Table 1
Results of 7 North American Trials of Labor Support including 2259 women
(comparing continuous labor support by doulas with usual care)
Author |
Cesarean |
Oxytocin |
Epidural |
Narcotics |
Instrumental |
Maternal |
5 min. |
Cogan (13) |
N.A. |
No diff |
N.A. |
decrease |
N.A. |
N.A. |
decrease |
Hodnett (14) |
No diff |
increase |
N.A. |
decrease |
No diff |
N.A. |
N.A. |
Kennell (7) |
decrease |
decrease |
decrease |
No diff |
decrease |
N.A. |
decrease |
Kennell (8) |
decrease |
N.A. |
No diff |
N.A. |
N.A. |
N.A. |
N.A. |
Gordon (15) |
No diff |
No diff |
decrease |
No diff |
No diff |
decrease |
N.A. |
McGrath (9) |
decrease |
decrease |
decrease |
decrease |
No diff |
N.A. |
N.A. |
Trueba (16) |
decrease |
decrease |
decrease |
N.A. |
N.A. |
N.A. |
N.A. |
KEY: No diff- no statistically significant difference between groups;N.A. – not assessed; increase – statistically significant increase in the supported group; decrease – statistically significant decrease in the supported group.
The results of 3 North American Trials 3, 17, 18 including 8052 women (comparing continuous labor support by NURSES – not doulas – with usual care) showed no differences in any outcomes listed in Table 1.
Findings of Hodnett’s et al meta-analysis of 15 trials from N. America, Europe, and Africa(10)
Women cared for during labor by a birth doula, compared to those receiving usual care were
- 26% less likely to give birth by cesarean section
- 41% less likely to give birth with a vacuum extractor or forceps
- 28% less likely to use any analgesia or anesthesia
- 33% less likely to be dissatisfied or negatively rate their birth experience