Alternative Strategy to Decrease Cesarean Section: Support by Doulas During Labor
Abstract:This research was conducted in a public general hospital in Mexico City, Mexico. The objective was to evaluate efficacy of the support given by a doula during labor to reduce cesarean rate. From March 1997 to February 1998, a group of 100 pregnant women were studied. These women were at term, engaged in an active phase of labor, exhibited 3 cm. or more cervical dilatation, were nuliparous, had no previous uterine incision, and possessed adequate pelvises. The group was randomly divided into two subgroups comprising 50 women, each: The first subgroup had the support of a childbirth educator trained as a doula, while the second subgroup did not have doula support. Measurements were recorded on the duration of labor, the use of pitocin, and whether or not the birth was a vaginal birth or cesarean section. Characteristics and gestational age were similar in both groups. Results confirmed that support by doulas during labor was associated with a significant reduction in cesarean birth and pitocin administration. There was a trend toward shorter labors and less use of epidurals. The results of this study showed, as in other trials measuring the impact of a doula's presence during labor and birth, that doula support during labor is associated with positive outcomes that have physical, emotional, and economic implications.
Document Type: Standard Article
Affiliations: 1: GUADALUPE TRUEBA is a doula trainer and Lamaze International Certified Childbirth Educator practicing in Mexico City, Mexico. She is also a coordinator for the Lamaze International Certification Program at Anahuac University in Mexico City and a member of the Lamaze International Education Council. 2: CARLOS CONTRERAS is a physician at Hospital Manuel Gea González in Mexico City, Mexico. 3: MARIA TERESA VELAZCO is a physician and chief of the Teaching Department at Hospital Manuel Gea González in Mexico City, Mexico. 4: ENRIQUE GARCIA LARA is a physician and the director of the Obstetrics and Gynecologic Department at Hospital Manuel Gea González in Mexico City, Mexico. 5: HUGO Martinez is a physician and chief of the Obstetrics and Gynecologic Department at Hospital Manuel Gea González in Mexico City, Mexico.
Publication date: April 1, 2000
- The Journal of Perinatal Education is the official journal of Lamaze International, whose mission is to promote, support, and protect natural, safe, and healthy birth through education and advocacy. The journal publishes peer-reviewed articles and evidence-based, practical resources that childbirth educators and other health care professionals can use to enhance the quality and effectiveness of their care or teaching to prepare expectant parents for birth.
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