Best Evidence: Labor Support
What is the bottom line about labor support?
What is the best evidence about the benefits of continuous support during labor?
Does it matter who provides continuous support in labor?
Does labor support have the same impact in all types of birth settings?
What factors most contribute to women's satisfaction in childbirth?
Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth (Hodnett and colleagues 2011).
Effects were strongest when the person was neither a member of the hospital staff nor a person in the woman's social network, and was present solely to provide one-to-one supportive care. Compared with women who had no continuous support, women with companions (such as a doula) who were neither on the hospital staff nor in the woman's social network were:
Support provided by a member of the hospital staff (such as a nurse) did not seem to impact a woman's likelihood of having a cesarean or her satisfaction. The authors note that hospital employees may have divided loyalties and other duties, and may be influenced by hospital policies, which could limit the impact of their supportive care.
ReferencesHodnett ED. Pain and women's satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol 2002; 186(5) S160-72.
Hodnett ED, Gates S, Hofmeyr G J, Sakala C, Weston J. Continuous support for women during childbirth [PDF]. Cochrane Database Syst Rev 2011, Issue 2.
Most recent page update: 3/12/2013
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Listening to MothersSM III is the third national survey exploring women’s experiences in pregnancy and childbirth. Commissioned by Childbirth Connection, conducted by Harris Interactive, and funded by the W.K. Kellogg Foundation, the survey polled 2,400 women who gave birth in U.S. hospitals from 2011 to 2012. Results show that medically intensive experiences are typical, and evidence-based practices are underutilized. Childbearing women need better support and knowledge to navigate their maternity care.
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