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In The News:
~ Women With Continuous Labor Support Less Likely To Undergo C-Section, Require Pain Medication

Kaisernetwork.org Daily Reproductive Health Report ~ September 23, 2003

Women who receive supportive care throughout labor are less likely than women without such support to deliver by caesarean section or undergo other medical interventions, according to a study conducted by the Cochrane Collaboration and published in the Cochrane Library, London's Independent reports (Laurance, Independent, 9/24). Elaine Hodnett, professor of nursing at the University of Toronto, and colleagues gathered information from 15 randomized controlled studies that included a total of 12,791 women and compared continuous labor support with standard medical care during delivery (Hodnett et al., Cochrane Library, 7/21). Overall, the women who received continuous labor support were less likely to need an epidural or other anesthesia, undergo delivery by c-section or experience dissatisfaction with their delivery experience. In addition, the study also found that type of person providing the continuous care makes a difference in childbirth outcomes. According to the study, women who received continuous labor support from a person who was not a member of the hospital staff and who was there for the express purpose of providing one-on-one continuous support for the laboring woman were 26% less likely than women without any continuous labor support to give birth by c-section; 41% less likely to give birth using forceps or vacuum extraction; 28% less likely to use analgesia or anesthesia; and 36% less likely to be dissatisfied with or negatively rate the birth experience.

Study co-author Carol Sakala, director of programs at the Maternity Center Association, said continuous labor support is "an important tool" to help women avoid interventions, such as c-sections and the use of vacuum extraction or forceps, that have the "potential for adverse short- and longer-term effects on mothers and babies" (MCA release, 9/8). Hodnett said that the presence of a person who is specially trained to provide care for the laboring woman, such as a doula, is a "very powerful" element during childbirth (Independent, 9/24). Sakala added, "Continuous labor support is a remarkable element of maternity care that offers well-established benefits and has no known downsides" (MCA release, 9/8). The study authors recommend that all women receive continuous support throughout labor and delivery (Cochrane Library, 7/21).

The Kaiser Daily Reproductive Health Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation, by The Advisory Board Company. © 2003 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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