Support of a Doula During Labor Significantly Affects Mother-Child Interaction

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SUPPORT OF A DOULA DURING LABOR SIGNIFICANTLY AFFECTS MOTHER-CHILD INTERACTION

HOUSTON -- (May 2, 1998) -- Providing laboring women with the continuous support of an experienced female labor companion, known as a doula, results in significantly more positive levels of interaction between mothers and infants after delivery.

Recent research conducted by John H. Kennell, M.D., of Case Western Reserve University, and Susan H. Landry, Ph.D., of The University of Texas-Houston Medical School, shows that the support of a doula has significant obstetric and perinatal benefits. Both Kennell and Landry are professors of pediatrics in their respective divisions of developmental pediatrics. "The continuous presence of a doula during labor results in fewer cesarean and forceps deliveries, less need for analgesia and shorter labors. This latest research shows the benefits of having a doula extend past the birthing process. Doula-supported mothers also exhibit more sensitivity and warmth toward their infants," says Landry.

First-time mothers with uncomplicated vaginal deliveries were randomly assigned to a doula or one of two no-doula groups. Home visits were made two months after birth in order to administer the Bayley Scales of Infant Development-Second Edition (BSID-II) and to observe the mother-infant interaction.

Landry and her collaborators found mothers who were assigned to the doula group interacted more positively with their infants than did mothers who did not have the assistance of a doula during childbirth. For example, mothers assigned to the doula group were more likely to hold their babies in a close, nurturing way and to look into the baby's eyes while smiling and stroking them.

Mother-infant interaction was scored on operational definitions of mother's physical contact, visual attention and affectionate behaviors toward the child. Interaction was assessed at five pre-defined points including: when the examiner entered the home, while a Bayley exam was being set up, while the exam was being scored, during a feeding and while the mother changed the baby.

The overall mean score of the doula-supported mothers' interaction scores was significantly higher than the no-doula groups.

The word "doula" comes from the Greek word for the most important female servant in an ancient Greek household, the woman who probably helped the lady of the house through her childbearing. The word has come to refer to "a woman experienced in childbirth who provides continuous physical, emotional and informational support to the mother before, during and just after childbirth." (Klaus, Kennell and Klaus, Mothering the Mother)

The acceptance of doulas in maternity care is growing with the recognition of their important contribution to the improved physical outcomes and emotional well-being of mothers and infants. The benefits of having a doula are in the numbers.

50% reduction in the cesarean rate

25% shorter labor

60% reduction in epidural requests

30% reduction in analgesia use

40% reduction in forceps deliveries

Doulas range from $200 to $800 and can be located by contacting organizations dealing with childbirth, hospitals, birthing centers, childbirth educators, maternity care providers, lactation consultants, La Leche members or anyone who works in their field.

According to DONA (Doulas of North America), there are approximately 5000 trained doulas practicing in the United States. However, only 1% of births in the U.S. are assisted by doulas --a number that could change as more is learned about the long-lasting effect of doula support.

NOTE TO EDITORS: Authors of the study are Susan H. Landry, The University of Texas-Houston Health Science Center; Susan McGrath, Case Western Reserve University; John H. Kennell, Case Western Reserve University; Scott Martin, Case Western Reserve University, and Laura Steelman, The University of Texas-Houston Health Science Center. This research will be presented at the 1998 Pediatric Academic Societies' Meeting May 1-5, at the New Orleans Convention Center. Before and after the meeting, media calls should be placed to the contact listed above. During the meeting, media calls should be directed to Jennifer Donavan in the meeting press room at (504)670-8502 or (504)670-8503 or (504)670-8508.

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This news release is available on the World Wide Web at http://www.uth.tmc.edu/uth_orgs/pub_affairs/news.html The University of Texas-Houston Health Science Center is dedicated to building a model health sciences center for the 21st century. It is a model built on education, research and patient care devoted to the maintenance of health and the prevention of disease. Located in the world-famous Texas Medical Center, the University is the state's most comprehensive institution of health sciences, comprising schools of medicine, dentistry, public health, nursing, allied health and biomedical sciences. In 1995, the Institute of Molecular Medicine for the Prevention of Human Diseases was created.