Abstract

We studied the effects of a supportive lay woman (“doula”) on the length of labor and on mother-infant interaction after delivery in healthy Guatemalan primigravid women. Initial assignment of mothers to the experimental (doula) or control group was random, but controls showed a higher rate (P less than 0.001) of subsequent perinatal problems (e.g. cesarean section and meconium staining). It was necessary to admit 103 mothers to the control group and 33 to the experimental group to obtain 20 in each group with uncomplicated deliveries. In the final sample, the length of time from admission to delivery was shorter in the experimental group (8.8 vs. 19.3 hours, P less than 0.001). Mothers who had a doula present during labor were awake more after delivery (P less than 0.02) and stroked (P less than 0.001), smiled at (P less than 0.009), and talked to (P less than 0.002) their babies more than the control mothers. These observations suggest that there may be major perinatal benefits of constant human support during labor.

Minnesota Finds Doula Care for Low-Income Women Could Save Taxpayers Money

A new study led by Dr. Katy Backes Kozhimannil, assistant professor at the University of Minnesota School of Public Health, found lower cesarean birth rates and lower preterm birth rates among Medicaid beneficiaries with access to support from a birth doula than among Medicaid patients nationally. A doula is not a medical provider, but is a trained, experienced professional person who can provide information, physical assistance, and support to a woman during childbirth.

The research indicates that policy changes to provide Medicaid coverage for birth doulas may actually decrease costs due to lower rates of cesarean births among Medicaid patients with doula support. Support during childbirth may be especially important for women with low health literacy or patients whose first language is not English and who may not fully understand all their clinical options during childbirth.

Positive health impacts of continuous labor support are well documented, but this is the first analysis of the potential financial impact of offering insurance coverage for that type of support.

The results are published online February 2013 in the American Journal of Public Health, download a copy here

Just Another Day in a Woman’s Life? Women’s Long-Term Perceptions of Their First Birth Experience.

Simkin, P. (Birth 19:4 December 1991)

Penny Simkin’s ground breaking study showed that women remember their birth experience in minute detail, even 20 years after the event. She shows that this experience has long term impacts on a woman’s life.

“The way a woman is treated by the professionals on whom she depends may largely determine how she feels about the experience for the rest of her life. A Woman in labor is highly vulnerable….. If she is treated without respect, if her efforts to maintain dignity and control are rebuffed, or if she is taken advantage of, the negative impact is permanent. If she is nurtured, treated with kindness and respect, and feels like a participant, the positive impact is permanent…”
“It is clear that the birth experience has a powerful effect on women with a potential for permanent or long-term positive or negative impact…. The potential for psychological benefits or damage is present at every birth.”

Read the entire article here.