Doula Supported Births

Discussion
This review provides a clear pattern of evidence that shows doula-supported births lead to a reduction in cesarean rates. A reduction in cesarean rate can be explained due to the fact that doula-supported births are also shown to decrease the length of labor, the amount and type of analgesic used, factors that greatly influence cesarean births. The reduction of cesarean rates through the use of continuous doula support is relevant because it provides a way to minimize the negative health outcomes and complications of the mother and baby and promote crucial aspects of the birthing process. With these results, medical professionals can continue to implement and promote the use of doulas in the hospital setting.
Limitations
This literature
review does not account for the type of medical provider who delivers the baby. This is important to note because some studies recognize a decrease in cesarean rate when a certified nurse midwife (CNM) works with a labor and delivery nurse. One study notes the use of CNM, yet does not have a control group without a midwife (Paterno, M. T., Van Zandt, S. E., & Jordan, E. T., 2011). Length of labor was not reported consistently enough to be of analytic use. Because length of labor may affect a client's decision to relieve pain with medication, a provider's decision to move forward with a cesarean birth, and the number of interventions used by the birth companions, the addition of this variable into the analysis could be important (Paterno, M. T., Van Zandt, S. E., & Jordan, E. T., 2011). Another limitation is to consider the interventions that the doula provided. Due to the fact that the doulas considered for this review received the same training, most doulas provided exceptionable doula support utilization a wide variety of interventions. Therefore, if the doula did not receive high quality training, a reduction in cesarean rates may not be achieved.
Summary, Conclusion and Recommendations
Summary
A literature review was conducted to examine the evidence surrounding the benefits a doula provides in laboring women for reducing cesarean rates.
PubMed and Ovid Medline were used to find studied related to doula support in the hospital setting and cesarean birth rates. There were 7 articles selected for this topic that further analyzed the mothers sociodemographic characteristics and interpreted various doula and medical interventions used in each study. In examining the data and results, it is clear that In-hospital doula support reduced cesarean rate in childbirth. Medical inventions were decreased with an increase in doula interventions. These findings were consistent through varied sociodemographic factors such as race, income and
education.
Conclusions
To conclude, the studies distinctly showed that cesarean rates were significantly reduced in childbirth through continuous doula support in the hospital setting. These findings correlate to an overall health mother and baby by decreasing negative health outcomes such as infection for the mother and decrease respiratory function for the baby. They also correlate to promote positive outcomes such as breastfeeding and attachment. Despite these clear findings, more research could be done to address some of the limitation and strengthen the results further.
Recommendations
A recommendation regarding prenatal doula care can be addressed.
Some of the doulas had the opportunity to get to know the mother and partner’s birth plan, needs, and preferences prenatally. Research shows the doula care is most successful when it is given before, during and after labor (Scott, Klaus & Klaus, 2009). Higher-level doula care leads to less interventions during labor, thus a reduction in cesarean births. I recommended that the review distinguish and compare studies that involve prenatal doula support and those that do not. This would yield evidence that would allow medical professionals to recognize the best practice, recommend doula support to laboring women as a way to reduce cesarean births and other negative birthing
outcomes.