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  Vol. 265 No. 17, May 1, 1991 TABLE OF CONTENTS
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Continuous Emotional Support During Labor in a US Hospital

A Randomized Controlled Trial

John Kennell, MD; Marshall Klaus, MD; Susan McGrath, PhD; Steven Robertson, PhD; Clark Hinkley, MD

JAMA. 1991;265(17):2197-2201.


Abstract

The continuous presence of a supportive companion (doula) during labor and delivery in two studies in Guatemala shortened labor and reduced the need for cesarean section and other interventions. In a US hospital with modern obstetric practices, 412 healthy nulliparous women in labor were randomly assigned to a supported group (n = 212) that received the continuous support of a doula or an observed group (n = 200) that was monitored by an inconspicuous observer. Two hundred four women were assigned to a control group after delivery. Continuous labor support significantly reduced the rate of cesarean section deliveries (supported group, 8%; observed group, 13%; and control group, 18%) and forceps deliveries. Epidural anesthesia for spontaneous vaginal deliveries varied across the three groups (supported group, 7.8%; observed group, 22.6%; and control group, 55.3%). Oxytocin use, duration of labor, prolonged infant hospitalization, and maternal fever followed a similar pattern. The beneficial effects of labor support underscore the need for a review of current obstetric practices.

(JAMA. 1991;265:2197-2201)



Author Affiliations

From the Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio (Drs Kennell and McGrath); the Department of Pediatrics, Childrens Hospital, Oakland Calif (Dr Klaus); the Department of Human Development and Family Studies, Cornell University, Ithaca, NY (Dr Robertson); and the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Tex (Dr Hinkley).


Footnotes

Reprint requests to Department of Pediatrics, Rainbow Babies and Childrens Hospital, 2103 Adelbert Rd, Cleveland, OH 44106 (Dr Kennell).



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