Childbirth Suport Research
Hodnett ED, Lowe NK, Hannah ME, Willan AR, Stevens B, Weston JA, Ohlsson A, Gafni A, Muir HA, Myhr TL, Stremler R. Effectiveness of nurses as providers of birth labor support in North American hospitals: a randomized controlled trial.
Nursing Supportive Care in Labor Trial Group. JAMA. 2003 Jan 8;289(2):175-6.
In one hospital in my area they have implemented one to one nursing in response to the research about continuity of care. However, in this study on nurses acting as doulas the researchers found that having nursing staff act in the doula role does not affect the "likelihood of cesarean delivery or other medical or psychosocial outcomes of labor and birth" like the presence of a doula does.
Hodnett ED, Gates S, Hofmeyr G J, Sakala C. Continuous support for women during childbirth (Cochrane Review)
In this review Hodnett and colegues found that "women who had continuous intrapartum support were less likely to have intrapartum analgesia, operative birth, or to report dissatisfaction with their childbirth experiences." They noted that, "In general, continuous intrapartum support was associated with greater benefits when the provider was not a member of the hospital staff, when it began early in labour, and in settings in which epidural analgesia was not routinely available."
Their conclusion was that all woman should have continuous support during labor.
Hodnett ED. Continuity of caregivers for care during pregnancy and childbirth (Cochrane Review)
In this review, Hodnett assessed the differences between "continuity of care by midwives with non-continuity of care by a combination of physicians and midwives." Continuity of care by midwives was associated with:
- less likelihood to be admitted to hospital antenatally
- more likelihood to attend antenatal education programs
- less likelihood to have drugs for pain relief during labour
- newborns were less likely to require resuscitation
- less likelihood to have an episiotomy but more likelihood to have either a vaginal or perineal tear
It was noted that it is unclear whether these results are caused by the continuity of care or by midwifery care.
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