Conference moira::parenting_v3

1111.0. "Personal support improves labor/delivery outcomes" by MOIRA::FAIMAN (light upon the figured leaf) Tue Aug 27 1991 10:50

    The following item is from the _Harvard Health Letter_, volume 16,
    number 10 (August 1991).  I find the statistics here rather
    astonishing.  Is it just my cynicism that makes me suspect that expect
    that if it were a drug, a machine, or a medical procedure that showed
    these sorts of results, instead of a human being who might be perceived
    as diluting the doctor's or hospital's authority, it would by now be a
    routine part of the birthing process?

	-Neil

    ----------------------------------------------------------------------

                             Labor Intensive

    Is there a low-cost, low-risk intervention that can shorten labor,
    reduce the need for anesthetics and caesarean delivery, and decrease
    the rate of complications in both babies and mothers?  A recent study
    conducted at the Jefferson Davis hospital in Houston, Texas, suggests
    that a supportive female companion can fill the bill -- and lower it,
    as well.

    John Kennell and colleagues studied 412 healthy women who were
    hospitalized to deliver their first child.  These women were randomly
    assigned to "supported" and "observed" groups; 212 were supported
    throughout labor and delivery by an experienced mother, or "doula," who
    soothed, touched, and encouraged them, explaining the process along the
    way.  The doula kept a record of medical interventions, procedures
    used, and the patient's contact with hospital staff.  Similar
    information was gathered for another 200 women by an observer who never
    spoke to the patients and attempted to remain inconspicuous.

    Supported women spent less time in labor (and average of 7.4 hours, as
    opposed to 8.4 hours), and fewer of them (17%, vs. 23%) required
    oxytocin to strengthen their contractions.  Among patients who
    delivered their babies vaginally, spinal anesthesia was necessary in
    only 8% of the supported group, as opposed to 23% of the observed
    group.  Fewer supported women required cesarean sections (8%, vs. 13%)
    or forceps deliveries (8%, vs. 21%).  After birth, supported patients
    were far less likely to run a fever (1%, vs. 7%), and only 10% of their
    infants (vs. 17%) were kept in the hospital for medical reasons.  A
    control group of 204 women (for whom no observer was present) scored
    measurably worse than did the observed one, indicating that the
    presence of an attentive onlooker was not without effect.

    These figures, together wuth results from two earlier studies done in
    Guatemala by Dr. Kennell and colleagues, indicate that continuous
    support from a doula during labor provides physical and emotional
    benefits for mothers and health bonuses for their babies.  With less
    medical intervention, fewer complications, and shorter hospital stays,
    there may be financial savings as well.  Although a male partner can
    fulfill a similar role -- and his help is important to the mother -- no
    randomized study has produced similar results from such a partner's
    presence.  (_JAMA_, May 1, 1991, pp 2197-2201.)

Thanks for posting this informative study.  I plan to look into a midwife
or doula to help support my next labor though I will likely have a conventional
hospital birthing room with an OB.

=ss

    I had a somewhat normal pregnancy and my hard labor was 3 hours.  I had
    a normal delivery, no forcepts used, no fever afterwards, and there
    were absolutely no problems with my daughter.  I attribute a lot of
    this to my midwife practice, and my midwife was with me through labor
    when I was in the hospital, encouraging me all the way.  My husband was
    also present, but the soothing experience of my midwife is what got me
    through the labor.  I will go to them again with my second child.  
    
    Mary
    

    
    	Both my sons were born in a teaching hospital (St Mary's,
    Portsmouth) and, in my naivity, I thought it was *normal* to have at
    least a student midwife in attendance throughout! The support and
    encouragement provided is invaluable to both parents.
    
    		Ian G.