants: Low-income, full gestation primiparae receiving doula care (n=44) or standard care (n=97).
Measures: Birth outcomes and newborn feeding data obtained from the hospital record. Follow-up interviews conducted at day 3 to record the timing of onset of lactogenesis and breastfeeding behavior and at 6 weeks to obtain current breastfeeding status.
Results: Adjusting for baseline differences, women receiving doula care were significantly more likely to have a short stage II labor, a noninstrumental vaginal delivery, and to experience onset of lactogenesis within 72 hours postpartum (timely onset of lactogenesis). Overall, 68% of women receiving doula care and 54% of women receiving standard care were breastfeeding at 6 weeks. In the subset with a prenatal stressor (n=63), the doula care group was more than twice as likely to be breastfeeding at 6 weeks (89% vs. standard care, 40%). Breastfeeding at 6 weeks was also significantly associated with timely onset of lactogenesis and maternal report that the infant “sucked well” at day 3.
Conclusions: Doula care was associated with improved childbirth outcomes and timely onset of lactogenesis. Both directly and as mediated by timely onset of lactogenesis, doula care was also associated with higher breastfeeding prevalence at 6 weeks.