Doulas have been helping woman in preparing for labor, birth/labor journey and postpartum for hundreds of years. They might not have had the title "Doula" but women have been helping, supporting and encouraging other women since the beginning. Science is now behind the awesome benefits of labor support and Doulas! The American College of Obstetricians and Gynecologist has once again endorsed improved maternal/fetal health outcomes for doula support in labor. The committee opinion report titled Approaches to Limit Intervention During Labor and Birth released this month highlights several factors that can lead to improved outcomes and higher patient satisfaction for women in labor. Additionally, the report was endorsed by The American College of Nurse–Midwives and the Association of Women’s Health, Obstetric and Neonatal Nurses. The report states: Evidence suggests that, in addition to regular nursing care, continuous one-to-one emotional support provided by support personnel, such as a doula, is associated with improved outcomes for women in labor. Benefits found in randomized trials include shortened labor, decreased need for analgesia, fewer operative deliveries, and fewer reports of dissatisfaction with the experience of labor (1, 17). As summarized in a Cochrane evidence review, a woman who received continuous support was less likely to have a cesarean delivery (RR, 0.78; 95% CI, 0.67–0.91) or a newborn with a low 5-minute Apgar score (fixed-effect, RR, 0.69; 95% CI, 0.50–0.95) (1). Continuous support for a laboring woman that is provided by a nonmedical person also has a modest positive effect on shortening the duration of labor (mean difference –0.58 hours; 95% CI, –0.85 to –0.31) and improving the rate of spontaneous vaginal birth (RR, 1.08; 95% CI, 1.04–1.12) (1) Also included in the report were recommendations on delaying hospital admission in the latent phase of labor, suggestions for using nonpharmacologic pain management techniques (for pain or fatigue in latent labor) including massage or water immersion, frequent position changes to enhance maternal comfort and optimal fetal position, as well as recommendations for hand-held Doppler devises for fetal monitoring in healthy labors. This is great news and will hopefully speed things along in regards to insurance companies and public knowledge of Doulas. Doulas are a tool and are beneficial to all laboring women. Who is your Doula?
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AuthorDoula Rachel has put together a blog of resources, info-graphics, and articles, with an occasional self-published blog. Enjoy! Archives
March 2020
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