1A. Consider all birthplace options, recognizing that birth experiences are enhanced in home, birth center, or hospital settings that support parent's informed choices for the labor, birthing, and postpartum process.
Premise: Doula support in labor is shown to be effective only when it is continuous.
Research Question: Does continuous support by doulas during labor, when compared to intermittent support, improve the outcome of delivery?
Variables: Continuos or intermittent support by the doulas; the age, race, culture, education, finances, parity for the patient; and any obstetrical complications that arose during labor (need for oxytocin for augmentation, forceps, analgesia, length of labor, need for C-section).
Subjects: Eleven clinical trials were conducted by meta-analytic techniques of full-term pregnant women with no complications and analyzed by meta-analysis technique.
Data Collection: Laboring women in the hospital were assigned to an experimental and control group. Subjects in some investigations were randomly assigned.
Analysis: When compared to no doula support, continuous support was significantly associated with shorter labors with a decreased use of analgesia, oxytocin, forceps, and cesarean births. Intermittent doula support was not significantly associated with any of the positive outcomes.
Research reviewed by Rochelle Gower, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.
Premise: One-to-one nursing support during labor is associated with superior outcomes.
Research Questions: Can one-to-one nursing be a benefit in reducing the use of pharmacological agents such as epidural analgesics? Can it decrease the number of cesarean sections? Can it decrease the rate of newborn needs for neonatal intensive care? Can it decrease the rate of perineal trauma?
Background: Comparison of the risk and benefits of one-to-one nursing support over the usual intrapartum nursing care.
Subjects: A total of 413 nulliparous women at >37weeks of gestation in labor.
Study Design: A randomized, controlled trial conducted at a university hospital in Montreal, Quebec. The experimental group (n=209) received one-to-one nursing and the control group (n=204) received the usual intrapartum nursing care.
Findings: The group of women receiving one-to-one nursing support demonstrated a 17% decrease in the use of oxytocin stimulation induction in the birthing process. No statistically significant relationships were found between nursing support and the use of analgesics, rate of cesarean sections, number of admissions to the neonatal intensive care units, or incidence of perineal trauma.
Research reviewed by Barbara Accord, RN, while a student at Virginia Commonwealth University School of Nursing, in Richmond, VA.