Potential benefits of increased access to doula support during childbirth.
نویسندگان
چکیده
OBJECTIVES The annual costs of US maternity-related hospitalizations exceed $27 billion. Continuous labor support from a trained doula is associated with improved outcomes and potential cost savings. This study aimed to document the relationship between doula support, desire for doula support, and cesarean delivery, distinguishing cesarean deliveries without a definitive medical indication. STUDY DESIGN Retrospective analysis of a nationally representative survey of women who delivered a singleton baby in a US hospital in 2011- 2012 (N = 2400). METHODS Multivariable logistic regression analysis of characteristics associated with doula support and desire for doula support; similar models examine the relationship between doula support, desire for doula support, and 1) any cesarean or 2) nonindicated cesarean. RESULTS Six percent of women reported doula care during childbirth. Characteristics associated with desiring but not having doula support were black race (vs white; adjusted odds ratio [AOR] = 1.77; 95% CI,1.03-3.03), and publicly insured or uninsured (vs privately insured; AOR = 1.83, CI, 1.17-2.85; AOR = 2.01, CI, 1.07-3.77, respectively). Doula-supported women had lower odds of cesarean compared without doula support and those who desired but did not have doula support (AOR = 0.41, CI, 0.18-0.96; and AOR = 0.31, CI, 0.13-0.74). The odds of nonindicated cesarean were 80-90% lower among doula-supported women (AOR= 0.17, CI, 0.07-0.39; and AOR= 0.11, CI, 0.03-0.36). CONCLUSIONS Women with doula support have lower odds of nonindicated cesareans than those who did not have a doula as well as those who desired but did not have doula support. Increasing awareness of doula care and access to support from a doula may facilitate decreases in nonindicated cesarean rates.
منابع مشابه
Swedish women's experiences of doula support during childbirth.
OBJECTIVE to describe women's experiences of having a doula present during childbirth. DESIGN AND SETTING a qualitative study with a phenomenological approach in two large Swedish cities. Data were collected via open-ended taped interviews 1-2 months after childbirth. The analysis of the text of transcripts included search for meaning units sorted into clusters for a final expression of the e...
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‘The greatest feeling you get, knowing you have made a big difference’: survey findings on the motivation and experiences of trained volunteer doulas in England
BACKGROUND Support from a doula is known to have physical and emotional benefits for mothers, but there is little evidence about the experiences of volunteer doulas. This research aimed to understand the motivation and experiences of volunteer doulas who have been trained to support women during pregnancy, birth and the postnatal period. METHODS A postal questionnaire survey was sent to volun...
متن کاملA randomized controlled trial of continuous labor support for middle-class couples: effect on cesarean delivery rates.
BACKGROUND Previous randomized controlled studies in several different settings demonstrated the positive effects of continuous labor support by an experienced woman (doula) for low-income women laboring without the support of family members. The objective of this randomized controlled trial was to examine the perinatal effects of doula support for nulliparous middle-income women accompanied by...
متن کاملEvaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences.
Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of...
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عنوان ژورنال:
- The American journal of managed care
دوره 20 8 شماره
صفحات -
تاریخ انتشار 2014