title: Lower epidural anesthesia use associated with labor support by student nurse doulas: implications for intrapartal nursing practice.
abstract: Interventions of baccalaureate nursing students, trained as doulas, were examined for their association with epidural anesthetic use. Doulas, trained to support laboring mothers, are associated with shorter labors and fewer medical interventions. Data from a convenience sample of 89 vaginal births attended between 1999 and 2002 were analyzed. Analysis showed an association of lower epidural use with increased complementary doula interventions (.62 OR, P=.003) and an association of higher epidural use with longer labors (1.22 OR, P=.004). No significant association was found between epidural use and parity, income, education and type of health care provider. These findings support previous research of decreased analgesia use by doula-supported women and suggest benefits of the interventions by student nurse doulas. Students trained in providing low-tech supportive care may change the environment for intrapartum nursing practice. Institutional changes may be required to allow greater opportunity for intrapartal nurses to provide support to laboring women.
authors: Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD 21205, USA. svanzand@son.jhmi.edu
authors: Shirley E
authors: SE
authors: Van Zandt
authors: Lori
authors: L
authors: Edwards
authors: Elizabeth T
authors: ET
authors: Jordan
mesh_terms: D000293:Adolescent; D000328:Adult; D000763:Anesthesia, Caudal / Q000706:statistics & numerical data*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000451:nursing* / Q000706:statistics & numerical data*; D015400:Clinical Nursing Research; D004508:Education, Nursing, Baccalaureate / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007743:Labor, Obstetric / Q000187:drug effects; D016015:Logistic Models; D015999:Multivariate Analysis; D009773:Obstetric Nursing / Q000379:methods* / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010043:Outcome and Process Assessment, Health Care; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D012959:Socioeconomic Factors