I was blessed with the opportunity to take a nursing theory and research course this semester. You read it correctly, Blessed. I may not truly enjoy academia based writing as much as I enjoy fiction writing, but the course gave me skills I will have for a lifetime to better present my knowledge to the medical world in a way that will be heard and appreciated. More than this, I had the chance to hear from many nurses who have actually been published. I was able to listen to the passion they bring to their practice, and see how they are shaping the future or nursing and patient care. My respect for nursing research is the way that is almost always focuses on prevention, healing (versus curing), and quality of life improvement.
I had to complete my own literature review based on a question I identified, and boy, did I work my butt off on that project. Now that it’s done, I am sad that it just sits in my computer files. SO, I will spare you the 13 pages of very dry writing, summarize my findings so my work can be share with someone. (and if you think I am writing this post to again delay my mental health case analysis, you are only half right…umm..I am just taking a break from it…)
The question: Does having a professional Doula increase the positive maternal newborn outcomes for low risk laboring mothers?
The short answer: YES.
The slightly longer answer:
Doulas are professional labor support people (almost exclusively women) that offer continuous support throughout labor to mothers and their partners. Their training and work is entirely separated from the medical aspect of labor, and is also unique and separate from the work of nurses, midwives, and obstetricians. With their skill set of therapeutic touch and emotional support, the positive outcomes are diverse and numerous. These include: shorter lengths of labor, statistically significant reductions in cesarean and instrument delivery, higher infant APGAR scores five minutes after birth, low levels of reported pain by mothers, reductions in the number of epidurals, and positive memories for the mothers concerning the birth. This data was collected from the Cochrane data base, and multiple research studies and articles. Intrigued? Do a little digging of your own, and pass the word. Feel free to read a few of my sources yourself. Not all of them are dry, and you might learn something new. Doulas are great. Now, back to my other paper…
A list of my references:
Campbell, D. A., Lake, M. F., Falk, M., & Backstrand, J. R. (2006). A randomized control trial of continuous support in labor by a lay doula. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(4), 456-464.
Gilliland, A. L. (2002). Beyond holding hands: The modern role of the professional doula. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 31(6), 762-769.
Gilliland, A., L. (2011). After praise and encouragement: Emotional support strategies used by birth doulas in the USA and canada. Midwifery, 27(4), 525-531. doi:10.1016/j.midw.2010.04.006
Green, J., Amis, D., & Hotelling, B. A. (2007). Care practice #3: Continuous labor support. Journal of Perinatal Education, 16(3), 25-28.
Hodnett, E. D., Gates, S., Hofmeyr, G. J., & Sakala, C. (2007). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, (3), 003766.
Hodnett, E. D., Lowe, N. K., Hannah, M. E., Willan, A. R., Stevens, B., Weston, J. A., . . . Nursing Supportive Care in Labor Trial,Group. (2002). Effectiveness of nurses as providers of birth labor support in north american hospitals: A randomized controlled trial. JAMA, 288(11), 1373-1381.
Hodnett, E. (2012). Traditional birth attendants are an effective resource: Strategies for ensuring their training and support in all settings are key. BMJ: British Medical Journal (Overseas & Retired Doctors Edition), 344(7840), 9-9.
Lundgren, I. (2010). Swedish women’s experiences of doula support during childbirth. Midwifery, 26(2), 173-180. doi:10.1016/j.midw.2008.05.002
McGrath, S. K., & Kennell, J. H. (2008). A randomized controlled trial of continuous labor support for middle-class couples: Effect on cesarean delivery rates. Birth: Issues in Perinatal Care, 35(2), 92-97.
McNiven, P., Hodnett, E., & O’Brien-Pallas, L. L. (1992). Supporting women in labor: A work sampling study of the activities of labor and delivery nurses. Birth, 19(1), 3-8.
Mottl-Santiago, J., Walker, C., Ewan, J., Vragovic, O., Winder, S., & Stubblefield, P. (2008). A hospital-based doula program and childbirth outcomes in an urban, multicultural setting. Maternal & Child Health Journal, 12(3), 372-377.
Stark, M. A., & Jones, M. (2006). Advanced preparation and positive labor support create an optimal experience for normal birth. Journal of Perinatal Education, 15(2), 4-7.
Weston, R. (2001). What is normal childbirth? the midwife practitioner’s view. Practising Midwife, 4(6), 13.