Doula at the bedside of the patient in labor

An article in the May 1, 1991 issue of The Journal of the American Medical Association reports on research that shows an improvement in the outcome of labor and delivery among women who received support during labor from trained support persons (doulas). Women with doulas, compared with controls, had shorter labor and fewer required epidural anesthesia; in addition, they required fewer cesarean sections. In most labor and delivery rooms, the nurse is the primary staff person to provide support for laboring mothers. However, nurses' tasks are many, and they are often diverted from a patient by other demands. While the study shows the benefits that can be attributed to emotional support, it is possible that knowledge by staff that this process was taking place led them to alter their caregiving behavior. Modern obstetrical practice relies to a great extent on instrumentation, and has moved away from 'hands-on' care. While older obstetrical textbooks cited the importance of using the resources of nature to deliver infants, one current text devotes 12 pages to anesthesia and analgesia, and 1 page to physiologic, non-drug methods of pain control. A brief review is presented of methods utilizing natural ways of combatting the discomfort and anxiety associated with childbirth. Whether the study findings can be generalized to other types of patients in other settings - the women who used doulas were poor and the majority had not attended childbirth classes - remains to be seen, but its results are most interesting. (Consumer Summary produced by Reliance Medical Information, Inc.)